Page Status: updated 2024-10-28

NLLMedicationDispense (MedicationDispense)

Page index

Introduction

The MedicationDispense resource, shown in the profile NLLMedicationDispense, represents a dispense of medication or medical consumable at a pharmacy. The profile NLLMedicationDispense represents the normal scenario, in which the prescription has been registered in the Swedish National Medication List prior to dispensing.

Regarding information about how the "must support"-property is used in the Swedish National MedicationList, please refer to the page Resources

Overview

idS Σ0..1string
id0..1string
extensionI0..*Extension
versionIdS Σ0..1id
lastUpdatedΣ0..1instant
sourceΣ0..1uri
profileΣ0..*canonical(StructureDefinition)
id0..1string
extensionI0..*Extension
systemS Σ0..1uri
versionS Σ0..1string
codeS Σ0..1code
displayΣ0..1string
userSelectedΣ0..1boolean
tagΣ0..*Coding
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..*Resource
nllNumberOfPackagesDispensedS I0..1Extension(positiveInt)
nllActorDispatchIdS I1..1Extension(string)
nllDispatchIdS I0..1Extension(string)
nllBenefitChoiceCodeS I1..1Extension(code)Binding
nllDispatchRowNoS I1..1Extension(decimal)
nllDeductedQuantityS I0..1Extension(decimal)
nllCompletePrescriptionChoiceS I0..1Extension(code)Binding
id0..1string
id0..1string
extensionI0..*Extension
url1..1uriFixed Value
valueDateTimedateTime
id0..1string
extensionI0..*Extension
url1..1uriFixed Value
valueStringstring
id0..1string
extensionI0..*Extension
url1..1uriFixed Value
valueBase64Binarybase64Binary
valueBooleanboolean
valueCanonicalcanonical()
valueCodecode
valueDatedate
valueDateTimedateTime
valueDecimaldecimal
valueIdid
valueInstantinstant
valueIntegerinteger
valueMarkdownmarkdown
valueOidoid
valuePositiveIntpositiveInt
valueStringstring
valueTimetime
valueUnsignedIntunsignedInt
valueUriuri
valueUrlurl
valueUuiduuid
valueAddressAddress
valueAgeAge
valueAnnotationAnnotation
valueAttachmentAttachment
valueCodeableConceptCodeableConcept
valueCodingCoding
valueContactPointContactPoint
valueCountCount
valueDistanceDistance
valueDurationDuration
valueHumanNameHumanName
valueIdentifierIdentifier
valueMoneyMoney
valuePeriodPeriod
valueQuantityQuantity
valueRangeRange
valueRatioRatio
valueSampledDataSampledData
valueSignatureSignature
valueTimingTiming
valueContactDetailContactDetail
valueContributorContributor
valueDataRequirementDataRequirement
valueExpressionExpression
valueParameterDefinitionParameterDefinition
valueRelatedArtifactRelatedArtifact
valueTriggerDefinitionTriggerDefinition
valueUsageContextUsageContext
valueDosageDosage
valueMetaMeta
valueReferenceReference()
url1..1uriFixed Value
modifierExtension?! I0..*Extension
identifier0..*Identifier
partOf0..*Reference(Procedure)
statusS Σ ?!1..1codeBinding
statusReasonCodeableConceptCodeableConcept
statusReasonReferenceReference(DetectedIssue)
category0..1CodeableConceptBinding
id0..1string
extensionI0..*Extension
id0..1string
extensionI0..*Extension
systemS Σ1..1uriFixed Value
versionΣ0..1string
codeS Σ1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
id0..1string
extensionI0..*Extension
systemS Σ1..1uriFixed Value
versionΣ0..1string
codeS Σ1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
id0..1string
extensionI0..*Extension
systemS Σ1..1uriFixed Value
versionΣ0..1string
codeS Σ1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
subjectΣ0..1Reference(Patient | Group)
context0..1Reference(Encounter | EpisodeOfCare)
supportingInformation0..*Reference(Resource)
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
function0..1CodeableConcept
actor1..1Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson)
location0..1Reference(Location)
authorizingPrescriptionS1..1Reference(NLLMedicationRequest)
id0..1string
extensionI0..*Extension
id0..1string
extensionI0..*Extension
systemS Σ0..1uri
versionS Σ0..1string
codeS Σ1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
id0..1string
extensionI0..*Extension
valueS Σ1..1decimal
comparatorΣ ?!0..0codeBinding
unitΣ0..1string
systemΣ I0..1uri
codeΣ0..1code
daysSupply0..1SimpleQuantity
whenPreparedΣ0..1dateTime
whenHandedOverS0..1dateTime
destination0..1Reference(Location)
receiver0..*Reference(Patient | Practitioner)
id0..1string
extensionI0..*Extension
authorStringstring
authorReferenceReference(Practitioner | Patient | RelatedPerson | Organization)
timeΣ0..1dateTime
textS Σ1..1markdown
id0..1string
nllObservandumDoseS I0..1Extension(boolean)
nllAdministeringInstructionS I0..1Extension(string)
id0..1string
extensionI0..*Extension
url1..1uriFixed Value
id0..1string
extensionI0..*Extension
id0..1string
extensionI0..*Extension
systemS Σ0..1uri
versionS Σ0..1string
codeS Σ1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
