DSTU2

This page is part of the FHIR Specification (v0.0.82: (v1.0.2: DSTU 1). 2). 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 4.15 Resource MedicationDispense - Content

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

Dispensing Indicates that a medication product is to be or has been dispensed for a named patient. person/patient. This includes a description of the supply 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.

4.11.1 4.15.1 Scope and Usage

This resource covers the supply of all medications to a patient. Examples include dispensing and pick-up from an out-patient or community pharmacy, dispensing patient-specific medications from in-patient pharmacy to ward 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.

4.11.2 4.15.2 Boundaries and Relationships

The Medication domain includes a number of related resources

MedicationPrescription MedicationOrder 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, patient or that the a medication has been given to a patient patient, where the record is the result of a report from the patient, patient or another clinician. A medication statement is not a part of the prescribe->dispense->administer sequence sequence, but is a report that such a sequence (or at least a part of it) did take place 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 4.15.3 Background and Context

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

4.11.4 4.15.4 Resource Content

Structure

Name Flags Card. Type Description & Constraints doco
.. MedicationDispense Σ I DomainResource Dispensing a medication to a named patient
whenHandedOver cannot be before whenPrepared
... identifier Σ 0..1 Identifier External identifier
... status ?! Σ 0..1 code in-progress | on-hold | completed | entered-in-error | stopped
MedicationDispenseStatus ( Required )
... patient Σ 0..1 Reference ( Patient ) Who the dispense is for
... dispenser Σ 0..1 Reference ( Practitioner ) Practitioner responsible for dispensing medication
... authorizingPrescription Σ 0..* Reference ( MedicationOrder ) Medication order that authorizes the dispense
... type Σ 0..1 CodeableConcept Trial fill, partial fill, emergency fill, etc.
ActPharmacySupplyType ( Example )
... quantity Σ 0..1 SimpleQuantity Amount dispensed
... daysSupply Σ 0..1 SimpleQuantity Days Supply
... medication[x] Σ 1..1 What medication was supplied
.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference ( Medication )
... whenPrepared Σ 0..1 dateTime Dispense processing time
... whenHandedOver Σ 0..1 dateTime When product was given out
... destination Σ 0..1 Reference ( Location ) Where the medication was sent
... receiver Σ 0..* Reference ( Patient | Practitioner ) Who collected the medication
... note Σ 0..1 string Information about the dispense
... dosageInstruction Σ 0..* BackboneElement Medicine administration instructions to the patient/caregiver
.... text Σ 0..1 string Dosage Instructions
.... additionalInstructions Σ 0..1 CodeableConcept E.g. "Take with food"
.... timing Σ 0..1 Timing When medication should be administered
.... asNeeded[x] Σ 0..1 Take "as needed" f(or x)
..... asNeededBoolean boolean
..... asNeededCodeableConcept CodeableConcept
.... site[x] Σ 0..1 Body site to administer to
SNOMED CT Anatomical Structure for Administration Site Codes ( Example )
..... siteCodeableConcept CodeableConcept
..... siteReference Reference ( BodySite )
.... route Σ 0..1 CodeableConcept How drug should enter body
SNOMED CT Route Codes ( Example )
.... method Σ 0..1 CodeableConcept Technique for administering medication
.... dose[x] Σ 0..1 Amount of medication per dose
..... doseRange Range
..... doseQuantity SimpleQuantity
.... rate[x] Σ 0..1 Amount of medication per unit of time
..... rateRatio Ratio
..... rateRange Range
.... maxDosePerPeriod Σ 0..1 Ratio Upper limit on medication per unit of time
... substitution Σ 0..1 BackboneElement Deals with substitution of one medicine for another
.... type Σ 1..1 CodeableConcept Type of substitution
ActSubstanceAdminSubstitutionCode ( Example )
.... reason Σ 0..* CodeableConcept Why was substitution made
SubstanceAdminSubstitutionReason ( Example )
.... responsibleParty Σ 0..* Reference ( Practitioner ) Who is responsible for the substitution

