Profile on MedicationDispense representing the e-resept messages "M6 Utleveringgsrapport" and "M8 Utleveringsrapport fastlege".
Most of the attributes of the Norwegian Utlevering datamodel are represented in extensions:
| FHIR | Extension ! Resept | |
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| dispenseinfo | sfm-dispenseinfo | M6:Utlevering |
| intervention | SfmIntervention | M6:Utlevering/intervensjon |
| SfmMedicationDispense (MedicationDispense) | I | MedicationDispense | There are no (further) constraints on this element Element idMedicationDispense Dispensing a medication to a named patient DefinitionIndicates 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.
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| id | Σ | 0..1 | id | There are no (further) constraints on this element Element idMedicationDispense.id Logical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
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| meta | Σ | 0..1 | Meta | There are no (further) constraints on this element Element idMedicationDispense.meta Metadata about the resource DefinitionThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
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| implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idMedicationDispense.implicitRules A set of rules under which this content was created DefinitionA reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
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| language | 0..1 | codeBinding | There are no (further) constraints on this element Element idMedicationDispense.language Language of the resource content DefinitionThe base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language.
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| text | 0..1 | Narrative | There are no (further) constraints on this element Element idMedicationDispense.text Text summary of the resource, for human interpretation Alternate namesnarrative, html, xhtml, display DefinitionA human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
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| contained | 0..* | Resource | There are no (further) constraints on this element Element idMedicationDispense.contained Contained, inline Resources Alternate namesinline resources, anonymous resources, contained resources DefinitionThese resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
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| extension | I | 0..* | Extension | Element idMedicationDispense.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| dispenseinfo | I | 0..1 | Extension(Complex) | Element idMedicationDispense.extension:dispenseinfo Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Complex) Extension URLhttp://ehelse.no/fhir/StructureDefinition/sfm-dispenseinfo Constraints
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| intervention | S I | 0..* | Extension(Complex) | Element idMedicationDispense.extension:intervention Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Complex) Extension URLhttp://ehelse.no/fhir/StructureDefinition/sfm-Intervention Constraints
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| modifierExtension | ?! I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationDispense.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| identifier | 0..* | Identifier | Element idMedicationDispense.identifier External identifier DefinitionIdentifiers associated with this Medication Dispense that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server. M10-id will be communicated as identifier. This is a business identifier, not a resource identifier.
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| partOf | I | 0..* | Reference(Procedure) | There are no (further) constraints on this element Element idMedicationDispense.partOf Event that dispense is part of DefinitionThe procedure that trigger the dispense. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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| status | S Σ ?! | 1..1 | codeBinding | Element idMedicationDispense.status preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | unknown DefinitionA code specifying the state of the set of dispense events. SFM will allways use "completed" since it is confirmed by pharmacy. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. A coded concept specifying the state of the dispense event.
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| statusReason[x] | 0..1 | There are no (further) constraints on this element Element idMedicationDispense.statusReason[x] Why a dispense was not performed DefinitionIndicates the reason why a dispense was not performed. A code describing why a dispense was not performed.
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| statusReasonCodeableConcept | CodeableConcept | There are no (further) constraints on this element Data type | ||
| statusReasonReference | Reference(DetectedIssue) | There are no (further) constraints on this element Data type | ||
| category | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idMedicationDispense.category Type of medication dispense DefinitionIndicates the type of medication dispense (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)). The category can be used to include where the medication is expected to be consumed or other types of dispenses. Invariants can be used to bind to different value sets when profiling to bind. A code describing where the dispensed medication is expected to be consumed or administered.
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| medication[x] | S Σ | 1..1 | There are no (further) constraints on this element Element idMedicationDispense.medication[x] What medication was supplied DefinitionIdentifies 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. If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource.
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| medicationReference | Reference(SfmMedication | SfmMagistrellMedication) | Data type | ||
| subject | S Σ I | 0..1 | Reference(Group | sfm-Patient) | Element idMedicationDispense.subject Who the dispense is for DefinitionA link to a resource representing the person or the group to whom the medication will be given. SubstanceAdministration->subject->Patient. Reference(Group | sfm-Patient) Constraints
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| context | I | 0..1 | Reference(Encounter | EpisodeOfCare) | There are no (further) constraints on this element Element idMedicationDispense.context Encounter / Episode associated with event DefinitionThe encounter or episode of care that establishes the context for this event. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Encounter | EpisodeOfCare) Constraints
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| supportingInformation | I | 0..* | Reference(Resource) | There are no (further) constraints on this element Element idMedicationDispense.supportingInformation Information that supports the dispensing of the medication DefinitionAdditional information that supports the medication being dispensed. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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| performer | S | 0..* | BackboneElement | There are no (further) constraints on this element Element idMedicationDispense.performer Who performed event DefinitionIndicates who or what performed the event.