textS Σ0..1string
nllSubSequenceS I0..1Extension(integer)
nllDosageTypeS I0..1Extension(code)
id0..1string
extensionI0..*Extension
url1..1uriFixed Value
id0..1string
extensionI0..*Extension
id0..1string
extensionI0..*Extension
systemS Σ0..1uri
versionS Σ0..1string
codeS Σ1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
textS Σ0..1string
modifierExtensionΣ ?! I0..*Extension
sequenceS Σ1..1integer
textS Σ0..1string
id0..1string
extensionI0..*Extension
codingΣ0..*Coding
textS Σ0..1string
patientInstructionS Σ1..1string
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
eventΣ0..*dateTime
id0..1string
nllSubSequenceDurationS I0..1Extension(Quantity)
id0..1string
extensionI0..*Extension
valueS Σ1..1decimal
comparatorΣ ?!0..1codeBinding
unitΣ0..1string
systemS Σ I0..1uri
codeS Σ1..1codeBindingFixed Value
id0..1string
extensionI0..*Extension
id0..1string
extensionI0..*Extension
valueS Σ1..1decimal
comparatorΣ ?!0..0codeBinding
unitΣ0..1string
systemS Σ I0..1uri
codeS Σ1..1codeBindingFixed Value
id0..1string
extensionI0..*Extension
valueS Σ1..1decimal
comparatorΣ ?!0..0codeBinding
unitΣ0..1string
systemS Σ I0..1uri
codeS Σ1..1codeBindingFixed Value
countS Σ0..1positiveInt
countMaxΣ0..1positiveInt
durationS Σ0..1decimal
durationMaxΣ0..1decimal
durationUnitS Σ0..1codeBinding
frequencyS Σ0..1positiveInt
frequencyMaxS Σ0..1positiveInt
periodS Σ0..1decimal
periodMaxS Σ0..1decimal
periodUnitS Σ0..1codeBinding
dayOfWeekS Σ0..*codeBinding
timeOfDayS Σ0..*time
whenS Σ0..*codeBinding
offsetΣ0..1unsignedInt
codeΣ0..1CodeableConceptBinding
asNeededBooleanboolean
id0..1string
extensionI0..*Extension
id0..1string
extensionI0..*Extension
systemS Σ0..1uri
versionS Σ0..1string
codeS Σ1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
textS Σ0..1string
id0..1string
extensionI0..*Extension
id0..1string
extensionI0..*Extension
systemS Σ0..1uri
versionS Σ0..1string
codeS Σ1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
textS Σ0..1string
id0..1string
extensionI0..*Extension
id0..1string
extensionI0..*Extension
systemS Σ0..1uri
versionS Σ0..1string
codeS Σ1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
textS Σ0..1string
id0..1string
extensionI0..*Extension
typeΣ0..1CodeableConcept
id0..1string
extensionI0..*Extension
id0..1string
extensionI0..*Extension
valueS Σ1..1decimal
comparatorΣ ?!0..0codeBinding
unitΣ0..1string
systemS Σ I0..1uri
codeS Σ1..1code
id0..1string
extensionI0..*Extension
valueS Σ1..1decimal
comparatorΣ ?!0..0codeBinding
unitΣ0..1string
systemS Σ I0..1uri
codeS Σ1..1code
id0..1string
extensionI0..*Extension
valueS Σ0..1decimal
comparatorΣ ?!0..0codeBinding
unitΣ0..1string
systemS Σ I0..1uri
codeS Σ0..1code
id0..1string
extensionI0..*Extension
valueS Σ0..1decimal
comparatorΣ ?!0..0codeBinding
unitΣ0..1string
systemS Σ I0..1uri
codeS Σ1..1code
id0..1string
extensionI0..*Extension
id0..1string
extensionI0..*Extension
valueS Σ0..1decimal
comparatorΣ ?!0..1codeBinding
unitΣ0..1string
systemS Σ I0..1uri
codeS Σ1..1code
id0..1string
extensionI0..*Extension
valueS Σ0..1decimalFixed Value
comparatorΣ ?!0..1codeBinding
unitΣ0..1string
systemS Σ I0..1uriFixed Value
codeS Σ0..1codeFixed Value
maxDosePerAdministrationΣ0..1SimpleQuantity
maxDosePerLifetimeΣ0..1SimpleQuantity
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
wasSubstitutedS1..1boolean
type0..1CodeableConcept
reason0..*CodeableConcept
responsibleParty0..*Reference(Practitioner | PractitionerRole)
detectedIssueS0..*Reference(NLLDetectedIssue)
eventHistory0..*Reference(Provenance)
MedicationDispense
DefinitionA medication dispense to a specific patient authorzied by a prescription in electronic format. Medication dispenses authorized by paper based prescriptions must use the profile NLLDispensePaperPrescription.
Cardinality0...*
Invariants
  • dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.empty()
  • dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
    contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
  • dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
  • dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
    contained.meta.security.empty()
  • dom-6: A resource should have narrative for robust management
    text.`div`.exists()
  • mdd-1: whenHandedOver cannot be before whenPrepared
    whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared
Mappings
  • rim: Entity. Role, or Act
  • workflow: Event
  • rim: Supply[moodCode=EVN]
MedicationDispense.id
DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality0...1
Typestring
Must SupportTrue
SummaryTrue
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation. This id is identified by the URI http://electronichealth.se/identifier/nllmedicationdispenseid in documentation and external systems.