doco Documentation for this format

UML Diagram

MedicationDispense ( Resource DomainResource ) 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 [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 << [0..1] « A code specifying the state of the dispense event. (Strength=Required) MedicationDispenseStatus >> ! » A link to a resource representing the person to whom the medication will be given patient : Resource Reference ( [0..1] « Patient ) 0..1 » The individual responsible for dispensing the medication dispenser : Resource Reference ( [0..1] « Practitioner ) 0..1 » Indicates the medication order that is being dispensed against authorizingPrescription : Resource Reference [0..*] « MedicationOrder » 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 ( MedicationPrescription SimpleQuantity ) 0..* [0..1] The amount of medication expressed as a timing amount daysSupply : Quantity ( SimpleQuantity ) [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[x] : Type [1..1] « CodeableConcept | Reference ( Medication ) » 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 : string [0..1] DosageInstruction 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 text : string [0..1] 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 : Timing [0..1] 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 asNeeded[x] : Type [0..1] « boolean | CodeableConcept » A coded specification of the anatomic site where the medication first enters the body site[x] : Type [0..1] « CodeableConcept | Reference ( BodySite ); A coded concept describing the site location the medicine enters into or onto the body (Strength=Example) SNOMED CT Anatomical Structur... ?? » 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 (Strength=Example) SNOMED CT Route ?? » A coded value indicating the method by which the medication is intended to be or was introduced into or on the body method : CodeableConcept [0..1] The amount of therapeutic or other substance given at one administration event dose[x] : Type [0..1] « Range | Quantity ( SimpleQuantity ) » 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 rate[x] : Type [0..1] « Ratio | Range » 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 (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 how the medication is to be used by the patient dosageInstruction [0..*] 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 -->
 <patient><!-- 0..1 Reference(Patient) Who the dispense is for --></patient>
 <dispenser><!-- 0..1 Reference(Practitioner) Practitioner responsible for dispensing medication --></dispenser>
 <authorizingPrescription><!-- 0..* Reference(MedicationOrder) 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) Days Supply --></daysSupply>
 <medication[x]><!-- 1..1 CodeableConcept|Reference(Medication) What medication was supplied --></medication[x]>
 <whenPrepared value="[dateTime]"/><!-- 0..1 Dispense processing time -->
 <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 value="[string]"/><!-- 0..1 Information about the dispense -->
 <dosageInstruction>  <!-- 0..* Medicine administration instructions to the patient/caregiver -->
  <text value="[string]"/><!-- 0..1 Dosage Instructions -->
  <additionalInstructions><!-- 0..1 CodeableConcept E.g. "Take with food" --></additionalInstructions>
  <timing><!-- 0..1 Timing When medication should be administered --></timing>
  <asNeeded[x]><!-- 0..1 boolean|CodeableConcept Take "as needed" f(or x) --></asNeeded[x]>
  <site[x]><!-- 0..1 CodeableConcept|Reference(BodySite) Body site to administer to --></site[x]>
  <route><!-- 0..1 CodeableConcept How drug should enter body --></route>
  <method><!-- 0..1 CodeableConcept Technique for administering medication --></method>
  <dose[x]><!-- 0..1 Range|Quantity(SimpleQuantity) Amount of medication per dose --></dose[x]>
  <rate[x]><!-- 0..1 Ratio|Range Amount of medication per unit of time --></rate[x]>
  <maxDosePerPeriod><!-- 0..1 Ratio Upper limit on medication per unit of time --></maxDosePerPeriod>
 </dosageInstruction>
 <substitution>  <!-- 0..1 Deals with substitution of one medicine for another -->
  <type><!-- 1..1 CodeableConcept Type of substitution --></type>
  <reason><!-- 0..* CodeableConcept Why was substitution made --></reason>
  <responsibleParty><!-- 0..* Reference(Practitioner) Who is responsible for the substitution --></responsibleParty>
 </substitution>
</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
  "patient" : { Reference(Patient) }, // Who the dispense is for
  "dispenser" : { Reference(Practitioner) }, // Practitioner responsible for dispensing medication
  "authorizingPrescription" : [{ Reference(MedicationOrder) }], // Medication order that authorizes the dispense
  "type" : { CodeableConcept }, // Trial fill, partial fill, emergency fill, etc.
  "quantity" : { Quantity(SimpleQuantity) }, // Amount dispensed
  "daysSupply" : { Quantity(SimpleQuantity) }, // Days Supply
  // medication[x]: What medication was supplied. One of these 2:

  "medicationCodeableConcept" : { CodeableConcept },
  "medicationReference" : { Reference(Medication) },
  "whenPrepared" : "<dateTime>", // Dispense processing time
  "whenHandedOver" : "<dateTime>", // When product was given out
  "destination" : { Reference(Location) }, // Where the medication was sent
  "receiver" : [{ Reference(Patient|Practitioner) }], // Who collected the medication
  "note" : "<string>", // Information about the dispense
  "dosageInstruction" : [{ // Medicine administration instructions to the patient/caregiver
    "text" : "<string>", // Dosage Instructions
    "additionalInstructions" : { CodeableConcept }, // E.g. "Take with food"
    "timing" : { Timing }, // When medication should be administered
    // asNeeded[x]: Take "as needed" f(or x). One of these 2:

    "asNeededBoolean" : <boolean>,
    "asNeededCodeableConcept" : { CodeableConcept },
    // site[x]: Body site to administer to. One of these 2:

    "siteCodeableConcept" : { CodeableConcept },
    "siteReference" : { Reference(BodySite) },
    "route" : { CodeableConcept }, // How drug should enter body
    "method" : { CodeableConcept }, // Technique for administering medication
    // dose[x]: Amount of medication per dose. One of these 2:

    "doseRange" : { Range },
    "doseQuantity" : { Quantity(SimpleQuantity) },
    // rate[x]: Amount of medication per unit of time. One of these 2:

    "rateRatio" : { Ratio },
    "rateRange" : { Range },
    "maxDosePerPeriod" : { Ratio } // Upper limit on medication per unit of time
  }],
  "substitution" : { // Deals with substitution of one medicine for another
    "type" : { CodeableConcept }, // R!  Type of substitution
    "reason" : [{ CodeableConcept }], // Why was substitution made
    "responsibleParty" : [{ Reference(Practitioner) }] // Who is responsible for the substitution
  }
}

Structure

Name Flags Card. Type Description & Constraints doco
.. MedicationDispense Σ I DomainResource Dispensing a medication to a named patient
whenHandedOver cannot be before whenPrepared
... identifier Σ 0..1 Identifier External identifier
... status ?! Σ 0..1 code in-progress | on-hold | completed | entered-in-error | stopped
MedicationDispenseStatus ( Required )
... patient Σ 0..1 Reference ( Patient ) Who the dispense is for
... dispenser Σ 0..1 Reference ( Practitioner ) Practitioner responsible for dispensing medication
... authorizingPrescription Σ 0..* Reference ( MedicationOrder ) Medication order that authorizes the dispense
... type Σ 0..1 CodeableConcept Trial fill, partial fill, emergency fill, etc.
ActPharmacySupplyType ( Example )
... quantity Σ 0..1 SimpleQuantity Amount dispensed
... daysSupply Σ 0..1 SimpleQuantity Days Supply
... medication[x] Σ 1..1 What medication was supplied
.... medicationCodeableConcept CodeableConcept
.... medicationReference Reference ( Medication )
... whenPrepared Σ 0..1 dateTime Dispense processing time
... whenHandedOver Σ 0..1 dateTime When product was given out
... destination Σ 0..1 Reference ( Location ) Where the medication was sent
... receiver Σ 0..* Reference ( Patient | Practitioner ) Who collected the medication
... note Σ 0..1 string Information about the dispense
... dosageInstruction Σ 0..* BackboneElement Medicine administration instructions to the patient/caregiver
.... text Σ 0..1 string Dosage Instructions
.... additionalInstructions Σ 0..1 CodeableConcept E.g. "Take with food"
.... timing Σ 0..1 Timing When medication should be administered
.... asNeeded[x] Σ 0..1 Take "as needed" f(or x)
..... asNeededBoolean boolean
..... asNeededCodeableConcept CodeableConcept
.... site[x] Σ 0..1 Body site to administer to
SNOMED CT Anatomical Structure for Administration Site Codes ( Example )
..... siteCodeableConcept CodeableConcept
..... siteReference Reference ( BodySite )
.... route Σ 0..1 CodeableConcept How drug should enter body
SNOMED CT Route Codes ( Example )
.... method Σ 0..1 CodeableConcept Technique for administering medication
.... dose[x] Σ 0..1 Amount of medication per dose
..... doseRange Range
..... doseQuantity SimpleQuantity
.... rate[x] Σ 0..1 Amount of medication per unit of time
..... rateRatio Ratio
..... rateRange Range
.... maxDosePerPeriod Σ 0..1 Ratio Upper limit on medication per unit of time
... substitution Σ 0..1 BackboneElement Deals with substitution of one medicine for another
.... type Σ 1..1 CodeableConcept Type of substitution
ActSubstanceAdminSubstitutionCode ( Example )
.... reason Σ 0..* CodeableConcept Why was substitution made
SubstanceAdminSubstitutionReason ( Example )
.... responsibleParty Σ 0..* Reference ( Practitioner ) Who is responsible for the substitution