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| id | 0..1 | There are no (further) constraints on this element Element idMedicationDispense.performer.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationDispense.performer.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationDispense.performer.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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| function | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationDispense.performer.function Who performed the dispense and what they did DefinitionDistinguishes the type of performer in the dispense. For example, date enterer, packager, final checker. Allows disambiguation of the types of involvement of different performers. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. A code describing the role an individual played in dispensing a medication.
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| actor | I | 1..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson) | Element idMedicationDispense.performer.actor Individual who was performing DefinitionThe pharmacy that delivered dispensed the medication. Use sfm-Organization References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson) Constraints
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| location | I | 0..1 | Reference(Location) | There are no (further) constraints on this element Element idMedicationDispense.location Where the dispense occurred DefinitionThe principal physical location where the dispense was performed. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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| authorizingPrescription | S I | 0..* | Reference(MedicationRequest | SfmMedicationStatement) | Element idMedicationDispense.authorizingPrescription Medication order that authorizes the dispense DefinitionIndicates the medication order that is being dispensed against. Maps to basedOn in Event logical model. Reference(MedicationRequest | SfmMedicationStatement) Constraints
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| type | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationDispense.type Trial fill, partial fill, emergency fill, etc. DefinitionIndicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.
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| quantity | S I | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element idMedicationDispense.quantity Amount dispensed DefinitionThe amount of medication that has been dispensed. Includes unit of measure. The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
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| daysSupply | I | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element idMedicationDispense.daysSupply Amount of medication expressed as a timing amount DefinitionThe amount of medication expressed as a timing amount. The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
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| whenPrepared | Σ | 0..1 | dateTime | There are no (further) constraints on this element Element idMedicationDispense.whenPrepared When product was packaged and reviewed DefinitionThe time when the dispensed product was packaged and reviewed.
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| whenHandedOver | S | 0..1 | dateTime | There are no (further) constraints on this element Element idMedicationDispense.whenHandedOver When product was given out DefinitionThe time the dispensed product was provided to the patient or their representative.
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| destination | I | 0..1 | Reference(Location) | There are no (further) constraints on this element Element idMedicationDispense.destination Where the medication was sent DefinitionIdentification of the facility/location where the medication was shipped to, as part of the dispense event. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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| receiver | I | 0..* | Reference(Patient | Practitioner) | There are no (further) constraints on this element Element idMedicationDispense.receiver Who collected the medication DefinitionIdentifies 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. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Patient | Practitioner) Constraints
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| note | 0..* | Annotation | There are no (further) constraints on this element Element idMedicationDispense.note Information about the dispense DefinitionExtra information about the dispense that could not be conveyed in the other attributes. For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).
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| dosageInstruction | S | 0..* | Dosage | There are no (further) constraints on this element Element idMedicationDispense.dosageInstruction How the medication is to be used by the patient or administered by the caregiver DefinitionIndicates how the medication is to be used by the patient. When the dose or rate is intended to change over the entire administration period (e.g. Tapering dose prescriptions), multiple instances of dosage instructions will need to be supplied to convey the different doses/rates. The pharmacist reviews the medication order prior to dispense and updates the dosageInstruction based on the actual product being dispensed.
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| substitution | S | 0..1 | BackboneElement | There are no (further) constraints on this element Element idMedicationDispense.substitution Whether a substitution was performed on the dispense DefinitionIndicates 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. If nothing is specified, substitution was not done.
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| id | 0..1 | There are no (further) constraints on this element Element idMedicationDispense.substitution.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationDispense.substitution.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationDispense.substitution.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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| wasSubstituted | 1..1 | boolean | There are no (further) constraints on this element Element idMedicationDispense.substitution.wasSubstituted Whether a substitution was or was not performed on the dispense DefinitionTrue if the dispenser dispensed a different drug or product from what was prescribed.
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| type | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationDispense.substitution.type Code signifying whether a different drug was dispensed from what was prescribed DefinitionA code signifying whether a different drug was dispensed from what was prescribed. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription.
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| reason | 0..* | CodeableConcept | There are no (further) constraints on this element Element idMedicationDispense.substitution.reason Why was substitution made DefinitionIndicates the reason for the substitution (or lack of substitution) from what was prescribed. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
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| responsibleParty | I | 0..* | Reference(Practitioner | PractitionerRole) | There are no (further) constraints on this element Element idMedicationDispense.substitution.responsibleParty Who is responsible for the substitution DefinitionThe person or organization that has primary responsibility for the substitution. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Practitioner | PractitionerRole) Constraints
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| detectedIssue | I | 0..* | Reference(DetectedIssue) | There are no (further) constraints on this element Element idMedicationDispense.detectedIssue Clinical issue with action Alternate namesContraindication, Drug Utilization Review (DUR), Alert DefinitionIndicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. drug-drug interaction, duplicate therapy, dosage alert etc. This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue.
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| eventHistory | I | 0..* | Reference(Provenance) | There are no (further) constraints on this element Element idMedicationDispense.eventHistory A list of relevant lifecycle events DefinitionA summary of the events of interest that have occurred, such as when the dispense was verified. This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).
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