Mappings
  • EHM: Logiskt id för uttag
MedicationDispense.meta
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.
Cardinality0...1
TypeMeta
Must SupportTrue
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
MedicationDispense.meta.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.meta.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.meta.versionId
DefinitionThe version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.
Cardinality0...1
Typeid
Must SupportTrue
SummaryTrue
Comments

The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • EHM: Uttagsversion
MedicationDispense.meta.lastUpdated
DefinitionWhen the resource last changed - e.g. when the version changed.
Cardinality0...1
Typeinstant
SummaryTrue
Comments

This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
MedicationDispense.meta.source
DefinitionA uri that identifies the source system of the resource. This provides a minimal amount of [Provenance](provenance.html#) information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.
Cardinality0...1
Typeuri
SummaryTrue
Comments

In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
MedicationDispense.meta.profile
DefinitionA list of profiles (references to [StructureDefinition](structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](structuredefinition-definitions.html#StructureDefinition.url).
Cardinality0...*
Typecanonical(StructureDefinition)
SummaryTrue
Comments

It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
MedicationDispense.meta.security
DefinitionSecurity labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.
Cardinality0...*
TypeCoding
Binding

Security Labels from the Healthcare Privacy and Security Classification System.

security-labels (extensible)
Must SupportTrue
SummaryTrue
Comments

The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
MedicationDispense.meta.security.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.meta.security.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.meta.security.system
DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Cardinality0...1
Typeuri
Must SupportTrue
SummaryTrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
MedicationDispense.meta.security.version
DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality0...1
Typestring
Must SupportTrue
SummaryTrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
MedicationDispense.meta.security.code
DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality0...1
Typecode
Must SupportTrue
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
MedicationDispense.meta.security.display
DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Cardinality0...1
Typestring
SummaryTrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
MedicationDispense.meta.security.userSelected
DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Cardinality0...1
Typeboolean
SummaryTrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
MedicationDispense.meta.tag
DefinitionTags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.
Cardinality0...*
TypeCoding
Binding

Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

CommonTags (example)
SummaryTrue
Comments

The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
MedicationDispense.implicitRules
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.
Cardinality0...1
Typeuri
ModifierTrue
SummaryTrue
Comments

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
MedicationDispense.language
DefinitionThe base language in which the resource is written.
Cardinality0...1
Typecode
Binding

A human language.

CommonLanguages (preferred)
Comments

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).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
MedicationDispense.text
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.
Cardinality0...1
TypeNarrative
Aliasnarrative, html, xhtml, display
Comments

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: Act.text?
MedicationDispense.contained
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.
Cardinality0...*
TypeResource
Aliasinline resources, anonymous resources, contained resources
Comments

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.

Mappings
  • rim: N/A
MedicationDispense.extension
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.
Cardinality3...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
MedicationDispense.extension:nllNumberOfPackagesDispensed
DefinitionThe number of packages that were included in the dispense. Shall not be set for dose dispensed dispenses.
Cardinality0...1
TypeExtension(positiveInt)
Must SupportTrue
Aliasextensions, user content
Comments

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
  • rim: n/a
  • EHM: Antal expedierade förpackningar
MedicationDispense.extension:nllActorDispatchId
DefinitionOptional Extension Element - found in all resources.
Cardinality1...1
TypeExtension(string)
Must SupportTrue
Aliasextensions, user content
Comments

Maximum string length: 12

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
  • rim: n/a
  • EHM: Aktörens expeditions-id
MedicationDispense.extension:nllDispatchId
DefinitionValue is treated as an integer, i.e the String can only contain numbers. May be entered by the pharmacy, otherwise it is calculated by the Swedish E-health Agency . The identifier of the dispatch in which the dispense was made.
Cardinality0...1
TypeExtension(string)
Must SupportTrue
Aliasextensions, user content
Comments

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
  • rim: n/a
  • EHM: Expeditions-id
MedicationDispense.extension:nllBenefitChoiceCode
DefinitionType of benefit for the dispense.
Cardinality1...1
TypeExtension(code)
Bindingbenefit-choices (required)
Must SupportTrue
Aliasextensions, user content
Comments

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
  • rim: n/a
  • EHM: Förmånsval
MedicationDispense.extension:nllDispatchRowNo
DefinitionUsed when communicationg an error or warning for a MedicationDispense within a dispatch. The DispatchRowNo (ExpeditionsRadNummer) uniquely identifies a MediationDispense within a dispatch.
Cardinality1...1
TypeExtension(decimal)
Must SupportTrue
Aliasextensions, user content
Comments

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
  • rim: n/a
  • EHM: Aktörens expeditionsradnummer
MedicationDispense.extension:nllDeductedQuantity
DefinitionThe quantity that is deducted form the prescription's remaining quantity. Only used if the deducted quantity should differ from the dispensed quantity.
Cardinality0...1
TypeExtension(decimal)
Must SupportTrue
Aliasextensions, user content
Comments

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
  • rim: n/a
  • EHM: Avräknad mängd
MedicationDispense.extension:nllCompletePrescriptionChoice
DefinitionOnly used for input. When 12% or less of the total quantity of the prescribed medication is left, the prescription will automatically be set to status "Completed". A pharmacist can make a descision to overrule the automatic rules by either choosing to set the prescription status to "Completed" or to keep the status "Active".
Cardinality0...1
TypeExtension(code)
Bindingcomplete-prescription-choices (required)
Must SupportTrue
Aliasextensions, user content
Comments

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
  • rim: n/a
  • EHM: Beslut slutexpediering
MedicationDispense.extension:nllDispenseCrediting
DefinitionCrediting details for a dispense
Cardinality0...1
TypeExtension(Complex)
Must SupportTrue
Aliasextensions, user content
Comments

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
  • rim: n/a
MedicationDispense.extension:nllDispenseCrediting.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.extension:nllDispenseCrediting.extension
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.
Cardinality2...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.extension:nllDispenseCrediting.extension:creditDate
DefinitionThe date and time when the dispense was credited.
Cardinality1...1
TypeExtension
Must SupportTrue
Aliasextensions, user content
Comments

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • EHM: Krediteringstidpunkt
MedicationDispense.extension:nllDispenseCrediting.extension:creditDate.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.extension:nllDispenseCrediting.extension:creditDate.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.extension:nllDispenseCrediting.extension:creditDate.url
DefinitionSource of the definition for the extension code - a logical name or a URL.
Cardinality1...1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value

creditDate

Mappings
  • rim: N/A
MedicationDispense.extension:nllDispenseCrediting.extension:creditDate.value[x]
DefinitionValue of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).
Cardinality1...1
TypedateTime
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
MedicationDispense.extension:nllDispenseCrediting.extension:creditDispatchId
DefinitionThe id of the crediting dispatch.
Cardinality1...1
TypeExtension
Must SupportTrue
Aliasextensions, user content
Comments

