STU3 Candidate

This page is part of the FHIR Specification (v1.8.0: STU 3 Draft). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

11.4 Resource MedicationDispense - Content

Pharmacy Work Group Maturity Level : 1 Compartments : Patient , Practitioner

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.

11.4.1 Scope and Usage

This resource covers the supply of medications to a patient. Examples include dispensing and pick-up from an out-patient or community pharmacy, dispensing patient-specific medications from in-patient pharmacy to ward, as well as issuing a single dose from ward stock to a patient for consumption. The medication dispense is the result of a pharmacy system responding to a medication order.

MedicationDispense is an event resource from a FHIR workflow perspective - see Workflow Event

11.4.2 Boundaries and Relationships

The Medication domain includes a number of related resources

MedicationRequest An order for both supply of the medication and the instructions for administration of the medicine to a patient.
MedicationDispense Provision of a supply of a medication with the intention that it is subsequently consumed by a patient (usually in response to a prescription).
MedicationAdministration When a patient actually consumes a medicine, or it is otherwise administered to them
MedicationStatement This is a record of a medication being taken by a patient or that a medication has been given to a patient, where the record is the result of a report from the patient or another clinician. A medication statement is not a part of the prescribe->dispense->administer sequence, but is a report that such a sequence (or at least a part of it) did take place, resulting in a belief that the patient has received a particular medication.

This resource does not deal with the supply or transfer of non-medication related items to a patient.

11.4.3 Background and Context

The supply and the associated administration instructions may not exactly follow the original order (prescription), either because some details were left for completion at this point in the process or because the dispenser exercised their clinical judgment to make some appropriate modification.

11.4.4 Resource Content

Structure

Name Flags Card. Type Description & Constraints doco
. . MedicationDispense I DomainResource Dispensing a medication to a named patient
whenHandedOver cannot be before whenPrepared
. . . identifier 0..1 Identifier External identifier
. . . status ?! Σ 0..1 code in-progress | on-hold | completed | entered-in-error | stopped
MedicationDispenseStatus ( Required )
. . . medication[x] Σ 1..1 What medication was supplied
SNOMED CT Medication Codes ( Example )
. . . . medicationCodeableConcept CodeableConcept
. . . . medicationReference Reference ( Medication )
. . . patient Σ 0..1 Reference ( Patient ) Who the dispense is for
. . . supportingInformation 0..* Reference ( Any ) Information that supports the dispensing of the medication
. . . dispenser 0..1 Reference ( Practitioner ) Practitioner responsible for dispensing medication
. . . dispensingOrganization 0..1 Reference ( Organization ) Organization responsible for the dispense of the medication
. . . authorizingPrescription 0..* Reference ( MedicationRequest ) Medication order that authorizes the dispense
. . . type 0..1 CodeableConcept Trial fill, partial fill, emergency fill, etc.
ActPharmacySupplyType ( Example )
. . . quantity 0..1 SimpleQuantity Amount dispensed
. . . daysSupply 0..1 SimpleQuantity Amount of medication expressed as a timing amount
. . . whenPrepared Σ 0..1 dateTime When product was packaged and reviewed
. . . whenHandedOver 0..1 dateTime When product was given out
. . . destination 0..1 Reference ( Location ) Where the medication was sent
. . . receiver 0..* Reference ( Patient | Practitioner ) Who collected the medication
. . . note 0..* Annotation Information about the dispense
. . . dosageInstruction 0..* DosageInstruction Medicine administration instructions to the patient/caregiver
. . . substitution 0..1 BackboneElement Deals with substitution of one medicine for another
. . . . type 1..1 CodeableConcept Code signifying whether a different drug was dispensed from what was prescribed
ActSubstanceAdminSubstitutionCode ( Example )
. . . . reason 0..* CodeableConcept Why was substitution made
SubstanceAdminSubstitutionReason ( Example )
. . . . responsibleParty 0..* Reference ( Practitioner ) Who is responsible for the substitution
. . . eventHistory 0..* Reference ( Provenance ) A list of events of interest in the lifecycle

doco Documentation for this format

UML Diagram ( Legend )

