This page is part of the FHIR Specification (v0.0.82: DSTU 1). 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

4.11 Resource MedicationDispense - Content

Dispensing a medication to a named patient. This includes a description of the supply provided and the instructions for administering the medication.

4.11.1 Scope and Usage

This resource covers the supply of all medications to a patient. Examples include dispensing and pick-up from an out-patient 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.

4.11.2 Boundaries and Relationships

The Medication domain includes a number of related resources

MedicationPrescription 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 medication being taken by a patient, or that the 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.

4.11.3 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.

4.11.4 Resource Content

MedicationDispense ( Resource ) Identifier assigned by the dispensing facility - this is an identifier assigned outside FHIR (this element modifies the meaning of other elements) 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 code specifying the state of the dispense event. MedicationDispenseStatus >> A link to a resource representing the person to whom the medication will be given patient : Resource ( Patient ) 0..1 The individual responsible for dispensing the medication dispenser : Resource ( Practitioner ) 0..1 Indicates the medication order that is being dispensed against authorizingPrescription : Resource ( MedicationPrescription ) 0..* Dispense Identifier assigned by the dispensing facility. This is an identifier assigned outside FHIR identifier : Identifier 0..1 A code specifying the state of the dispense event (this element modifies the meaning of other elements) status : code 0..1 << A code specifying the state of the dispense event. MedicationDispenseStatus >> Indicates the type of dispensing event that is performed. Examples include: Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc type : CodeableConcept 0..1 << Indicates the type of dispensing event that is performed. Examples include: Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc. MedicationDispenseType >> The amount of medication that has been dispensed. Includes unit of measure quantity : Quantity 0..1 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 : Resource ( Medication ) 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 : Resource ( Location ) 0..1 Identifies the person who picked up the medication. This will usually be a patient or their carer, but some cases exist where it can be a healthcare professional receiver : Resource ( Patient | Practitioner ) 0..* Dosage Additional instructions such as "Swallow with plenty of water" which may or may not be coded additionalInstructions : CodeableConcept 0..1 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" timing[x] : dateTime | Period | Schedule 0..1 If set to true or if specified as a CodeableConcept, indicates that the medication is only taken when needed within the specified schedule rather than at every scheduled dose. If a CodeableConcept is present, it indicates the pre-condition for taking the Medication asNeeded[x] : boolean | CodeableConcept 0..1 A coded specification of the anatomic site where the medication first enters the body site : CodeableConcept 0..1 << A coded concept describing the site location the medicine enters into or onto the body MedicationAdministrationSite >> A code specifying the route or physiological path of administration of a therapeutic agent into or onto a subject route : CodeableConcept 0..1 << A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. RouteOfAdministration >> A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. Examples: Slow Push; Deep IV. Terminologies used often pre-coordinate this term with the route and or form of administration method : CodeableConcept 0..1 << A coded concept describing the technique by which the medicine is administered MedicationAdministrationMethod >> The amount of therapeutic or other substance given at one administration event quantity : Quantity 0..1 Identifies the speed with which the substance is introduced into the subject. Typically the rate for an infusion. 200ml in 2 hours rate : Ratio 0..1 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 maxDosePerPeriod : Ratio 0..1 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 MedicationIntendedSubstitutionType >> 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. MedicationIntendedSubstitutionReason >> The person or organization that has primary responsibility for the substitution responsibleParty : Resource ( Practitioner ) 0..* Indicates how the medication is to be used by the patient dosage 0..* Indicates the details of the dispense event such as the days supply and quantity of medication dispensed dispense 0..* Indicates whether or not substitution was made as part of the dispense. In some cases substitution will be expected but doesn't happen, in other cases substitution is not expected but does happen. This block explains what substitition did or did not happen and why substitution 0..1

This resource is referenced by [Procedure] 