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • EHM: Krediterande expeditions-id
MedicationDispense.extension:nllDispenseCrediting.extension:creditDispatchId.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.extension:nllDispenseCrediting.extension:creditDispatchId.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.extension:nllDispenseCrediting.extension:creditDispatchId.url
DefinitionSource of the definition for the extension code - a logical name or a URL.
Cardinality1...1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value

creditDispatchId

Mappings
  • rim: N/A
MedicationDispense.extension:nllDispenseCrediting.extension:creditDispatchId.value[x]
DefinitionValue of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).
Cardinality1...1
Typestring
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
MedicationDispense.extension:nllDispenseCrediting.extension:creditDispatchRowNo
DefinitionNB! New attribute planned in release 21.9. Display only. The row number of the crediting dispatch. Identifier for a dispense within a credited dispatch. The crediting row number is submitted in the attribute 'MedicationDispense.extension:nllDispatchRowNo', but will be displayed in 'creditDispatchRowNo'.
Cardinality0...1
TypeExtension
Must SupportTrue
Aliasextensions, user content
Comments

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • EHM: Aktörens krediterande expeditionsradnummer
MedicationDispense.extension:nllDispenseCrediting.extension:creditDispatchRowNo.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.extension:nllDispenseCrediting.extension:creditDispatchRowNo.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.extension:nllDispenseCrediting.extension:creditDispatchRowNo.url
DefinitionSource of the definition for the extension code - a logical name or a URL.
Cardinality1...1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value

creditDispatchRowNo

Mappings
  • rim: N/A
MedicationDispense.extension:nllDispenseCrediting.extension:creditDispatchRowNo.value[x]
DefinitionValue of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).
Cardinality0...1
Typebase64Binary
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
MedicationDispense.extension:nllDispenseCrediting.url
DefinitionSource of the definition for the extension code - a logical name or a URL.
Cardinality1...1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value

http://electronichealth.se/fhir/StructureDefinition/NLLDispenseCrediting

Mappings
  • rim: N/A
MedicationDispense.extension:nllDispenseCrediting.value[x]
DefinitionValue of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).
Cardinality0...0
Typebase64Binary
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
MedicationDispense.modifierExtension
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).
Cardinality0...*
TypeExtension
ModifierTrue
Aliasextensions, user content
Requirements

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.

Comments

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
MedicationDispense.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.
Cardinality0...*
TypeIdentifier
Comments

This is a business identifier, not a resource identifier.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.identifier
  • w5: FiveWs.identifier
  • rim: .id
  • rx-dispense-rmim: CombinedMedicationDispense.id
MedicationDispense.partOf
DefinitionThe procedure that trigger the dispense.
Cardinality0...*
TypeReference(Procedure)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.partOf
  • rim: .outboundRelationship[typeCode=COMP]/target[classCode=PROC,moodCode=EVN]
MedicationDispense.status
DefinitionA code specifying the state of the set of dispense events.
Cardinality1...1
Typecode
Binding

A coded concept specifying the state of the dispense event.

medication-dispense-status (required)
Must SupportTrue
ModifierTrue
SummaryTrue
Comments

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.status
  • w5: FiveWs.status
  • rim: .statusCode
  • rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.statusCode
  • EHM: Uttagsstatus
MedicationDispense.statusReason[x]
DefinitionIndicates the reason why a dispense was not performed.
Cardinality0...1
TypeCodeableConcept
Binding

A code describing why a dispense was not performed.

MedicationDispense Status Reason Codes (example)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.statusReason
  • rim: .outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code="not done reason"].value
MedicationDispense.category
DefinitionIndicates the type of medication dispense (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)).
Cardinality0...1
TypeCodeableConcept
Binding

A code describing where the dispensed medication is expected to be consumed or administered.

MedicationDispense Category Codes (preferred)
Comments

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication dispense"].value
MedicationDispense.medication[x]
DefinitionIdentifies the medication or reimbursed consumable being dispensed. The codes used are Swedish NplId for medical products, NplPackId for medicine packages and Varunr for reimbursed consumables. For a medicine package, both the NplId and the NplPackId shall be provided. Varunr is not allowed to use when dispensing a medication. For a reimbursed consumable, only Varunr shall be provided.
Cardinality1...1
TypeCodeableConcept
Binding

A coded concept identifying which substance or product can be dispensed.

SNOMEDCTMedicationCodes (required)
Must SupportTrue
SummaryTrue
Comments

If more information is required, then the use of the medication resource is recommended.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.code
  • w5: FiveWs.what[x]
  • v2: RXD-2-Dispense/Give Code
  • rim: .participation[typeCode=PRD].role
  • rx-dispense-rmim: CombinedMedicationRequest.component1.AdministrationRequest.consumable
  • EHM: Expedierad artikel
MedicationDispense.medication[x].id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.medication[x].extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.medication[x].coding
DefinitionA reference to a code defined by a terminology system.
Cardinality1...*
TypeCoding
Must SupportTrue
SummaryTrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

SlicingUnordered, Open, by system(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
MedicationDispense.medication[x].coding:nplid
DefinitionA unique identifier of a medical product according to "Nationellt produktregister för läkemedel" provided by the Swedish Medical Products Agency (sv Läkemedelsverket)
Cardinality0...1
TypeCoding
Must SupportTrue
SummaryTrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  • EHM: NPL-id
MedicationDispense.medication[x].coding:nplid.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.medication[x].coding:nplid.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.medication[x].coding:nplid.system
DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Cardinality1...1
Typeuri
Must SupportTrue
SummaryTrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value

http://electronichealth.se/fhir/NamingSystem/nplid

Mappings
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
MedicationDispense.medication[x].coding:nplid.version
DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality0...1
Typestring
SummaryTrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
MedicationDispense.medication[x].coding:nplid.code
DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality1...1
Typecode
Must SupportTrue
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Comments