MedicationDispense ( DomainResource ) Identifier assigned by the dispensing facility - this is an identifier assigned outside FHIR identifier : Identifier [0..1] A code specifying the state of the set of dispense events (this element modifies the meaning of other elements) status : code [0..1] « A coded concept specifying the state of the dispense event. (Strength=Required) MedicationDispenseStatus ! » 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 medication[x] : Type [1..1] « CodeableConcept | Reference ( Medication ); A coded concept identifying which substance or product can be dispensed (Strength=Example) SNOMED CT Medication ?? » A link to a resource representing the person to whom the medication will be given patient : Reference [0..1] « Patient » Additional information that supports the medication being dispensed supportingInformation : Reference [0..*] « Any » The individual responsible for dispensing the medication dispenser : Reference [0..1] « Practitioner » The organizaation responsible for the dispense of the medication dispensingOrganization : Reference [0..1] « Organization » Indicates the medication order that is being dispensed against authorizingPrescription : Reference [0..*] « MedicationRequest » Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc type : CodeableConcept [0..1] « Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc. (Strength=Example) ActPharmacySupplyType ?? » The amount of medication that has been dispensed. Includes unit of measure quantity : Quantity ( SimpleQuantity ) [0..1] The amount of medication expressed as a timing amount daysSupply : Quantity ( SimpleQuantity ) [0..1] The time when the dispensed product was packaged and reviewed whenPrepared : dateTime [0..1] The time the dispensed product was provided to the patient or their representative whenHandedOver : dateTime [0..1] Identification of the facility/location where the medication was shipped to, as part of the dispense event destination : Reference [0..1] « Location » 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 receiver : Reference [0..*] « Patient | Practitioner » Extra information about the dispense that could not be conveyed in the other attributes note : Annotation [0..*] 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 dosageInstruction : DosageInstruction [0..*] A summary of the events of interest that have occurred, such as when the dispense was verified eventHistory : Reference [0..*] « Provenance » Substitution A code signifying whether a different drug was dispensed from what was prescribed type : CodeableConcept [1..1] « A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription (Strength=Example) ActSubstanceAdminSubstitution... ?? » Indicates the reason for the substitution of (or lack of substitution) from what was prescribed reason : CodeableConcept [0..*] « A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed (Strength=Example) SubstanceAdminSubstitutionRea... ?? » The person or organization that has primary responsibility for the substitution responsibleParty : Reference [0..*] « Practitioner » 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 substitution [0..1]

XML Template 

<MedicationDispense xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..1 Identifier External identifier --></identifier>
 <status value="[code]"/><!-- 0..1 in-progress | on-hold | completed | entered-in-error | stopped -->
 <medication[x]><!-- 1..1 CodeableConcept|Reference(Medication) What medication was supplied --></medication[x]>
 <patient><!-- 0..1 Reference(Patient) Who the dispense is for --></patient>
 <supportingInformation><!-- 0..* Reference(Any) Information that supports the dispensing of the medication --></supportingInformation>
 <dispenser><!-- 0..1 Reference(Practitioner) Practitioner responsible for dispensing medication --></dispenser>
 <dispensingOrganization><!-- 0..1 Reference(Organization) Organization responsible for the dispense of the medication --></dispensingOrganization>
 <authorizingPrescription><!-- 0..* Reference(MedicationRequest) Medication order that authorizes the dispense --></authorizingPrescription>
 <type><!-- 0..1 CodeableConcept Trial fill, partial fill, emergency fill, etc. --></type>
 <quantity><!-- 0..1 Quantity(SimpleQuantity) Amount dispensed --></quantity>
 <daysSupply><!-- 0..1 Quantity(SimpleQuantity) Amount of medication expressed as a timing amount --></daysSupply>
 <whenPrepared value="[dateTime]"/><!-- 0..1 When product was packaged and reviewed -->
 <whenHandedOver value="[dateTime]"/><!-- 0..1 When product was given out -->
 <destination><!-- 0..1 Reference(Location) Where the medication was sent --></destination>
 <receiver><!-- 0..* Reference(Patient|Practitioner) Who collected the medication --></receiver>
 <note><!-- 0..* Annotation Information about the dispense --></note>
 <dosageInstruction><!-- 0..* DosageInstruction Medicine administration instructions to the patient/caregiver --></dosageInstruction>
 <substitution>  <!-- 0..1 Deals with substitution of one medicine for another -->
  <type><!-- 1..1 CodeableConcept Code signifying whether a different drug was dispensed from what was prescribed --></type>
  <reason><!-- 0..* CodeableConcept Why was substitution made --></reason>
  <responsibleParty><!-- 0..* Reference(Practitioner) Who is responsible for the substitution --></responsibleParty>
 </substitution>
 <eventHistory><!-- 0..* Reference(Provenance) A list of events of interest in the lifecycle --></eventHistory>
</MedicationDispense>

