|
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.
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.
|
|
Control
|
1..1
|
|
Summary
|
true
|
|
Invariants
|
Defined
on
this
element
Defined on this element
mdd-1
:
whenHandedOver
cannot
be
before
whenPrepared
(xpath:
not(exists(f:whenHandedOver/@value))
or
not(exists(f:whenPrepared/@value))
or
(
f:whenHandedOver/@value
>=
f:whenPrepared/@value))
: whenHandedOver cannot be before whenPrepared (
expression
: whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared, xpath: not(exists(f:whenHandedOver/@value)) or not(exists(f:whenPrepared/@value)) or ( f:whenHandedOver/@value >= f:whenPrepared/@value))
|
|
MedicationDispense.identifier
|
|
Definition
|
Identifier
assigned
by
the
dispensing
facility
-
this
is
an
identifier
assigned
outside
FHIR.
Identifier assigned by the dispensing facility - this is an identifier assigned outside FHIR.
|
|
Note
|
This
is
a
business
identifer,
not
a
resource
identifier
(see
This is a business identifer, not a resource identifier (see
discussion
)
|
|
Control
|
0..1
|
|
Type
|
Identifier
|
|
Summary
|
true
|
|
MedicationDispense.status
|
|
Definition
|
A
code
specifying
the
state
of
the
set
of
dispense
events.
A code specifying the state of the set of dispense events.
|
|
Control
|
0..1
|
|
Binding
|
MedicationDispenseStatus:
A
code
specifying
the
state
of
the
dispense
event.
(
MedicationDispenseStatus:
A code specifying the state of the dispense event.
(
Required
)
|
|
Type
|
code
|
Is
Modifier
Is Modifier
|
true
|
|
Summary
|
true
|
MedicationDispense.patient
MedicationDispense.medication[x]
|
|
Definition
|
A
link
to
a
resource
representing
the
person
to
whom
the
medication
will
be
given.
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.
|
|
Control
|
0..1
1..1
|
|
Type
|
CodeableConcept
|
Reference
(
Patient
Medication
)
|
|
[x] Note
|
See
Choice of Data Types
for further information about how to use [x] |
|
Summary
|
true
|
|
Comments
|
SubstanceAdministration->subject->Patient.
To
Do
Why
is
patient
optional?
Can
this
be
used
for
non-patient
med
tranfers?
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. Note: do not use Medication.name to describe the dispensed medication. When the only available information is a text description of the medication, Medication.code.text should be used.
|
MedicationDispense.dispenser
MedicationDispense.patient
|
|
Definition
|
The
individual
responsible
for
dispensing
the
medication.
A link to a resource representing the person to whom the medication will be given.
|
|
Control
|
0..1
|
|
Type
|
Reference
(
Practitioner
Patient
)
|
|
Summary
|
true
|
|
Comments
|
SubstanceAdministration->subject->Patient.
|
MedicationDispense.authorizingPrescription
MedicationDispense.dispenser
|
|
Definition
|
Indicates
the
medication
order
that
is
being
dispensed
against.
The individual responsible for dispensing the medication.
|
|
Control
|
0..*
0..1
|
|
Type
|
Reference
(
MedicationOrder
Practitioner
)
|
|
Summary
|
true
|
MedicationDispense.type
MedicationDispense.authorizingPrescription
|
|
Definition
|
Indicates
the
type
of
dispensing
event
that
is
performed.
For
example,
Trial
Fill,
Completion
of
Trial,
Partial
Fill,
Emergency
Fill,
Samples,
etc.
Indicates the medication order that is being dispensed against.
|
|
Control
|
0..1
Binding
ActPharmacySupplyType:
Indicates
the
type
of
dispensing
event
that
is
performed.
For
example,
Trial
Fill,
Completion
of
Trial,
Partial
Fill,
Emergency
Fill,
Samples,
etc.
(
Example
)
0..*
|
|
Type
|
CodeableConcept
Reference
(
MedicationOrder
)
|
|
Summary
|
true
|
MedicationDispense.quantity
MedicationDispense.type
|
|
Definition
|
The
amount
of
medication
that
has
been
dispensed.
Includes
unit
of
measure.
Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.
|
|
Control
|
0..1
|
|
Binding
|
ActPharmacySupplyType:
Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.
(
Example
)
|
|
Type
|
SimpleQuantity
CodeableConcept
|
|
Summary
|
true
|
MedicationDispense.daysSupply
MedicationDispense.quantity
|
|
Definition
|
The
amount
of
medication
expressed
as
a
timing
amount.