doco Documentation for this format

UML Diagram

MedicationDispense ( DomainResource ) Identifier assigned by the dispensing facility. This facility - this is an identifier assigned outside FHIR identifier : Identifier 0..1 [0..1] A code specifying the state of the set of dispense event events (this element modifies the meaning of other elements) status : code 0..1 << [0..1] « A code specifying the state of the dispense event. (Strength=Required) MedicationDispenseStatus ! » A link to a resource representing the person to whom the medication will be given patient >> : Reference [0..1] « Patient » The individual responsible for dispensing the medication dispenser : Reference [0..1] « Practitioner » Indicates the medication order that is being dispensed against authorizingPrescription : Reference [0..*] « MedicationOrder » Indicates the type of dispensing event that is performed. Examples include: For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc type : CodeableConcept 0..1 << [0..1] « Indicates the type of dispensing event that is performed. Examples include: For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc. (Strength=Example) MedicationDispenseType ActPharmacySupplyType >> ?? » The amount of medication that has been dispensed. Includes unit of measure quantity : Quantity 0..1 ( SimpleQuantity ) [0..1] The amount of medication expressed as a timing amount daysSupply : Quantity ( SimpleQuantity ) [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 medication[x] : Resource Type [1..1] « CodeableConcept | Reference ( Medication ) 0..1 » The time when the dispensed product was packaged and reviewed whenPrepared : dateTime 0..1 [0..1] The time the dispensed product was provided to the patient or their representative whenHandedOver : dateTime 0..1 [0..1] Identification of the facility/location where the medication was shipped to, as part of the dispense event destination : Resource Reference ( [0..1] « Location ) 0..1 » Identifies the person who picked up the medication. This will usually be a patient or their carer, caregiver, but some cases exist where it can be a healthcare professional receiver : Resource Reference ( [0..*] « Patient | Practitioner ) 0..* » Dosage Extra information about the dispense that could not be conveyed in the other attributes note : string [0..1] DosageInstruction 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 text : string [0..1] Additional instructions such as "Swallow with plenty of water" which may or may not be coded additionalInstructions : CodeableConcept 0..1 [0..1] The timing schedule for giving the medication to the patient. The Schedule data type allows many different expressions, for example. 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] timing : dateTime | Period | Schedule Timing 0..1 [0..1] If set to true or if specified as a CodeableConcept, indicates that Indicates whether the medication Medication is only taken when needed within the specified schedule rather than at every scheduled dose. If a CodeableConcept is present, specific dosing schedule (Boolean option), or it indicates the pre-condition 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 asNeeded[x] : Type [0..1] « boolean | CodeableConcept 0..1 » A coded specification of the anatomic site where the medication first enters the body site site[x] : Type [0..1] « CodeableConcept 0..1 << | Reference ( BodySite ); A coded concept describing the site location the medicine enters into or onto the body (Strength=Example) MedicationAdministrationSite SNOMED >> CT Anatomical Structur... ?? » A code specifying the route or physiological path of administration of a therapeutic agent into or onto a subject route : CodeableConcept 0..1 << [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. subject (Strength=Example) RouteOfAdministration SNOMED CT Route >> ?? » A coded value indicating the method by which the medication is intended to be or was introduced into or onto the body. Most commonly used for injections. Examples: Slow Push; Deep IV. Terminologies used often pre-coordinate this term with on the route and or form of administration body method : CodeableConcept 0..1 << A coded concept describing the technique by which the medicine is administered MedicationAdministrationMethod >> [0..1] The amount of therapeutic or other substance given at one administration event quantity dose[x] : Type [0..1] « Range | Quantity 0..1 ( SimpleQuantity ) » Identifies the speed with which the substance is medication was or will be introduced into the subject. patient. Typically the rate for an infusion. 200ml in 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 rate rate[x] : Type [0..1] « Ratio 0..1 | Range » 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 [0..1] Substitution A code signifying whether a different drug was dispensed from what was prescribed type : CodeableConcept 1..1 << [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) MedicationIntendedSubstitutionType ActSubstanceAdminSubstitution... >> ?? » Indicates the reason for the substitution of (or lack of substitution) from what was prescribed reason : CodeableConcept 0..* << [0..*] « A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed. prescribed (Strength=Example) MedicationIntendedSubstitutionReason SubstanceAdminSubstitutionRea... >> ?? » The person or organization that has primary responsibility for the substitution responsibleParty : Resource Reference ( [0..*] « 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 dosageInstruction 0..* [0..*] Indicates whether or not substitution was made as part of the dispense. In some cases substitution will be expected but doesn't does not happen, in other cases substitution is not expected but does happen. This block explains what substitition substitution did or did not happen and why substitution 0..1 [0..1] This resource is referenced by [Procedure]

