Bản hướng dẫn thực thi (IG) dành cho các hệ thống thông tin Y tế tại Việt Nam
1.0.0 - CI Build

Bản hướng dẫn thực thi (IG) dành cho các hệ thống thông tin Y tế tại Việt Nam, published by Cục Công nghệ thông tin - Bộ Y tế. 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/hl7vn/vn-core-ig/ and changes regularly. See the Directory of published versions

Resource Profile: VNCoreMedicationDispense - Detailed Descriptions

Definitions for the vn-core-medication-dispense Profile.

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

0. MedicationDispense
Definition

Indicates that a medication product is to be or has been dispensed for a named person/patient. This includes a description of the medication product (supply) provided and the instructions for administering the medication. The medication dispense is the result of a pharmacy system responding to a medication order.

ShortDispensing a medication to a named patient
Control0..*
Is Modifierfalse
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().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
mdd-1: whenHandedOver cannot be before whenPrepared (whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared)
2. MedicationDispense.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

ShortLogical id of this artifact
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Control0..1
Typeid
Is Modifierfalse
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
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 it's 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 it's meaning or interpretation
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()))
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 SHOULD be taken from CommonLanguages
(preferred to http://hl7.org/fhir/ValueSet/languages)

A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
Typecode
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()))
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 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
TypeNarrative
Is Modifierfalse
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, and nor can they have their own independent transaction scope.

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..*
TypeResource
Is Modifierfalse
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
14. MedicationDispense.extension
Definition

May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

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())
16. 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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

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
Summaryfalse
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())
18. 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..*
TypeIdentifier
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. MedicationDispense.partOf
Definition

The procedure that trigger the dispense.

ShortEvent that dispense is part of
Control0..*
TypeReference(Procedure)
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. MedicationDispense.status
Definition

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

Shortpreparation | 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 MedicationDispense Status Codes
(required to http://hl7.org/fhir/ValueSet/medicationdispense-status|4.0.1)

A coded concept specifying the state of the dispense event.

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
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. MedicationDispense.statusReason[x]
Definition

Indicates the reason why a dispense was not performed.

ShortWhy a dispense was not performed
Control0..1
BindingFor example codes, see MedicationDispense Status Reason Codes
(example to http://hl7.org/fhir/ValueSet/medicationdispense-status-reason)

A code describing why a dispense was not performed.

TypeChoice of: CodeableConcept, Reference(DetectedIssue)
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. MedicationDispense.category
Definition

A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

ShortConcept - reference to a terminology or just text
Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Control0..1
This element is affected by the following invariants: ele-1
BindingThe codes SHOULD be taken from MedicationDispense Category Codes
(preferred to http://hl7.org/fhir/ValueSet/medicationdispense-category)

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

TypeCodeableConcept(Codeable Concept profile - VN Core R4)
Is Modifierfalse
Must Supporttrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. MedicationDispense.medication[x]
Definition

Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.

ShortWhat 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 SNOMEDCTMedicationCodes
(example to http://hl7.org/fhir/ValueSet/medication-codes)

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

TypeChoice of: CodeableConcept, Reference(Medication)
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on MedicationDispense.medication[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
  • type @ $this
  • 30. MedicationDispense.medication[x]:medicationCodeableConcept
    Slice NamemedicationCodeableConcept
    Definition

    A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

    ShortConcept - reference to a terminology or just text
    Comments

    Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

    Control0..1
    This element is affected by the following invariants: ele-1
    BindingUnless not suitable, these codes SHALL be taken from ValueSet dành cho Mã dược phẩm
    (extensible to http://fhir.ehealth.gov.vn/core/ValueSet/vn-medication-code)
    TypeCodeableConcept(Codeable Concept profile - VN Core R4)
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifierfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    32. MedicationDispense.medication[x]:medicationReference
    Slice NamemedicationReference
    Definition

    Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.

    ShortWhat 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.

    Control0..1
    TypeReference(Medication, Medication Profile - VN Core R4)
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    34. MedicationDispense.subject
    Definition

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

    ShortWho the dispense is for
    Comments

    SubstanceAdministration->subject->Patient.

    Control1..1
    TypeReference(Patient Profile - VN Core R4)
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    36. MedicationDispense.context
    Definition

    The encounter or episode of care that establishes the context for this event.

    ShortEncounter / Episode associated with event
    Control0..1
    TypeReference(Encounter Profile - VN Core R4)
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    38. MedicationDispense.supportingInformation
    Definition

    Additional information that supports the medication being dispensed.

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

    Indicates who or what performed the event.