Maximum string length: 14

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
MedicationDispense.medication[x].coding:nplid.display
DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Cardinality0...1
Typestring
SummaryTrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
MedicationDispense.medication[x].coding:nplid.userSelected
DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Cardinality0...1
Typeboolean
SummaryTrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
MedicationDispense.medication[x].coding:nplpackid
DefinitionA unique identifier of a medical product package according to "Nationellt produktregister för läkemedel" provided by the Swedish Medical Products Agency (sv Läkemedelsverket).
Cardinality0...1
TypeCoding
Must SupportTrue
SummaryTrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  • EHM: NPL-pack-id
MedicationDispense.medication[x].coding:nplpackid.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.medication[x].coding:nplpackid.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.medication[x].coding:nplpackid.system
DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Cardinality1...1
Typeuri
Must SupportTrue
SummaryTrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value

http://electronichealth.se/fhir/NamingSystem/nplpackid

Mappings
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
MedicationDispense.medication[x].coding:nplpackid.version
DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality0...1
Typestring
SummaryTrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
MedicationDispense.medication[x].coding:nplpackid.code
DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality1...1
Typecode
Must SupportTrue
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Comments

Maximum string length: 14

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
MedicationDispense.medication[x].coding:nplpackid.display
DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Cardinality0...1
Typestring
SummaryTrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
MedicationDispense.medication[x].coding:nplpackid.userSelected
DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Cardinality0...1
Typeboolean
SummaryTrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
MedicationDispense.medication[x].coding:varunr
DefinitionA unique identifier of a medical consumable according to "Nationellt produktregister för läkemedel" provided by the Swedish Medical Products Agency (sv Läkemedelsverket) Also a non-unique identifier of a medical product package.
Cardinality0...1
TypeCoding
Must SupportTrue
SummaryTrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  • EHM: Varunummer
MedicationDispense.medication[x].coding:varunr.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.medication[x].coding:varunr.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.medication[x].coding:varunr.system
DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Cardinality1...1
Typeuri
Must SupportTrue
SummaryTrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value

http://electronichealth.se/fhir/NamingSystem/varunr

Mappings
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
MedicationDispense.medication[x].coding:varunr.version
DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality0...1
Typestring
SummaryTrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
MedicationDispense.medication[x].coding:varunr.code
DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality1...1
Typecode
Must SupportTrue
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Comments

Minimum string length: 6 Maximum string length: 6

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
MedicationDispense.medication[x].coding:varunr.display
DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Cardinality0...1
Typestring
SummaryTrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
MedicationDispense.medication[x].coding:varunr.userSelected
DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Cardinality0...1
Typeboolean
SummaryTrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
MedicationDispense.medication[x].text
DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Cardinality0...1
Typestring
SummaryTrue
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
MedicationDispense.subject
DefinitionA link to a resource representing the person or the group to whom the medication will be given.
Cardinality0...1
TypeReference(Patient | Group)
SummaryTrue
Comments

SubstanceAdministration->subject->Patient.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.subject
  • w5: FiveWs.subject[x]
  • v2: PID-3-Patient ID List
  • rim: .participation[typeCode=SBJ].role[classCode=PAT]
  • w5: FiveWs.subject
MedicationDispense.context
DefinitionThe encounter or episode of care that establishes the context for this event.
Cardinality0...1
TypeReference(Encounter | EpisodeOfCare)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.context
  • rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]
MedicationDispense.supportingInformation
DefinitionAdditional information that supports the medication being dispensed.
Cardinality0...*
TypeReference(Resource)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.context
  • rim: .outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]
MedicationDispense.performer
DefinitionIndicates who or what performed the event.
Cardinality0...*
TypeBackboneElement
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.performer
  • rim: .participation[typeCode=PRF]
MedicationDispense.performer.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.performer.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.performer.modifierExtension
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).
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Requirements

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.

Comments

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
MedicationDispense.performer.function
DefinitionDistinguishes the type of performer in the dispense. For example, date enterer, packager, final checker.
Cardinality0...1
TypeCodeableConcept
Binding

A code describing the role an individual played in dispensing a medication.

MedicationDispense Performer Function Codes (example)
Requirements

Allows disambiguation of the types of involvement of different performers.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: participation[typeCode=PRF].functionCode
MedicationDispense.performer.actor
DefinitionThe device, practitioner, etc. who performed the action. It should be assumed that the actor is the dispenser of the medication.
Cardinality1...1
TypeReference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.performer.actor
  • rim: .role
MedicationDispense.location
DefinitionThe principal physical location where the dispense was performed.
Cardinality0...1
TypeReference(Location)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .participation[typeCode=LOC].role
MedicationDispense.authorizingPrescription
DefinitionReference to the MedicationRequest that was dispatched. Note that authorizingprescription must include the version of the medication request. That is done by using the /_history/ suffix.
Cardinality1...1
TypeReference(NLLMedicationRequest)
Must SupportTrue
Comments

Maps to basedOn in Event logical model.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.basedOn
  • v2: ORC-2 Placer Order Number
  • rim: .outboundRelationship[typeCode=FLFS].target[moodCode=RQO]
  • rx-dispense-rmim: CombinedMedicationDispense.inFulfillmentOf
  • EHM: Förskrivningsversion
MedicationDispense.type
DefinitionType is used for specifing if the dispense was a "Standard packing fill" , "Trial fill" (startförpackning) or "Dose dispensed fill" in the Swedish National Medication List. (Trial fill is not used for dose dispensed fills).
Cardinality1...1
TypeCodeableConcept
Binding