JSON Template 

{doco
  "resourceType" : "MedicationDispense",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : { Identifier }, // External identifier
  "status" : "<code>", // in-progress | on-hold | completed | entered-in-error | stopped
  // medication[x]: What medication was supplied. One of these 2:
  "medicationCodeableConcept" : { CodeableConcept },
  "medicationReference" : { Reference(Medication) },
  "patient" : { Reference(Patient) }, // Who the dispense is for
  "supportingInformation" : [{ Reference(Any) }], // Information that supports the dispensing of the medication
  "dispenser" : { Reference(Practitioner) }, // Practitioner responsible for dispensing medication
  "dispensingOrganization" : { Reference(Organization) }, // Organization responsible for the dispense of the medication
  "authorizingPrescription" : [{ Reference(MedicationRequest) }], // Medication order that authorizes the dispense
  "type" : { CodeableConcept }, // Trial fill, partial fill, emergency fill, etc.
  "quantity" : { Quantity(SimpleQuantity) }, // Amount dispensed
  "daysSupply" : { Quantity(SimpleQuantity) }, // Amount of medication expressed as a timing amount
  "whenPrepared" : "<dateTime>", // When product was packaged and reviewed
  "whenHandedOver" : "<dateTime>", // When product was given out
  "destination" : { Reference(Location) }, // Where the medication was sent
  "receiver" : [{ Reference(Patient|Practitioner) }], // Who collected the medication
  "note" : [{ Annotation }], // Information about the dispense
  "dosageInstruction" : [{ DosageInstruction }], // Medicine administration instructions to the patient/caregiver
  "substitution" : { // Deals with substitution of one medicine for another
    "type" : { CodeableConcept }, // R!  Code signifying whether a different drug was dispensed from what was prescribed
    "reason" : [{ CodeableConcept }], // Why was substitution made
    "responsibleParty" : [{ Reference(Practitioner) }] // Who is responsible for the substitution
  },
  "eventHistory" : [{ Reference(Provenance) }] // A list of events of interest in the lifecycle
}

Turtle Template 

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:MedicationDispense;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:MedicationDispense.identifier [ Identifier ]; # 0..1 External identifier
  fhir:MedicationDispense.status [ code ]; # 0..1 in-progress | on-hold | completed | entered-in-error | stopped
  # MedicationDispense.medication[x] : 1..1 What medication was supplied. One of these 2
    fhir:MedicationDispense.medicationCodeableConcept [ CodeableConcept ]
    fhir:MedicationDispense.medicationReference [ Reference(Medication) ]
  fhir:MedicationDispense.patient [ Reference(Patient) ]; # 0..1 Who the dispense is for
  fhir:MedicationDispense.supportingInformation [ Reference(Any) ], ... ; # 0..* Information that supports the dispensing of the medication
  fhir:MedicationDispense.dispenser [ Reference(Practitioner) ]; # 0..1 Practitioner responsible for dispensing medication
  fhir:MedicationDispense.dispensingOrganization [ Reference(Organization) ]; # 0..1 Organization responsible for the dispense of the medication
  fhir:MedicationDispense.authorizingPrescription [ Reference(MedicationRequest) ], ... ; # 0..* Medication order that authorizes the dispense
  fhir:MedicationDispense.type [ CodeableConcept ]; # 0..1 Trial fill, partial fill, emergency fill, etc.
  fhir:MedicationDispense.quantity [ Quantity(SimpleQuantity) ]; # 0..1 Amount dispensed
  fhir:MedicationDispense.daysSupply [ Quantity(SimpleQuantity) ]; # 0..1 Amount of medication expressed as a timing amount
  fhir:MedicationDispense.whenPrepared [ dateTime ]; # 0..1 When product was packaged and reviewed
  fhir:MedicationDispense.whenHandedOver [ dateTime ]; # 0..1 When product was given out
  fhir:MedicationDispense.destination [ Reference(Location) ]; # 0..1 Where the medication was sent
  fhir:MedicationDispense.receiver [ Reference(Patient|Practitioner) ], ... ; # 0..* Who collected the medication
  fhir:MedicationDispense.note [ Annotation ], ... ; # 0..* Information about the dispense
  fhir:MedicationDispense.dosageInstruction [ DosageInstruction ], ... ; # 0..* Medicine administration instructions to the patient/caregiver
  fhir:MedicationDispense.substitution [ # 0..1 Deals with substitution of one medicine for another
    fhir:MedicationDispense.substitution.type [ CodeableConcept ]; # 1..1 Code signifying whether a different drug was dispensed from what was prescribed
    fhir:MedicationDispense.substitution.reason [ CodeableConcept ], ... ; # 0..* Why was substitution made
    fhir:MedicationDispense.substitution.responsibleParty [ Reference(Practitioner) ], ... ; # 0..* Who is responsible for the substitution
  ];
  fhir:MedicationDispense.eventHistory [ Reference(Provenance) ], ... ; # 0..* A list of events of interest in the lifecycle
]