XML Template

< <!-- from --> <</identifier> < <</patient> < Practitioner responsible for dispensing medication</dispenser> < Medication order that authorizes the dispense</authorizingPrescription> < <</identifier> < <</type> <</quantity> <</medication> < < <</destination> <</receiver> < <</additionalInstructions> <</timing[x]> <</asNeeded[x]> <</site> <</route> <<a title="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. 
<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 -->
 <patient><!-- 0..1 Reference(Patient) Who the dispense is for --></patient>
 <dispenser><!-- 0..1 Reference(Practitioner) Practitioner responsible for dispensing medication --></dispenser>
 <authorizingPrescription><!-- 0..* Reference(MedicationOrder) 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) Days Supply --></daysSupply>
 <medication[x]><!-- 1..1 CodeableConcept|Reference(Medication) What medication was supplied --></medication[x]>
 <whenPrepared value="[dateTime]"/><!-- 0..1 Dispense processing time -->
 <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 value="[string]"/><!-- 0..1 Information about the dispense -->
 <dosageInstruction>  <!-- 0..* Medicine administration instructions to the patient/caregiver -->
  <text value="[string]"/><!-- 0..1 Dosage Instructions -->
  <additionalInstructions><!-- 0..1 CodeableConcept E.g. "Take with food" --></additionalInstructions>
  <timing><!-- 0..1 Timing When medication should be administered --></timing>
  <Terminologies used often pre-coordinate this term with the route and or form of administration." class="dict" href="medicationdispense-definitions.html#MedicationDispense.dispense.dosage.method"></method>
   <</quantity>
   <</rate>
   <</maxDosePerPeriod>
  </dosage>
 </dispense>
 <
  <</type>
  <</reason>
  <
      Who is responsible for the substitution</responsibleParty>

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." class="dict" href="medicationdispense-definitions.html#MedicationDispense.dosageInstruction.asNeeded[x]">asNeeded[x]><!-- 0..1 boolean|CodeableConcept Take "as needed" f(or x) --></asNeeded[x]>
  <site[x]><!-- 0..1 CodeableConcept|Reference(BodySite) Body site to administer to --></site[x]>
  <route><!-- 0..1 CodeableConcept How drug should enter body --></route>
  <method><!-- 0..1 CodeableConcept Technique for administering medication --></method>
  <dose[x]><!-- 0..1 Range|Quantity(SimpleQuantity) Amount of medication per dose --></dose[x]>
  <rate[x]><!-- 0..1 Ratio|Range Amount of medication per unit of time --></rate[x]>
  <maxDosePerPeriod><!-- 0..1 Ratio Upper limit on medication per unit of time --></maxDosePerPeriod>
 </dosageInstruction>
 <substitution>  <!-- 0..1 Deals with substitution of one medicine for another -->
  <type><!-- 1..1 CodeableConcept Type of substitution --></type>
  <reason><!-- 0..* CodeableConcept Why was substitution made --></reason>
  <responsibleParty><!-- 0..* Reference(Practitioner) Who is responsible for the substitution --></responsibleParty>

 </substitution>
</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
  "patient" : { Reference(Patient) }, // Who the dispense is for
  "dispenser" : { Reference(Practitioner) }, // Practitioner responsible for dispensing medication
  "authorizingPrescription" : [{ Reference(MedicationOrder) }], // Medication order that authorizes the dispense
  "type" : { CodeableConcept }, // Trial fill, partial fill, emergency fill, etc.
  "quantity" : { Quantity(SimpleQuantity) }, // Amount dispensed
  "daysSupply" : { Quantity(SimpleQuantity) }, // Days Supply
  // medication[x]: What medication was supplied. One of these 2:

  "medicationCodeableConcept" : { CodeableConcept },
  "medicationReference" : { Reference(Medication) },
  "whenPrepared" : "<dateTime>", // Dispense processing time
  "whenHandedOver" : "<dateTime>", // When product was given out
  "destination" : { Reference(Location) }, // Where the medication was sent
  "receiver" : [{ Reference(Patient|Practitioner) }], // Who collected the medication
  "note" : "<string>", // Information about the dispense
  "dosageInstruction" : [{ // Medicine administration instructions to the patient/caregiver
    "text" : "<string>", // Dosage Instructions
    "additionalInstructions" : { CodeableConcept }, // E.g. "Take with food"
    "timing" : { Timing }, // When medication should be administered
    // asNeeded[x]: Take "as needed" f(or x). One of these 2:

    "asNeededBoolean" : <boolean>,
    "asNeededCodeableConcept" : { CodeableConcept },
    // site[x]: Body site to administer to. One of these 2:

    "siteCodeableConcept" : { CodeableConcept },
    "siteReference" : { Reference(BodySite) },
    "route" : { CodeableConcept }, // How drug should enter body
    "method" : { CodeableConcept }, // Technique for administering medication
    // dose[x]: Amount of medication per dose. One of these 2:

    "doseRange" : { Range },
    "doseQuantity" : { Quantity(SimpleQuantity) },
    // rate[x]: Amount of medication per unit of time. One of these 2:

    "rateRatio" : { Ratio },
    "rateRange" : { Range },
    "maxDosePerPeriod" : { Ratio } // Upper limit on medication per unit of time
  }],
  "substitution" : { // Deals with substitution of one medicine for another
    "type" : { CodeableConcept }, // R!  Type of substitution
    "reason" : [{ CodeableConcept }], // Why was substitution made
    "responsibleParty" : [{ Reference(Practitioner) }] // Who is responsible for the substitution
  }
}

 

Alternate definitions: Schema / Schematron , Resource Profile ( XML , JSON ), Questionnaire

4.11.4.1 4.15.4.1 Terminology Bindings

MedicationDispense.dispense.type MedicationDispense.dispense.dosage.site MedicationDispense.dispense.dosage.route
Path Definition Type Reference
MedicationDispense.status MedicationDispense.dispense.status A code specifying the state of the dispense event. Fixed Required http://hl7.org/fhir/medication-dispense-status MedicationDispenseStatus
MedicationDispense.type Indicates the type of dispensing event that is performed. Examples include: For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc. Example http://hl7.org/fhir/v3/vs/ActPharmacySupplyType ActPharmacySupplyType
MedicationDispense.dosageInstruction.additionalInstructions Codes identifying additional instructions such as "take with water" or "avoid operating heavy machinery" Unknown No details provided yet
MedicationDispense.dispense.dosage.asNeeded[x] MedicationDispense.dosageInstruction.asNeeded[x] A coded concept identifying the pre-condition precondition that should hold be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up", flare-up" etc. Unknown No details provided yet
MedicationDispense.dosageInstruction.site[x] A coded concept describing the site location the medicine enters into or onto the body Example http://hl7.org/fhir/vs/approach-site-codes SNOMED CT Anatomical Structure for Administration Site Codes
MedicationDispense.dosageInstruction.route A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. subject Example http://hl7.org/fhir/vs/route-codes SNOMED CT Route Codes
MedicationDispense.dispense.dosage.method MedicationDispense.dosageInstruction.method A coded concept describing the technique by which the medicine is administered Example Unknown http://hl7.org/fhir/vs/administration-method-codes No details provided yet
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 ActSubstanceAdminSubstitutionCode
MedicationDispense.substitution.reason A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed. prescribed Example http://hl7.org/fhir/v3/vs/SubstanceAdminSubstitutionReason SubstanceAdminSubstitutionReason

4.11.4.2 4.15.4.2 Constraints

  • Inv-1 mdd-1 : On MedicationDispense.dispense: whenHandedOver cannot be before whenPrepared (xpath on f:MedicationDispense/f:dispense: (xpath: not(exists(f:whenHandedOver/@value)) or not(exists(f:whenPrepared/@value)) or ( f:whenHandedOver/@value >= f:whenPrepared/@value) )

4.11.5 4.15.5 Search Parameters

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

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