Indicates the type of dispensing event that is performed, e.g. Standard packing fill, Trial fill or Dose dispense refill

dispense-types (required)
Must SupportTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: RXD-33-Dispense Type
  • rim: .code
  • rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.code
  • EHM: Uttagstyp
MedicationDispense.type.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.type.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.type.coding
DefinitionA reference to a code defined by a terminology system.
Cardinality1...1
TypeCoding
Must SupportTrue
SummaryTrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
MedicationDispense.type.coding.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.type.coding.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.type.coding.system
DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Cardinality0...1
Typeuri
Must SupportTrue
SummaryTrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
MedicationDispense.type.coding.version
DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality0...1
Typestring
Must SupportTrue
SummaryTrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
MedicationDispense.type.coding.code
DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality1...1
Typecode
Must SupportTrue
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
MedicationDispense.type.coding.display
DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Cardinality0...1
Typestring
SummaryTrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
MedicationDispense.type.coding.userSelected
DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Cardinality0...1
Typeboolean
SummaryTrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
MedicationDispense.type.text
DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Cardinality0...1
Typestring
SummaryTrue
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
MedicationDispense.quantity
DefinitionThe amount of the article that has been dispensed.
Cardinality0...1
TypeSimpleQuantity
Must SupportTrue
Comments

When dispensing an article (not for dose dispenses), this will be either set by the pharmacy or calculated based on the number of packages and the package size. <br> If complete packages are dispensed, the quantity is calculated by the Swedish eHealth Agency. In this scenarion only the number of packages should be entered (no quantity).<br> If only a part of a package is dispensed (sv bruten helförpackning), the pharmacy must enter both the quantity and the number of packages that was dispensed. <br>

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense Units.name of coding system
  • rim: .quantity
  • rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.quantity
  • EHM: Expedierad mängd
MedicationDispense.quantity.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.quantity.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.quantity.value
DefinitionThe value of the measured amount. The value includes an implicit precision in the presentation of the value.
Cardinality1...1
Typedecimal
Must SupportTrue
SummaryTrue
Requirements

Precision is handled implicitly in almost all cases of measurement.

Comments

The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: SN.2 / CQ - N/A
  • rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
MedicationDispense.quantity.comparator
DefinitionNot allowed to be used in this context
Cardinality0...0
Typecode
Binding

How the Quantity should be understood and represented.

QuantityComparator (required)
ModifierTrue
SummaryTrue
Requirements

Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: SN.1 / CQ.1
  • rim: IVL properties
MedicationDispense.quantity.unit
DefinitionA human-readable form of the unit.
Cardinality0...1
Typestring
SummaryTrue
Requirements

There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.unit
MedicationDispense.quantity.system
DefinitionThe identification of the system that provides the coded form of the unit.
Cardinality0...1
Typeuri
SummaryTrue
Requirements

Need to know the system that defines the coded form of the unit.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: CO.codeSystem, PQ.translation.codeSystem
MedicationDispense.quantity.code
DefinitionA computer processable form of the unit in some unit representation system.
Cardinality0...1
Typecode
SummaryTrue
Requirements

Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

Comments

The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.code, MO.currency, PQ.translation.code
MedicationDispense.daysSupply
DefinitionThe amount of medication expressed as a timing amount.
Cardinality0...1
TypeSimpleQuantity
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: TQ1.6 Timing/Quantity Segment Service Duration. Prior to v2.5, ORC.7.3 Common Order Segment / Quantity/Timing / Duration component. This is a formatted string, first character for the time unit (e.g., D=days), followed by the value. For example, “D14” represents “14 days supply” From v2.5 on, TQ1.6 Timing/Quantity Segment / Service Duration. This is a CQ data type (<Quantity (NM)> ^ <Units (CWE)>), thus for days supply, assuming the unit of measure is “days”, the numeric value is TQ1.6.1 (…|14^ For backwards compatibility, ORC.7 was permitted through v2.6. Both forms (field and segment) may be present in v2.5, v2.5.1, and v2.6
  • rim: effectiveUseTime
MedicationDispense.whenPrepared
DefinitionThe time when the dispensed product was packaged and reviewed.
Cardinality0...1
TypedateTime
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: RXD-3-Date/Time Dispensed
  • rim: .effectiveTime[xmi:type=IVL_TS].low
  • rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.effectiveTime
MedicationDispense.whenHandedOver
DefinitionThe time the dispensed product was provided to the patient or their representative.
Cardinality0...1
TypedateTime
Must SupportTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.occurrence[x]
  • v2: RXD-3-Date/Time Dispensed
  • rim: .effectiveTime[xmi:type=IVL_TS].high
  • rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.effectiveTime
  • EHM: Expeditionstidpunkt
MedicationDispense.destination
DefinitionIdentification of the facility/location where the medication was shipped to, as part of the dispense event.
Cardinality0...1
TypeReference(Location)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: RXD-13 Dispense-to Location; RXD-30 Dispense to Pharmacy; RXD-31 Dispense to Pharmacy Address
  • rim: .participation[typeCode=DST].role
  • rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.destination
MedicationDispense.receiver
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.
Cardinality0...*
TypeReference(Patient | Practitioner)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .participation[typeCode=RCV].role
  • rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.receiver
MedicationDispense.note
DefinitionThe pharmacists note about the dispense.
Cardinality0...1
TypeAnnotation
Must SupportTrue
Comments

Maximum string length: 1016

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.note
  • v2: RXD-9 Dispense Notes
  • rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=ACT,moodCode=EVN]
  • EHM: Uttagsnotering
MedicationDispense.note.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.note.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.note.author[x]
DefinitionThe individual responsible for making the annotation.
Cardinality0...1
TypeReference(Practitioner | Patient | RelatedPerson | Organization)
SummaryTrue
Comments

Organization is used when there's no need for specific attribution as to who made the comment.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: N/A
  • rim: Act.participant[typeCode=AUT].role
MedicationDispense.note.time
DefinitionIndicates when this particular annotation was made.
Cardinality0...1
TypedateTime
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: N/A
  • rim: Act.effectiveTime
MedicationDispense.note.text
DefinitionThe text of the annotation in markdown format.
Cardinality1...1
Typemarkdown
Must SupportTrue
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: N/A
  • rim: Act.text
MedicationDispense.dosageInstruction
DefinitionIndicates how the medication is/was taken or should be taken by the patient.
Cardinality0...*
TypeNLLDosage
Must SupportTrue
Comments