Changes since DSTU2

MedicationDispense
MedicationDispense.supportingInformation added Element
MedicationDispense.dispensingOrganization added Element
MedicationDispense.authorizingPrescription Type changed from Reference(MedicationOrder) to Reference(MedicationRequest)
MedicationDispense.note Max Cardinality changed from 1 to *
Type changed from string to Annotation
MedicationDispense.dosageInstruction Type changed from BackboneElement to DosageInstruction
MedicationDispense.eventHistory added Element
MedicationDispense.dosageInstruction.text deleted
MedicationDispense.dosageInstruction.additionalInstructions deleted
MedicationDispense.dosageInstruction.timing deleted
MedicationDispense.dosageInstruction.asNeeded[x] deleted
MedicationDispense.dosageInstruction.site[x] deleted
MedicationDispense.dosageInstruction.route deleted
MedicationDispense.dosageInstruction.method deleted
MedicationDispense.dosageInstruction.dose[x] deleted
MedicationDispense.dosageInstruction.rate[x] deleted
MedicationDispense.dosageInstruction.maxDosePerPeriod deleted

See the Full Difference for further information

Structure

Name Flags Card. Type Description & Constraints doco
. . MedicationDispense I DomainResource Dispensing a medication to a named patient
whenHandedOver cannot be before whenPrepared
. . . identifier 0..1 Identifier External identifier
. . . status ?! Σ 0..1 code in-progress | on-hold | completed | entered-in-error | stopped
MedicationDispenseStatus ( Required )
. . . medication[x] Σ 1..1 What medication was supplied
SNOMED CT Medication Codes ( Example )
. . . . medicationCodeableConcept CodeableConcept
. . . . medicationReference Reference ( Medication )
. . . patient Σ 0..1 Reference ( Patient ) Who the dispense is for
. . . supportingInformation 0..* Reference ( Any ) Information that supports the dispensing of the medication
. . . dispenser 0..1 Reference ( Practitioner ) Practitioner responsible for dispensing medication
. . . dispensingOrganization 0..1 Reference ( Organization ) Organization responsible for the dispense of the medication
. . . authorizingPrescription 0..* Reference ( MedicationRequest ) Medication order that authorizes the dispense
. . . type 0..1 CodeableConcept Trial fill, partial fill, emergency fill, etc.
ActPharmacySupplyType ( Example )
. . . quantity 0..1 SimpleQuantity Amount dispensed
. . . daysSupply 0..1 SimpleQuantity Amount of medication expressed as a timing amount
. . . whenPrepared Σ 0..1 dateTime When product was packaged and reviewed
. . . whenHandedOver 0..1 dateTime When product was given out
. . . destination 0..1 Reference ( Location ) Where the medication was sent
. . . receiver 0..* Reference ( Patient | Practitioner ) Who collected the medication
. . . note 0..* Annotation Information about the dispense
. . . dosageInstruction 0..* DosageInstruction Medicine administration instructions to the patient/caregiver
. . . substitution 0..1 BackboneElement Deals with substitution of one medicine for another
. . . . type 1..1 CodeableConcept Code signifying whether a different drug was dispensed from what was prescribed
ActSubstanceAdminSubstitutionCode ( Example )
. . . . reason 0..* CodeableConcept Why was substitution made
SubstanceAdminSubstitutionReason ( Example )
. . . . responsibleParty 0..* Reference ( Practitioner ) Who is responsible for the substitution
. . . eventHistory 0..* Reference ( Provenance ) A list of events of interest in the lifecycle

doco Documentation for this format

UML Diagram ( Legend )