<MedicationDispense xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: extension, modifierExtension, language, text, and contained -->
 <identifier><!-- 0..1 Identifier External identifier --></identifier>
 <status value="[code]"/><!-- 0..1 in progress | on hold | completed | entered in error | stopped -->
 <patient><!-- 0..1 Resource(Patient) Who the dispense is for --></patient>
 <dispenser><!-- 0..1 Resource(Practitioner) 
     Practitioner responsible for dispensing medication --></dispenser>
 <authorizingPrescription><!-- 0..* Resource(MedicationPrescription) 
     Medication order that authorizes the dispense --></authorizingPrescription>
 <dispense>  <!-- 0..* Details for individual dispensed medicationdetails -->
  <identifier><!-- 0..1 Identifier External identifier for individual item --></identifier>
  <status value="[code]"/><!-- 0..1 in progress | on hold | completed | entered in error | stopped -->
  <type><!-- 0..1 CodeableConcept Trial fill, partial fill, emergency fill, etc. --></type>
  <quantity><!-- 0..1 Quantity Amount dispensed --></quantity>
  <medication><!-- 0..1 Resource(Medication) What medication was supplied --></medication>
  <whenPrepared value="[dateTime]"/><!-- 0..1 Dispense processing time -->
  <whenHandedOver value="[dateTime]"/><!-- 0..1 Handover time -->
  <destination><!-- 0..1 Resource(Location) Where the medication was sent --></destination>
  <receiver><!-- 0..* Resource(Patient|Practitioner) Who collected the medication --></receiver>
  <dosage>  <!-- 0..* Medicine administration instructions to the patient/carer -->
   <additionalInstructions><!-- 0..1 CodeableConcept E.g. "Take with food" --></additionalInstructions>
   <timing[x]><!-- 0..1 dateTime|Period|Schedule When medication should be administered --></timing[x]>
   <asNeeded[x]><!-- 0..1 boolean|CodeableConcept Take "as needed" f(or x) --></asNeeded[x]>
   <site><!-- 0..1 CodeableConcept Body site to administer to --></site>
   <route><!-- 0..1 CodeableConcept How drug should enter body --></route>
   <method><!-- 0..1 CodeableConcept Technique for administering medication --></method>
   <quantity><!-- 0..1 Quantity Amount of medication per dose --></quantity>
   <rate><!-- 0..1 Ratio Amount of medication per unit of time --></rate>
   <maxDosePerPeriod><!-- 0..1 Ratio Upper limit on medication per unit of time --></maxDosePerPeriod>
  </dosage>
 </dispense>
 <substitution>  <!-- 0..1 Deals with substitution of one medicine for another -->
  <type><!-- 1..1 CodeableConcept Type of substitiution --></type>
  <reason><!-- 0..* CodeableConcept Why was substitution made --></reason>
  <responsibleParty><!-- 0..* Resource(Practitioner) 
      Who is responsible for the substitution --></responsibleParty>
 </substitution>
</MedicationDispense>

Alternate definitions: Schema / Schematron , Resource Profile

4.11.4.1 Terminology Bindings

Path Definition Type Reference
MedicationDispense.status
MedicationDispense.dispense.status 		A code specifying the state of the dispense event. Fixed http://hl7.org/fhir/medication-dispense-status
MedicationDispense.dispense.type Indicates the type of dispensing event that is performed. Examples include: Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc. Example http://hl7.org/fhir/v3/vs/ActPharmacySupplyType
MedicationDispense.dispense.dosage.asNeeded[x] A coded concept identifying the pre-condition that should hold prior to consuming a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up", etc. Unknown No details provided yet
MedicationDispense.dispense.dosage.site A coded concept describing the site location the medicine enters into or onto the body Example http://hl7.org/fhir/vs/approach-site-codes
MedicationDispense.dispense.dosage.route A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. Example http://hl7.org/fhir/vs/route-codes
MedicationDispense.dispense.dosage.method A coded concept describing the technique by which the medicine is administered Example http://hl7.org/fhir/vs/administration-method-codes
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 http://hl7.org/fhir/v3/vs/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 http://hl7.org/fhir/v3/vs/SubstanceAdminSubstitutionReason

4.11.4.2 Constraints

4.11.5 Search Parameters

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

Name Type Description Paths
_id token The logical resource id associated with the resource (must be supported by all servers)
_language token The language of the resource
destination reference Return dispenses that should be sent to a secific destination MedicationDispense.dispense.destination
( Location )
dispenser reference Return all dispenses performed by a specific indiividual MedicationDispense.dispenser
( Practitioner )
identifier token Return dispenses with this external identity MedicationDispense.identifier
medication reference Returns dispenses of this medicine MedicationDispense.dispense.medication
( Medication )
patient reference The identity of a patient to list dispenses for MedicationDispense.patient
( Patient )
prescription reference The identity of a prescription to list dispenses from MedicationDispense.authorizingPrescription
( MedicationPrescription )
responsibleparty reference Return all dispenses with the specified responsible party MedicationDispense.substitution.responsibleParty
( Practitioner )
status token Status of the dispense MedicationDispense.dispense.status
type token Return all dispenses of a specific type MedicationDispense.dispense.type
whenhandedover date Date when medication handed over to patient (outpatient setting), or supplied to ward or clinic (inpatient setting) MedicationDispense.dispense.whenHandedOver
whenprepared date Date when medication prepared MedicationDispense.dispense.whenPrepared
comments powered by Disqus