FHIR CI-Build

This is the Continuous Integration Build of FHIR (will be incorrect/inconsistent at times).
See the Directory of published versions icon

Pharmacy icon Work GroupMaturity Level: 2 Trial UseSecurity Category: Patient Compartments: Encounter, Patient, Practitioner

Detailed Descriptions for the elements in the MedicationDispense resource.

MedicationDispense
Element IdMedicationDispense
Definition

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

Short DisplayDispensing a medication to a named patient
Cardinality0..*
TypeDomainResource
Summaryfalse
Invariants
Defined on this element
mdd-1Rule whenHandedOver cannot be before whenPreparedwhenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared
MedicationDispense.identifier
Element IdMedicationDispense.identifier
Definition

Identifiers associated with this Medication Dispense that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.

Short DisplayExternal identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
Cardinality0..*
TypeIdentifier
Summaryfalse
Comments

This is a business identifier, not a resource identifier.

MedicationDispense.basedOn
Element IdMedicationDispense.basedOn
Definition

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

Short DisplayPlan that is fulfilled by this dispense
Cardinality0..*
TypeReference(CarePlan)
Summaryfalse
MedicationDispense.partOf
Element IdMedicationDispense.partOf
Definition

The procedure or medication administration that triggered the dispense.

Short DisplayEvent that dispense is part of
Cardinality0..*
TypeReference(Procedure | MedicationAdministration)
Summaryfalse
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.

MedicationDispense.status
Element IdMedicationDispense.status
Definition

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

Short Displaypreparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown
Cardinality1..1
Terminology BindingMedicationDispense Status Codes (Required)
Typecode
Is Modifiertrue (Reason: 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)
Summarytrue
Comments

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

MedicationDispense.notPerformedReason
Element IdMedicationDispense.notPerformedReason
Definition

Indicates the reason why a dispense was not performed.

Short DisplayWhy a dispense was not performed
Cardinality0..1
Terminology BindingMedicationDispense Status Reason Codes (Example)
TypeCodeableReference(DetectedIssue)
Summaryfalse
MedicationDispense.statusChanged
Element IdMedicationDispense.statusChanged
Definition

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

Short DisplayWhen the status changed
Cardinality0..1
TypedateTime
Summaryfalse
MedicationDispense.category
Element IdMedicationDispense.category
Definition

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

Short DisplayType of medication dispense
Cardinality0..*
Terminology BindingMedicationDispense Administration Location Codes (Example)
TypeCodeableConcept
Summaryfalse
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.

MedicationDispense.medication
Element IdMedicationDispense.medication
Definition

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.

Short DisplayWhat medication was supplied
Cardinality1..1
Terminology BindingSNOMED CT Medication Codes (Example)
TypeCodeableReference(Medication)
Summarytrue
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.

MedicationDispense.subject
Element IdMedicationDispense.subject
Definition

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

Short DisplayWho the dispense is for
Cardinality1..1
TypeReference(Patient | Group)
Summarytrue
Comments

SubstanceAdministration->subject->Patient.

MedicationDispense.encounter
Element IdMedicationDispense.encounter
Definition

The encounter that establishes the context for this event.

Short DisplayEncounter associated with event
Cardinality0..1
TypeReference(Encounter)
Summaryfalse
MedicationDispense.supportingInformation
Element IdMedicationDispense.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.

Short DisplayInformation that supports the dispensing of the medication
Cardinality0..*
TypeReference(Any)
Summaryfalse
MedicationDispense.performer
Element IdMedicationDispense.performer
Definition

Indicates who or what performed the event.

Short DisplayWho performed event
Cardinality0..*
Summaryfalse
MedicationDispense.performer.function
Element IdMedicationDispense.performer.function
Definition

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

Short DisplayWho performed the dispense and what they did
Cardinality0..1
Terminology BindingMedicationDispense Performer Function Codes (Example)
TypeCodeableConcept
Requirements

Allows disambiguation of the types of involvement of different performers.

Summaryfalse
MedicationDispense.performer.actor
Element IdMedicationDispense.performer.actor
Definition

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

Short DisplayIndividual who was performing
Cardinality1..1
TypeReference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam)
Summaryfalse
MedicationDispense.location
Element IdMedicationDispense.location
Definition

The principal physical location where the dispense was performed.

Short DisplayWhere the dispense occurred
Cardinality0..1
TypeReference(Location)
Summaryfalse
MedicationDispense.authorizingPrescription
Element IdMedicationDispense.authorizingPrescription
Definition

Indicates the medication order that is being dispensed against.