MedicationDispense ( DomainResource ) Identifier assigned by the dispensing facility - this is an identifier assigned outside FHIR identifier : Identifier [0..1] A code specifying the state of the set of dispense events (this element modifies the meaning of other elements) status : code [0..1] « A coded concept specifying the state of the dispense event. (Strength=Required) MedicationDispenseStatus ! » 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 medication[x] : Type [1..1] « CodeableConcept | Reference ( Medication ); A coded concept identifying which substance or product can be dispensed (Strength=Example) SNOMED CT Medication ?? » A link to a resource representing the person to whom the medication will be given patient : Reference [0..1] « Patient » Additional information that supports the medication being dispensed supportingInformation : Reference [0..*] « Any » The individual responsible for dispensing the medication dispenser : Reference [0..1] « Practitioner » The organizaation responsible for the dispense of the medication dispensingOrganization : Reference [0..1] « Organization » Indicates the medication order that is being dispensed against authorizingPrescription : Reference [0..*] « MedicationRequest » Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc type : CodeableConcept [0..1] « Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc. (Strength=Example) ActPharmacySupplyType ?? » The amount of medication that has been dispensed. Includes unit of measure quantity : Quantity ( SimpleQuantity ) [0..1] The amount of medication expressed as a timing amount daysSupply : Quantity ( SimpleQuantity ) [0..1] The time when the dispensed product was packaged and reviewed whenPrepared : dateTime [0..1] The time the dispensed product was provided to the patient or their representative whenHandedOver : dateTime [0..1] Identification of the facility/location where the medication was shipped to, as part of the dispense event destination : Reference [0..1] « Location » 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 receiver : Reference [0..*] « Patient | Practitioner » Extra information about the dispense that could not be conveyed in the other attributes note : Annotation [0..*] 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 dosageInstruction : DosageInstruction [0..*] A summary of the events of interest that have occurred, such as when the dispense was verified eventHistory : Reference [0..*] « Provenance » Substitution A code signifying whether a different drug was dispensed from what was prescribed type : CodeableConcept [1..1] « A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription (Strength=Example) ActSubstanceAdminSubstitution... ?? » Indicates the reason for the substitution of (or lack of substitution) from what was prescribed reason : CodeableConcept [0..*] « A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed (Strength=Example) SubstanceAdminSubstitutionRea... ?? » The person or organization that has primary responsibility for the substitution responsibleParty : Reference [0..*] « Practitioner » 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 substitution [0..1]

XML Template 

<MedicationDispense xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..1 Identifier External identifier --></identifier>
 <status value="[code]"/><!-- 0..1 in-progress | on-hold | completed | entered-in-error | stopped -->
 <medication[x]><!-- 1..1 CodeableConcept|Reference(Medication) What medication was supplied --></medication[x]>
 <patient><!-- 0..1 Reference(Patient) Who the dispense is for --></patient>
 <supportingInformation><!-- 0..* Reference(Any) Information that supports the dispensing of the medication --></supportingInformation>
 <dispenser><!-- 0..1 Reference(Practitioner) Practitioner responsible for dispensing medication --></dispenser>
 <dispensingOrganization><!-- 0..1 Reference(Organization) Organization responsible for the dispense of the medication --></dispensingOrganization>
 <authorizingPrescription><!-- 0..* Reference(MedicationRequest) Medication order that authorizes the dispense --></authorizingPrescription>
 <type><!-- 0..1 CodeableConcept Trial fill, partial fill, emergency fill, etc. --></type>
 <quantity><!-- 0..1 Quantity(SimpleQuantity) Amount dispensed --></quantity>
 <daysSupply><!-- 0..1 Quantity(SimpleQuantity) Amount of medication expressed as a timing amount --></daysSupply>
 <whenPrepared value="[dateTime]"/><!-- 0..1 When product was packaged and reviewed -->
 <whenHandedOver value="[dateTime]"/><!-- 0..1 When product was given out -->
 <destination><!-- 0..1 Reference(Location) Where the medication was sent --></destination>
 <receiver><!-- 0..* Reference(Patient|Practitioner) Who collected the medication --></receiver>
 <note><!-- 0..* Annotation Information about the dispense --></note>
 <dosageInstruction><!-- 0..* DosageInstruction Medicine administration instructions to the patient/caregiver --></dosageInstruction>
 <substitution>  <!-- 0..1 Deals with substitution of one medicine for another -->
  <type><!-- 1..1 CodeableConcept Code signifying whether a different drug was dispensed from what was prescribed --></type>
  <reason><!-- 0..* CodeableConcept Why was substitution made --></reason>
  <responsibleParty><!-- 0..* Reference(Practitioner) Who is responsible for the substitution --></responsibleParty>
 </substitution>
 <eventHistory><!-- 0..* Reference(Provenance) A list of events of interest in the lifecycle --></eventHistory>
</MedicationDispense>