The amount of medication that has been dispensed. Includes unit of measure.
|
|
Control
|
0..1
|
|
Type
|
SimpleQuantity
|
|
Summary
|
true
|
MedicationDispense.medication[x]
MedicationDispense.daysSupply
|
|
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.
The amount of medication expressed as a timing amount.
|
|
Control
|
1..1
0..1
|
|
Type
|
CodeableConcept
|
Reference
(
Medication
SimpleQuantity
)
[x]
Note
See
Choice
of
Data
Types
for
further
information
about
how
to
use
[x]
|
|
Summary
|
true
|
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.
Note:
do
not
use
Medication.name
to
describe
the
dispensed
medication.
When
the
only
available
information
is
a
text
description
of
the
medication,
Medication.code.text
should
be
used.
|
MedicationDispense.whenPrepared
|
|
Definition
|
The
time
when
the
dispensed
product
was
packaged
and
reviewed.
The time when the dispensed product was packaged and reviewed.
|
|
Control
|
0..1
|
|
Type
|
dateTime
|
|
Summary
|
true
|
|
MedicationDispense.whenHandedOver
|
|
Definition
|
The
time
the
dispensed
product
was
provided
to
the
patient
or
their
representative.
The time the dispensed product was provided to the patient or their representative.
|
|
Control
|
0..1
|
|
Type
|
dateTime
|
|
Summary
|
true
|
|
MedicationDispense.destination
|
|
Definition
|
Identification
of
the
facility/location
where
the
medication
was
shipped
to,
as
part
of
the
dispense
event.
Identification of the facility/location where the medication was shipped to, as part of the dispense event.
|
|
Control
|
0..1
|
|
Type
|
Reference
(
Location
)
|
|
Summary
|
true
|
|
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.
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.
|
|
Control
|
0..*
|
|
Type
|
Reference
(
Patient
|
|
Practitioner
)
|
|
Summary
|
true
|
|
MedicationDispense.note
|
|
Definition
|
Extra
information
about
the
dispense
that
could
not
be
conveyed
in
the
other
attributes.
Extra information about the dispense that could not be conveyed in the other attributes.
|
|
Control
|
0..1
0..*
|
|
Type
|
string
Annotation
|
|
Summary
|
true
|
|
MedicationDispense.dosageInstruction
|
|
Definition
|
Indicates
how
the
medication
is
to
be
used
by
the
patient.
Indicates how the medication is to be used by the patient. The pharmacist reviews the medication order prior to dispense and updates the dosageInstruction based on the actual product being dispensed.
|
|
Control
|
0..*
|
|
Summary
|
true
|
|
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.
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.
|
|
MedicationDispense.dosageInstruction.text
|
|
Definition
|
Free
text
dosage
instructions
can
be
used
for
cases
where
the
instructions
are
too
complex
to
code.
When
coded
instructions
are
present,
the
free
text
instructions
may
still
be
present
for
display
to
humans
taking
or
administering
the
medication.
Free text dosage instructions can be used for cases where the instructions are too complex to code. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication.
|
|
Control
|
0..1
|
|
Type
|
string
|
|
Summary
|
true
|
|
MedicationDispense.dosageInstruction.additionalInstructions
|
|
Definition
|
Additional
instructions
such
as
"Swallow
with
plenty
of
water"
which
may
or
may
not
be
coded.
Additional instructions such as "Swallow with plenty of water" which may or may not be coded.
|
|
Control
|
0..1
|
|
Binding
|
AdditionalInstructions
:
Codes
identifying
additional
instructions
such
as
"take
with
water"
or
"avoid
operating
heavy
machinery"
: Codes identifying additional instructions such as "take with water" or "avoid operating heavy machinery"
|
|
Type
|
CodeableConcept
|
|
Summary
|
true
|
|
MedicationDispense.dosageInstruction.timing
|
|
Definition
|
The
timing
schedule
for
giving
the
medication
to
the
patient.
The
Schedule
data
type
allows
many
different
expressions.
For
example,
"Every
8
hours";
"Three
times
a
day";
"1/2
an
hour
before
breakfast
for
10
days
from
23-Dec
2011:";
"15
Oct
2013,
17
Oct
2013
and
1
Nov
2013".
The timing schedule for giving the medication to the patient. The Schedule data type allows many different expressions. For example, "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013".
|
|
Control
|
0..1
|
|
Type
|
Timing
|
|
Summary
|
true
|
|
MedicationDispense.dosageInstruction.asNeeded[x]
|
|
Definition
|
Indicates
whether
the
Medication
is
only
taken
when
needed
within
a
specific
dosing
schedule
(Boolean
option),
or
it
indicates
the
precondition
for
taking
the
Medication
(CodeableConcept).
Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).
Specifically
if
'boolean'
datatype
is
selected,
then
the
following
logic
applies:
If
set
to
True,
this
indicates
that
the
medication
is
only
taken
when
needed,
within
the
specified
schedule.
Specifically if 'boolean' datatype is selected, then the following logic applies: If set to True, this indicates that the medication is only taken when needed, within the specified schedule.
|
|
Control
|
0..1
|
|
Binding
|
MedicationAsNeededReason
:
A
coded
concept
identifying
the
precondition
that
should
be
met
or
evaluated
prior
to
consuming
or
administering
a
medication
dose.
For
example
"pain",
"30
minutes
prior
to
sexual
intercourse",
"on
flare-up"
etc.
: A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
|
|
Type
|
boolean
|
CodeableConcept
|
[x]
Note
[x] Note
|
See
Choice
of
Data
Types
for
further
information
about
how
to
use
[x]
See
Choice of Data Types
for further information about how to use [x]
|
|
Summary
|
true
|
|
MedicationDispense.dosageInstruction.site[x]
|
|
Definition
|
A
coded
specification
of
the
anatomic
site
where
the
medication
first
enters
the
body.
A coded specification of the anatomic site where the medication first enters the body.
|
|
Control
|
0..1
|
|
Binding
|
SNOMED
CT
Anatomical
Structure
for
Administration
Site
Codes:
A
coded
concept
describing
the
site
location
the
medicine
enters
into
or
onto
the
body
(
SNOMED CT Anatomical Structure for Administration Site Codes:
A coded concept describing the site location the medicine enters into or onto the body
(
Example
)
|
|
Type
|
CodeableConcept
|
Reference
(
BodySite
)
|
[x]
Note
[x] Note
|
See
Choice
of
Data
Types
for
further
information
about
how
to
use
[x]
See
Choice of Data Types
for further information about how to use [x]
|
|
Summary
|
true
|
|
MedicationDispense.dosageInstruction.route
|
|
Definition
|
A
code
specifying
the
route
or
physiological
path
of
administration
of
a
therapeutic
agent
into
or
onto
a
subject.
A code specifying the route or physiological path of administration of a therapeutic agent into or onto a subject.
|
|
Control
|
0..1
|
|
Binding
|
SNOMED
CT
Route
Codes:
A
coded
concept
describing
the
route
or
physiological
path
of
administration
of
a
therapeutic
agent
into
or
onto
the
body
of
a
subject
(
SNOMED CT Route Codes:
A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject
(
Example
)
|
|
Type
|
CodeableConcept
|
|
Summary
|
true
|
|
MedicationDispense.dosageInstruction.method
|
|
Definition
|
A
coded
value
indicating
the
method
by
which
the
medication
is
intended
to
be
or
was
introduced
into
or
on
the
body.
A coded value indicating the method by which the medication is intended to be or was introduced into or on the body.
|
|
Control
|
0..1
|
|
Binding
|
MedicationAdministrationMethod
:
A
coded
concept
describing
the
technique
by
which
the
medicine
is
administered
: A coded concept describing the technique by which the medicine is administered
|
|
Type
|
CodeableConcept
|
|
Summary
|
true
|
|
Comments
|
This
attribute
will
most
often
NOT
be
populated.
It
is
most
commonly
used
for
injections.
For
example,
Slow
Push,
Deep
IV.
One
of
the
reasons
this
attribute
is
not
used
often,
is
that
the
method
is
often
pre-coordinated
with
the
route
and/or
form
of
administration.
This
means
the
codes
used
in
route
or
form
may
pre-coordinate
the
method
in
the
route
code
or
the
form
code.
The
implementation
decision
about
what
coding
system
to
use
for
route
or
form
code
will
determine
how
frequently
the
method
code
will
be
populated
e.g.
if
route
or
form
code
pre-coordinate
method
code,
then
this
attribute
will
not
be
populated
often;
if
there
is
no
pre-coordination
then
method
code
may
be
used
frequently.
This attribute will most often NOT be populated. It is most commonly used for injections. For example, Slow Push, Deep IV. One of the reasons this attribute is not used often, is that the method is often pre-coordinated with the route and/or form of administration. This means the codes used in route or form may pre-coordinate the method in the route code or the form code. The implementation decision about what coding system to use for route or form code will determine how frequently the method code will be populated e.g. if route or form code pre-coordinate method code, then this attribute will not be populated often; if there is no pre-coordination then method code may be used frequently.
|
|
MedicationDispense.dosageInstruction.dose[x]
|
|
Definition
|
The
amount
of
therapeutic
or
other
substance
given
at
one
administration
event.