A medication dispense is always based/dispatched on a specific version of a medication request. <br> A dosage instruction must be provided of there is a unique dosage for the medication dispense which differs from the dosage instruction on the medication request version. <br> The dosage instruction on the medication request version is used as the valid dosage if no other dosage instruction is provided on the medication dispense. <br> If a new dosage instruction should be in effect for the current and following medication dispenses, the medication request needs to be updated before the medication dispense is made.<br> For a read-operation on a medication dispense, the dosage instruction must be read from the medication request version if there is no dosage instruction on the specific medication dispense resource.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]
  • rim: n/a
MedicationDispense.dosageInstruction.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.extension:nllObservandumDose
DefinitionIndicates that the prescriber has made a conscious choice where the dose exceeds what is recommended for the prescribed medication.
Cardinality0...1
TypeExtension(boolean)
Must SupportTrue
Aliasextensions, user content
Comments

NB! The same value must be provided in this element on each sequence / subsequence.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
  • EHM: Obs. överstiger rekommenderad dos
MedicationDispense.dosageInstruction.extension:nllAdministeringInstruction
DefinitionAdministration instructions put in terms that are comprehensible to the patient. This shall be generated from the structured administration information attributes.
Cardinality0...1
TypeExtension(string)
Must SupportTrue
Aliasextensions, user content
Comments

Maximum string length: 512 <br> NB! The same value must be provided in this element on each sequence / subsequence.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
  • EHM: Administreringsinstruktion
MedicationDispense.dosageInstruction.extension:nllMedicalDevice
DefinitionMedical device to use for administration.
Cardinality0...1
TypeExtension(CodeableConcept)
Must SupportTrue
Aliasextensions, user content
Requirements

If there is no appropriate coded value, then the code OTH=Other should be used together with the free text element "text”

Comments

NB! The same value must be provided in this element on each sequence / subsequence.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
  • EHM: Medicinteknisk produkt vid läkemedelsadministrering
MedicationDispense.dosageInstruction.extension:nllMedicalDevice.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.extension:nllMedicalDevice.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.extension:nllMedicalDevice.url
DefinitionSource of the definition for the extension code - a logical name or a URL.
Cardinality1...1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value

http://electronichealth.se/fhir/StructureDefinition/NLLMedicalDevice

Mappings
  • rim: N/A
MedicationDispense.dosageInstruction.extension:nllMedicalDevice.value[x]
DefinitionValue of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).
Cardinality1...1
TypeCodeableConcept
Must SupportTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
MedicationDispense.dosageInstruction.extension:nllMedicalDevice.value[x].id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.extension:nllMedicalDevice.value[x].extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.extension:nllMedicalDevice.value[x].coding
DefinitionA reference to a code defined by a terminology system.
Cardinality0...1
TypeCoding
Bindinghttp://electronichealth.se/fhir/ValueSet/nll-snomed-medical-device (required)
Must SupportTrue
SummaryTrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
MedicationDispense.dosageInstruction.extension:nllMedicalDevice.value[x].coding.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.extension:nllMedicalDevice.value[x].coding.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.extension:nllMedicalDevice.value[x].coding.system
DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Cardinality0...1
Typeuri
Must SupportTrue
SummaryTrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
MedicationDispense.dosageInstruction.extension:nllMedicalDevice.value[x].coding.version
DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality0...1
Typestring
Must SupportTrue
SummaryTrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
MedicationDispense.dosageInstruction.extension:nllMedicalDevice.value[x].coding.code
DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality1...1
Typecode
Must SupportTrue
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
MedicationDispense.dosageInstruction.extension:nllMedicalDevice.value[x].coding.display
DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Cardinality0...1
Typestring
SummaryTrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
MedicationDispense.dosageInstruction.extension:nllMedicalDevice.value[x].coding.userSelected
DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Cardinality0...1
Typeboolean
SummaryTrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
MedicationDispense.dosageInstruction.extension:nllMedicalDevice.value[x].text
DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Cardinality0...1
Typestring
Must SupportTrue
SummaryTrue
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Maximum string length: 256

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
  • EHM: Beskrivning annan medicinteknisk produkt
MedicationDispense.dosageInstruction.extension:nllSubSequence
DefinitionIndicates the order of subqeuences within a sequence.
Cardinality0...1
TypeExtension(integer)
Must SupportTrue
Aliasextensions, user content
Requirements

Only used in dosage type "tillfällesdosering”, using "timeOfDay" or "when"

Comments

The purpose of a subsequence is to provide a repeating mechanism within a sequence. Subsequences enable communication of irregular dosage schedules that should be repeated within a sequence. <br> NB! There are a number of elements that must contain the same values on each sequence and subsequence. For example the dose unit and dose rate unit, the site, route and method and the asNeeded-attribute.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
  • EHM: Subsekvens
MedicationDispense.dosageInstruction.extension:nllDosageType
DefinitionCalculated by the Swedish eHealth Agency. The dosage type that matches the provided set of dosage data.
Cardinality0...1
TypeExtension(code)
Must SupportTrue
Aliasextensions, user content
Comments

_

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
  • EHM: Doseringstyp
MedicationDispense.dosageInstruction.extension:nllSiteQualifier
DefinitionQualified adminsitration site is used when more exact information about the site is needed.
Cardinality0...1
TypeExtension(CodeableConcept)
Must SupportTrue
Aliasextensions, user content
Requirements

To be used only when combinated with MedicationRequest.dosageInstruction.site.coding If there is no appropriate coded value, then the code OTH=Other must be used in combination the free text attribute "text".