JSON Template 

{doco
  "resourceType" : "MedicationDispense",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : { Identifier }, // External identifier
  "status" : "<code>", // in-progress | on-hold | completed | entered-in-error | stopped
  // medication[x]: What medication was supplied. One of these 2:
  "medicationCodeableConcept" : { CodeableConcept },
  "medicationReference" : { Reference(Medication) },
  "patient" : { Reference(Patient) }, // Who the dispense is for
  "supportingInformation" : [{ Reference(Any) }], // Information that supports the dispensing of the medication
  "dispenser" : { Reference(Practitioner) }, // Practitioner responsible for dispensing medication
  "dispensingOrganization" : { Reference(Organization) }, // Organization responsible for the dispense of the medication
  "authorizingPrescription" : [{ Reference(MedicationRequest) }], // Medication order that authorizes the dispense
  "type" : { CodeableConcept }, // Trial fill, partial fill, emergency fill, etc.
  "quantity" : { Quantity(SimpleQuantity) }, // Amount dispensed
  "daysSupply" : { Quantity(SimpleQuantity) }, // Amount of medication expressed as a timing amount
  "whenPrepared" : "<dateTime>", // When product was packaged and reviewed
  "whenHandedOver" : "<dateTime>", // When product was given out
  "destination" : { Reference(Location) }, // Where the medication was sent
  "receiver" : [{ Reference(Patient|Practitioner) }], // Who collected the medication
  "note" : [{ Annotation }], // Information about the dispense
  "dosageInstruction" : [{ DosageInstruction }], // Medicine administration instructions to the patient/caregiver
  "substitution" : { // Deals with substitution of one medicine for another
    "type" : { CodeableConcept }, // R!  Code signifying whether a different drug was dispensed from what was prescribed
    "reason" : [{ CodeableConcept }], // Why was substitution made
    "responsibleParty" : [{ Reference(Practitioner) }] // Who is responsible for the substitution
  },
  "eventHistory" : [{ Reference(Provenance) }] // A list of events of interest in the lifecycle
}

Turtle Template 

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:MedicationDispense;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:MedicationDispense.identifier [ Identifier ]; # 0..1 External identifier
  fhir:MedicationDispense.status [ code ]; # 0..1 in-progress | on-hold | completed | entered-in-error | stopped
  # MedicationDispense.medication[x] : 1..1 What medication was supplied. One of these 2
    fhir:MedicationDispense.medicationCodeableConcept [ CodeableConcept ]
    fhir:MedicationDispense.medicationReference [ Reference(Medication) ]
  fhir:MedicationDispense.patient [ Reference(Patient) ]; # 0..1 Who the dispense is for
  fhir:MedicationDispense.supportingInformation [ Reference(Any) ], ... ; # 0..* Information that supports the dispensing of the medication
  fhir:MedicationDispense.dispenser [ Reference(Practitioner) ]; # 0..1 Practitioner responsible for dispensing medication
  fhir:MedicationDispense.dispensingOrganization [ Reference(Organization) ]; # 0..1 Organization responsible for the dispense of the medication
  fhir:MedicationDispense.authorizingPrescription [ Reference(MedicationRequest) ], ... ; # 0..* Medication order that authorizes the dispense
  fhir:MedicationDispense.type [ CodeableConcept ]; # 0..1 Trial fill, partial fill, emergency fill, etc.
  fhir:MedicationDispense.quantity [ Quantity(SimpleQuantity) ]; # 0..1 Amount dispensed
  fhir:MedicationDispense.daysSupply [ Quantity(SimpleQuantity) ]; # 0..1 Amount of medication expressed as a timing amount
  fhir:MedicationDispense.whenPrepared [ dateTime ]; # 0..1 When product was packaged and reviewed
  fhir:MedicationDispense.whenHandedOver [ dateTime ]; # 0..1 When product was given out
  fhir:MedicationDispense.destination [ Reference(Location) ]; # 0..1 Where the medication was sent
  fhir:MedicationDispense.receiver [ Reference(Patient|Practitioner) ], ... ; # 0..* Who collected the medication
  fhir:MedicationDispense.note [ Annotation ], ... ; # 0..* Information about the dispense
  fhir:MedicationDispense.dosageInstruction [ DosageInstruction ], ... ; # 0..* Medicine administration instructions to the patient/caregiver
  fhir:MedicationDispense.substitution [ # 0..1 Deals with substitution of one medicine for another
    fhir:MedicationDispense.substitution.type [ CodeableConcept ]; # 1..1 Code signifying whether a different drug was dispensed from what was prescribed
    fhir:MedicationDispense.substitution.reason [ CodeableConcept ], ... ; # 0..* Why was substitution made
    fhir:MedicationDispense.substitution.responsibleParty [ Reference(Practitioner) ], ... ; # 0..* Who is responsible for the substitution
  ];
  fhir:MedicationDispense.eventHistory [ Reference(Provenance) ], ... ; # 0..* A list of events of interest in the lifecycle
]