Short DisplayMedication order that authorizes the dispense
Cardinality0..*
TypeReference(MedicationRequest)
Summaryfalse
Comments

Maps to basedOn in Event logical model.

MedicationDispense.type
Element IdMedicationDispense.type
Definition

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

Short DisplayTrial fill, partial fill, emergency fill, etc.
Cardinality0..1
Terminology BindingActPharmacySupplyType icon (Example)
TypeCodeableConcept
Summaryfalse
MedicationDispense.quantity
Element IdMedicationDispense.quantity
Definition

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

Short DisplayAmount dispensed
Cardinality0..1
TypeSimpleQuantity
Summaryfalse
MedicationDispense.daysSupply
Element IdMedicationDispense.daysSupply
Definition

The amount of medication expressed as a timing amount.

Short DisplayAmount of medication expressed as a timing amount
Cardinality0..1
TypeSimpleQuantity
Summaryfalse
MedicationDispense.recorded
Element IdMedicationDispense.recorded
Definition

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

Short DisplayWhen the recording of the dispense started
Cardinality0..1
TypedateTime
Summaryfalse
MedicationDispense.whenPrepared
Element IdMedicationDispense.whenPrepared
Definition

The time when the dispensed product was packaged and reviewed.

Short DisplayWhen product was packaged and reviewed
Cardinality0..1
TypedateTime
Summarytrue
MedicationDispense.whenHandedOver
Element IdMedicationDispense.whenHandedOver
Definition

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

Short DisplayWhen product was given out
Cardinality0..1
TypedateTime
Summaryfalse
MedicationDispense.destination
Element IdMedicationDispense.destination
Definition

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

Short DisplayWhere the medication was sent
Cardinality0..1
TypeReference(Location)
Summaryfalse
MedicationDispense.receiver
Element IdMedicationDispense.receiver
Definition

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.

Short DisplayWho collected the medication or where the medication was delivered
Cardinality0..*
TypeReference(Patient | Practitioner | RelatedPerson | Location | PractitionerRole)
Summaryfalse
MedicationDispense.note
Element IdMedicationDispense.note
Definition

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

Short DisplayInformation about the dispense
Cardinality0..*
TypeAnnotation
Summaryfalse
MedicationDispense.renderedDosageInstruction
Element IdMedicationDispense.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.

Short DisplayFull representation of the dosage instructions
Cardinality0..1
Typestring
Summaryfalse
Comments

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

MedicationDispense.dosageInstruction
Element IdMedicationDispense.dosageInstruction
Definition

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

Short DisplayHow the medication is to be used by the patient or administered by the caregiver
Cardinality0..*
TypeDosage
Summaryfalse
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.

MedicationDispense.substitution
Element IdMedicationDispense.substitution
Definition

Indicates whether or not substitution was made as part of the dispense. In some cases, substitution will be expected but does not happen, in other cases substitution is not expected but does happen. This block explains what substitution did or did not happen and why. If nothing is specified, substitution was not done.

Short DisplayWhether a substitution was performed on the dispense
Cardinality0..1
Summaryfalse
MedicationDispense.substitution.wasSubstituted
Element IdMedicationDispense.substitution.wasSubstituted
Definition

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

Short DisplayWhether a substitution was or was not performed on the dispense
Cardinality1..1
Typeboolean
Summaryfalse
MedicationDispense.substitution.type
Element IdMedicationDispense.substitution.type
Definition

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

Short DisplayCode signifying whether a different drug was dispensed from what was prescribed
Cardinality0..1
Terminology BindingActSubstanceAdminSubstitutionCode icon (Example)
TypeCodeableConcept
Summaryfalse
MedicationDispense.substitution.reason
Element IdMedicationDispense.substitution.reason
Definition

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

Short DisplayWhy was substitution made
Cardinality0..*
Terminology BindingSubstanceAdminSubstitutionReason icon (Example)
TypeCodeableConcept
Summaryfalse
MedicationDispense.substitution.responsibleParty
Element IdMedicationDispense.substitution.responsibleParty
Definition

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

Short DisplayWho is responsible for the substitution
Cardinality0..1
TypeReference(Practitioner | PractitionerRole | Organization)
Summaryfalse
MedicationDispense.eventHistory
Element IdMedicationDispense.eventHistory
Definition

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

Short DisplayA list of relevant lifecycle events
Cardinality0..*
TypeReference(Provenance)
Summaryfalse
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.).