{
  "resourceType": "StructureDefinition",
  "id": "profile-medicationdispense",
  "url": "http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-medicationdispense",
  "version": "1.1.2",
  "name": "MedicationDispenseProfile",
  "title": "MedicationDispense Profile",
  "status": "draft",
  "date": "2026-01-09",
  "publisher": "HL7 Canada - FHIR Implementation Work Group",
  "contact": [
    {
      "telecom": [
        {
          "system": "url",
          "value": "https://infocentral.infoway-inforoute.ca/en/collaboration/wg/fhir-implementations"
        }
      ]
    }
  ],
  "description": "Proposed constraints and extensions on the MedicationDispense resource.  Generated as a first step toward creating a set of Canadian Baseline FHIR profiles.",
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "urn:iso:std:iso:3166",
          "code": "CA"
        }
      ]
    }
  ],
  "fhirVersion": "4.0.1",
  "mapping": [
    {
      "identity": "workflow",
      "uri": "http://hl7.org/fhir/workflow",
      "name": "Workflow Pattern"
    },
    {
      "identity": "rim",
      "uri": "http://hl7.org/v3",
      "name": "RIM Mapping"
    },
    {
      "identity": "w5",
      "uri": "http://hl7.org/fhir/fivews",
      "name": "FiveWs Pattern Mapping"
    },
    {
      "identity": "rx-dispense-rmim",
      "uri": "http://www.hl7.org/v3/PORX_RM020070UV",
      "name": "V3 Pharmacy Dispense RMIM"
    },
    {
      "identity": "v2",
      "uri": "http://hl7.org/v2",
      "name": "HL7 v2 Mapping"
    }
  ],
  "kind": "resource",
  "abstract": false,
  "type": "MedicationDispense",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/MedicationDispense",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "MedicationDispense",
        "path": "MedicationDispense",
        "short": "MedicationDispense Profile",
        "definition": "The Canadian Baseline MedicationDispense Profile is based upon the core FHIR MedicationDispense Resource"
      },
      {
        "id": "MedicationDispense.extension",
        "path": "MedicationDispense.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        }
      },
      {
        "id": "MedicationDispense.extension:renderedDosageInstruction",
        "path": "MedicationDispense.extension",
        "sliceName": "renderedDosageInstruction",
        "short": "Socialized Optional Extension: PrescribeIT renderedDosageInstruction",
        "definition": "Provides a complete text rendering of dosageInstruction lines for an order or dispense (separate from the rendering of the overall resource instance)",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "http://prescribeit.ca/fhir/StructureDefinition/ext-medication-rendered-dosage"
            ]
          }
        ]
      },
      {
        "id": "MedicationDispense.extension:quantityRemaining",
        "path": "MedicationDispense.extension",
        "sliceName": "quantityRemaining",
        "short": "Socialized Optional Extension: PrescribeIT quantityRemaining",
        "definition": "The total authorized quantity outstanding after the fill issued as part of this dispense record",
        "comment": "In R5, an equivalent extension is put forth in the base FHIR specification - R5 implementors are encouraged to review: http://hl7.org/fhir/StructureDefinition/medicationdispense-quantityRemaining",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "http://prescribeit.ca/fhir/StructureDefinition/ext-dispense-quantity-remaining"
            ]
          }
        ]
      },
      {
        "id": "MedicationDispense.partOf",
        "path": "MedicationDispense.partOf",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-procedure"
            ]
          }
        ]
      },
      {
        "id": "MedicationDispense.medication[x]",
        "path": "MedicationDispense.medication[x]",
        "type": [
          {
            "code": "CodeableConcept"
          },
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-medication"
            ]
          }
        ],
        "example": [
          {
            "label": "DIN",
            "valueCodeableConcept": {
              "coding": [
                {
                  "system": "https://fhir.infoway-inforoute.ca/ValueSet/CA-HC-DIN"
                }
              ]
            }
          },
          {
            "label": "NPN",
            "valueCodeableConcept": {
              "coding": [
                {
                  "system": "https://fhir.infoway-inforoute.ca/ValueSet/CA-HC-NPN"
                }
              ]
            }
          },
          {
            "label": "CCDD",
            "valueCodeableConcept": {
              "coding": [
                {
                  "system": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct"
                }
              ]
            }
          },
          {
            "label": "SNOMED CT (Medications) - IPS",
            "valueCodeableConcept": {
              "coding": [
                {
                  "system": "http://hl7.org/fhir/uv/ips/ValueSet/medication-snomed-uv-ips"
                }
              ]
            }
          },
          {
            "label": "WHO ATC IPS",
            "valueCodeableConcept": {
              "coding": [
                {
                  "system": "http://hl7.org/fhir/uv/ips/ValueSet/whoatc-uv-ips"
                }
              ]
            }
          }
        ],
        "binding": {
          "strength": "preferred",
          "description": "TBD. This is a placeholder for a comprehensive valueset, consisting of all Manufactured Product (MP), Non-proprietary Therapeutic Product (NTP) and Therapeutic Moiety (TM) codes, which would be created and maintained by Canada Health Infoway. Medicinal products for prescribing and dispensing in Canada. The content of this subset only contains commonly used medicinal products that are available for prescribing and dispensing in Canada. This content will expand to include all human medicinal products over time.",
          "valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct"
        }
      },
      {
        "id": "MedicationDispense.subject",
        "path": "MedicationDispense.subject",
        "min": 1,
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-patient"
            ]
          }
        ]
      },
      {
        "id": "MedicationDispense.context",
        "path": "MedicationDispense.context",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-encounter",
              "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
            ]
          }
        ]
      },
      {
        "id": "MedicationDispense.performer.actor",
        "path": "MedicationDispense.performer.actor",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitioner",
              "http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitionerrole",
              "http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-organization",
              "http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-patient",
              "http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-device",
              "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
            ]
          }
        ]
      },
      {
        "id": "MedicationDispense.location",
        "path": "MedicationDispense.location",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-location"
            ]
          }
        ]
      },
      {
        "id": "MedicationDispense.authorizingPrescription",
        "path": "MedicationDispense.authorizingPrescription",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-medicationrequest"
            ]
          }
        ]
      },
      {
        "id": "MedicationDispense.destination",
        "path": "MedicationDispense.destination",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-location"
            ]
          }
        ]
      },
      {
        "id": "MedicationDispense.receiver",
        "path": "MedicationDispense.receiver",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-patient",
              "http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitioner"
            ]
          }
        ]
      },
      {
        "id": "MedicationDispense.dosageInstruction.extension",
        "path": "MedicationDispense.dosageInstruction.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        }
      },
      {
        "id": "MedicationDispense.dosageInstruction.extension:instructionRelationship",
        "path": "MedicationDispense.dosageInstruction.extension",
        "sliceName": "instructionRelationship",
        "short": "Socialized Optional Extension: PrescribeIT dosageInstruction Relationship",
        "definition": "Indicates how the timing of this dosage instruction relates to the preceding dosage instruction. Specifically, is it concurrent (AND) or sequential (THEN).",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "http://prescribeit.ca/fhir/StructureDefinition/ext-medicationorder-dosageinstruction-relationship"
            ]
          }
        ]
      },
      {
        "id": "MedicationDispense.substitution.responsibleParty",
        "path": "MedicationDispense.substitution.responsibleParty",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitioner",
              "http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitionerrole"
            ]
          }
        ]
      }
    ]
  }
}