    ShortWho performed event
    Control0..*
    TypeBackboneElement
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    42. 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
    Typestring
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    44. 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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

    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())
    46. 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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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())
    48. 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..1
    BindingFor example codes, see MedicationDispense Performer Function Codes
    (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
    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()))
    50. MedicationDispense.performer.actor
    Definition

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

    ShortIndividual who was performing
    Control1..1
    TypeReference(Practitioner, PractitionerRole, Organization, Patient, Device, RelatedPerson, Practitioner Profile - VN Core R4)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    52. MedicationDispense.location
    Definition

    The principal physical location where the dispense was performed.

    ShortWhere the dispense occurred
    Control0..1
    TypeReference(Location, Location Profile - VN Core R4)
    Is Modifierfalse
    Must Supporttrue
    Must Support TypesNo must-support rules about the choice of types/profiles
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    54. MedicationDispense.authorizingPrescription
    Definition

    Indicates the medication order that is being dispensed against.

    ShortMedication order that authorizes the dispense
    Comments

    Maps to basedOn in Event logical model.

    Control0..*
    TypeReference(MedicationRequest)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    56. MedicationDispense.type
    Definition

    A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

    ShortConcept - reference to a terminology or just text
    Comments

    Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

    Control0..1
    This element is affected by the following invariants: ele-1
    BindingFor example codes, see ActPharmacySupplyType
    (example to http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType)

    Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.

    TypeCodeableConcept(Codeable Concept profile - VN Core R4)
    Is Modifierfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    58. MedicationDispense.quantity
    Definition

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

    ShortAmount dispensed
    Control0..1
    TypeQuantity(SimpleQuantity, SimpleQuantity (IPS))
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    60. MedicationDispense.daysSupply
    Definition

    The amount of medication expressed as a timing amount.

    ShortAmount of medication expressed as a timing amount
    Control0..1
    TypeQuantity(SimpleQuantity)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    62. MedicationDispense.whenPrepared
    Definition

    The time when the dispensed product was packaged and reviewed.

    ShortWhen product was packaged and reviewed
    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()))
    64. MedicationDispense.whenHandedOver
    Definition

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

    ShortWhen product was given out
    Control0..1
    TypedateTime
    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()))
    66. MedicationDispense.destination
    Definition

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

    ShortWhere the medication was sent
    Control0..1
    TypeReference(Location, Location Profile - VN Core R4)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    68. MedicationDispense.receiver
    Definition

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

    ShortWho collected the medication
    Control0..*
    TypeReference(Patient Profile - VN Core R4, Practitioner Profile - VN Core R4)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    70. MedicationDispense.note
    Definition

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

    ShortInformation about the dispense
    Control0..*
    TypeAnnotation
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    72. MedicationDispense.dosageInstruction
    Definition

    Indicates how the medication is/was taken or should be taken by the patient.

    ShortHow the medication is/was taken or should be taken
    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..*
    TypeDosage(Dosage profile - VN Core R4)
    Is Modifierfalse
    Must Supporttrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    74. 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..1
    TypeBackboneElement
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    76. MedicationDispense.substitution.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
    Typestring
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    78. MedicationDispense.substitution.extension
    Definition

    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

    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())
    80. MedicationDispense.substitution.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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())
    82. MedicationDispense.substitution.wasSubstituted
    Definition

    True if the dispenser dispensed a different drug or product from what was prescribed.

    ShortWhether a substitution was or was not performed on the dispense
    Control1..1
    Typeboolean
    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()))
    84. MedicationDispense.substitution.type
    Definition

    A code signifying whether a different drug was dispensed from what was prescribed.

    ShortCode signifying whether a different drug was dispensed from what was prescribed
    Control0..1
    BindingFor example codes, see ActSubstanceAdminSubstitutionCode
    (example to http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode)

    A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription.

    TypeCodeableConcept
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    86. MedicationDispense.substitution.reason
    Definition

    Indicates the reason for the substitution (or lack of substitution) from what was prescribed.

    ShortWhy was substitution made
    Control0..*
    BindingFor example codes, see SubstanceAdminSubstitutionReason
    (example to http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason)

    A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.

    TypeCodeableConcept
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    88. MedicationDispense.substitution.responsibleParty
    Definition

    The person or organization that has primary responsibility for the substitution.

    ShortWho is responsible for the substitution
    Control0..*
    TypeReference(Practitioner, PractitionerRole)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    90. MedicationDispense.detectedIssue
    Definition

    Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. drug-drug interaction, duplicate therapy, dosage alert etc.

    ShortClinical issue with action
    Comments

    This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue.

    Control0..*
    TypeReference(DetectedIssue)
    Is Modifierfalse
    Summaryfalse
    Alternate NamesContraindication, Drug Utilization Review (DUR), Alert
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    92. 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..*
    TypeReference(Provenance)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))