The amount of therapeutic or other substance given at one administration event.
|
|
Control
|
0..1
|
|
Type
|
Range
|
SimpleQuantity
|
[x]
Note
[x] Note
|
See
Choice
of
Data
Types
for
further
information
about
how
to
use
[x]
See
Choice of Data Types
for further information about how to use [x]
|
|
Summary
|
true
|
|
Comments
|
Note
that
this
specifies
the
quantity
of
the
specified
medication,
not
the
quantity
of
active
ingredient(s).
The
prescribed
strength
can
be
calculated
by
multiplying
the
doseQuantity
by
the
strength
of
each
active
ingredient
in
the
prescribed
Medication.
If
the
administration
is
not
intended
to
be
instantaneous
(rate
is
present
or
timing
has
a
duration),
this
can
be
specified
to
convey
the
total
amount
to
be
administered
over
the
period
of
time
as
indicated
by
the
schedule.
Note that this specifies the quantity of the specified medication, not the quantity of active ingredient(s). The prescribed strength can be calculated by multiplying the doseQuantity by the strength of each active ingredient in the prescribed Medication. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule.
|
|
MedicationDispense.dosageInstruction.rate[x]
|
|
Definition
|
Identifies
the
speed
with
which
the
medication
was
or
will
be
introduced
into
the
patient.
Typically
the
rate
for
an
infusion
e.g.
100
ml
per
1
hour
or
100
ml/hr.
May
also
be
expressed
as
a
rate
per
unit
of
time
e.g.
500
ml
per
2
hours.
Currently
we
do
not
specify
a
default
of
'1'
in
the
denominator,
but
this
is
being
discussed.
Other
examples:
200
mcg/min
or
200
mcg/1
minute;
1
liter/8
hours.
Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Currently we do not specify a default of '1' in the denominator, but this is being discussed. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours.
|
|
Control
|
0..1
|
|
Type
|
Ratio
|
Range
|
[x]
Note
[x] Note
|
See
Choice
of
Data
Types
for
further
information
about
how
to
use
[x]
See
Choice of Data Types
for further information about how to use [x]
|
|
Summary
|
true
|
|
MedicationDispense.dosageInstruction.maxDosePerPeriod
|
|
Definition
|
The
maximum
total
quantity
of
a
therapeutic
substance
that
may
be
administered
to
a
subject
over
the
period
of
time,
e.g.
1000mg
in
24
hours.
The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time, e.g. 1000mg in 24 hours.
|
|
Control
|
0..1
|
|
Type
|
Ratio
|
|
Summary
|
true
|
|
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.
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.
|
|
Control
|
0..1
|
|
Summary
|
true
|
To
Do
Shouldn't
substitution
be
captured
on
a
product
by
product
basis?
|
MedicationDispense.substitution.type
|
|
Definition
|
A
code
signifying
whether
a
different
drug
was
dispensed
from
what
was
prescribed.
A code signifying whether a different drug was dispensed from what was prescribed.
|
|
Control
|
1..1
|
|
Binding
|
ActSubstanceAdminSubstitutionCode:
A
coded
concept
describing
whether
a
different
medicinal
product
may
be
dispensed
other
than
the
product
as
specified
exactly
in
the
prescription
(
ActSubstanceAdminSubstitutionCode:
A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription
(
Example
)
|
|
Type
|
CodeableConcept
|
|
Summary
|
true
|
|
MedicationDispense.substitution.reason
|
|
Definition
|
Indicates
the
reason
for
the
substitution
of
(or
lack
of
substitution)
from
what
was
prescribed.
Indicates the reason for the substitution of (or lack of substitution) from what was prescribed.
|
|
Control
|
0..*
|
|
Binding
|
SubstanceAdminSubstitutionReason:
A
coded
concept
describing
the
reason
that
a
different
medication
should
(or
should
not)
be
substituted
from
what
was
prescribed
(
SubstanceAdminSubstitutionReason:
A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed
(
Example
)
|
|
Type
|
CodeableConcept
|
|
Summary
|
true
|
|
MedicationDispense.substitution.responsibleParty
|
|
Definition
|
The
person
or
organization
that
has
primary
responsibility
for
the
substitution.
The person or organization that has primary responsibility for the substitution.
|
|
Control
|
0..*
|
|
Type
|
Reference
(
Practitioner
)
|
|
Summary
|
true
|
To
Do
rename.
©
HL7.org
2011+.
FHIR
DSTU2
(v1.0.2-7202)
generated
on
Sat,
Oct
24,
2015
07:43+1100.
Links:
Search