Changes since DSTU2

MedicationDispense
MedicationDispense.supportingInformation added Element
MedicationDispense.dispensingOrganization added Element
MedicationDispense.authorizingPrescription Type changed from Reference(MedicationOrder) to Reference(MedicationRequest)
MedicationDispense.note Max Cardinality changed from 1 to *
Type changed from string to Annotation
MedicationDispense.dosageInstruction Type changed from BackboneElement to DosageInstruction
MedicationDispense.eventHistory added Element
MedicationDispense.dosageInstruction.text deleted
MedicationDispense.dosageInstruction.additionalInstructions deleted
MedicationDispense.dosageInstruction.timing deleted
MedicationDispense.dosageInstruction.asNeeded[x] deleted
MedicationDispense.dosageInstruction.site[x] deleted
MedicationDispense.dosageInstruction.route deleted
MedicationDispense.dosageInstruction.method deleted
MedicationDispense.dosageInstruction.dose[x] deleted
MedicationDispense.dosageInstruction.rate[x] deleted
MedicationDispense.dosageInstruction.maxDosePerPeriod deleted

See the Full Difference for further information

 

Alternate definitions: Master Definition ( XML , JSON ), XML Schema / Schematron (for ) + JSON Schema , ShEx (for Turtle ), JSON-LD (for RDF as JSON-LD ),

11.4.4.1 Terminology Bindings

Path Definition Type Reference
MedicationDispense.status A coded concept specifying the state of the dispense event. Required MedicationDispenseStatus
MedicationDispense.medication[x] A coded concept identifying which substance or product can be dispensed Example SNOMED CT Medication Codes
MedicationDispense.type Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc. Example ActPharmacySupplyType
MedicationDispense.substitution.type A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription Example ActSubstanceAdminSubstitutionCode
MedicationDispense.substitution.reason A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed Example SubstanceAdminSubstitutionReason

11.4.4.2 Constraints

  • mdd-1 : whenHandedOver cannot be before whenPrepared ( expression : whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared )

11.4.5 Search Parameters

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

Name Type Description Paths In Common
code token Return dispenses of this medicine code MedicationDispense.medicationCodeableConcept 4 Resources
destination reference Return dispenses that should be sent to a specific destination MedicationDispense.destination
( Location )
dispenser reference Return dispenses performed by a specific individual MedicationDispense.dispenser
( Practitioner )
identifier token Return dispenses with this external identifier MedicationDispense.identifier 3 Resources
medication reference Return dispenses of this medicine resource MedicationDispense.medicationReference
( Medication ) 		3 Resources
patient reference The identity of a patient to list dispenses for MedicationDispense.patient
( Patient ) 		3 Resources
prescription reference The identity of a prescription to list dispenses from MedicationDispense.authorizingPrescription
( MedicationRequest ) 		1 Resources
receiver reference The identity of a receiver to list dispenses for MedicationDispense.receiver
( Practitioner , Patient )
responsibleparty reference Return dispenses with the specified responsible party MedicationDispense.substitution.responsibleParty
( Practitioner )
status token Return dispenses with a specified dispense status MedicationDispense.status 3 Resources
type token Return dispenses of a specific type MedicationDispense.type
whenhandedover date Returns dispenses handed over on this date MedicationDispense.whenHandedOver
whenprepared date Returns dispenses prepared on this date MedicationDispense.whenPrepared