Comments

NB! The same value must be provided in this element on each sequence / subsequence.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
  • EHM: Precisering av administreringsställe
MedicationDispense.dosageInstruction.extension:nllSiteQualifier.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.extension:nllSiteQualifier.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.extension:nllSiteQualifier.url
DefinitionSource of the definition for the extension code - a logical name or a URL.
Cardinality1...1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value

http://electronichealth.se/fhir/StructureDefinition/NLLSiteQualifier

Mappings
  • rim: N/A
MedicationDispense.dosageInstruction.extension:nllSiteQualifier.value[x]
DefinitionValue of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).
Cardinality1...1
TypeCodeableConcept
Must SupportTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: N/A
MedicationDispense.dosageInstruction.extension:nllSiteQualifier.value[x].id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.extension:nllSiteQualifier.value[x].extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.extension:nllSiteQualifier.value[x].coding
DefinitionA reference to a code defined by a terminology system.
Cardinality1...1
TypeCoding
Bindinghttp://electronichealth.se/fhir/ValueSet/nll-snomed-qualifier (required)
Must SupportTrue
SummaryTrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
MedicationDispense.dosageInstruction.extension:nllSiteQualifier.value[x].coding.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.extension:nllSiteQualifier.value[x].coding.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.extension:nllSiteQualifier.value[x].coding.system
DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Cardinality0...1
Typeuri
Must SupportTrue
SummaryTrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
MedicationDispense.dosageInstruction.extension:nllSiteQualifier.value[x].coding.version
DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality0...1
Typestring
Must SupportTrue
SummaryTrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
MedicationDispense.dosageInstruction.extension:nllSiteQualifier.value[x].coding.code
DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality1...1
Typecode
Must SupportTrue
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
  • EHM: Precisering av administreringsställe
MedicationDispense.dosageInstruction.extension:nllSiteQualifier.value[x].coding.display
DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Cardinality0...1
Typestring
SummaryTrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
MedicationDispense.dosageInstruction.extension:nllSiteQualifier.value[x].coding.userSelected
DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Cardinality0...1
Typeboolean
SummaryTrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
MedicationDispense.dosageInstruction.extension:nllSiteQualifier.value[x].text
DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Cardinality0...1
Typestring
Must SupportTrue
SummaryTrue
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Maximum string length: 256

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
  • EHM: Beskrivning annan precisering av administreringsställe
MedicationDispense.dosageInstruction.modifierExtension
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).
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Requirements

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.

Comments

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
MedicationDispense.dosageInstruction.sequence
DefinitionIndicates the order in which the dosage instructions should be applied or interpreted .
Cardinality1...1
Typeinteger
Must SupportTrue
SummaryTrue
Requirements

If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential.

Comments

NB! There are a number of elements that must contain the same values on each sequence and subsequence. For example the dose unit and dose rate unit, the site, route and method and the asNeeded-attribute.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: TQ1-1
  • rim: .text
  • EHM: Sekvens
MedicationDispense.dosageInstruction.text
DefinitionFree text dosage
Cardinality0...1
Typestring
Must SupportTrue
SummaryTrue
Requirements

In the Swedish National Medication List there will be either a free text dosage or coded dosage instructions, never both.

Comments

Maximum string length: 512

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: RXO-6; RXE-21
  • rim: .text
  • EHM: Fritextdosering
MedicationDispense.dosageInstruction.additionalInstruction
DefinitionSupplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps").
Cardinality0...1
TypeCodeableConcept
Binding

A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".

SNOMEDCTAdditionalDosageInstructions (example)
Must SupportTrue
SummaryTrue
Requirements

In the Swedish National Medication List Additional instruction is written in free text.

Comments

NB! The same value must be provided in this element on each sequence / subsequence.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: RXO-7
  • rim: .text
MedicationDispense.dosageInstruction.additionalInstruction.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.additionalInstruction.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.additionalInstruction.coding
DefinitionA reference to a code defined by a terminology system.
Cardinality0...*
TypeCoding
SummaryTrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
MedicationDispense.dosageInstruction.additionalInstruction.text
DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Cardinality0...1
Typestring
Must SupportTrue
SummaryTrue
Requirements

In the Swedish National Medication List Additional instruction is written in free text.

Comments

Maximum string length: 512

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
  • EHM: Annan instruktion
MedicationDispense.dosageInstruction.patientInstruction
DefinitionDosage instructions in terms that are understood by the patient. This shall be generated from the structured dosage information attributes.
Cardinality1...1
Typestring
Must SupportTrue
SummaryTrue
Comments

Maximum string length: 512 <br> NB! The same value must be provided in this element on each sequence / subsequence.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: RXO-7
  • rim: .text
  • EHM: Doseringsinstruktion
MedicationDispense.dosageInstruction.timing
DefinitionWhen medication should be administered.
Cardinality0...1
TypeTiming
Must SupportTrue
SummaryTrue
Requirements

The timing schedule for giving the medication to the patient. This 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". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

Comments

_

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .effectiveTime
MedicationDispense.dosageInstruction.timing.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.timing.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.timing.modifierExtension
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).
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Requirements

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.

Comments

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
MedicationDispense.dosageInstruction.timing.event
DefinitionIdentifies specific times when the event occurs.
Cardinality0...*
TypedateTime
SummaryTrue
Requirements

In a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: QLIST<TS>
MedicationDispense.dosageInstruction.timing.repeat
DefinitionA set of rules that describe when the event is scheduled.
Cardinality0...1
TypeElement
Must SupportTrue
SummaryTrue
Requirements

Many timing schedules are determined by regular repetitions.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • tim-1: if there's a duration, there needs to be duration units
    duration.empty() or durationUnit.exists()
  • tim-2: if there's a period, there needs to be period units
    period.empty() or periodUnit.exists()
  • tim-4: duration SHALL be a non-negative value
    duration.exists() implies duration >= 0
  • tim-5: period SHALL be a non-negative value
    period.exists() implies period >= 0
  • tim-6: If there's a periodMax, there must be a period
    periodMax.empty() or period.exists()
  • tim-7: If there's a durationMax, there must be a duration
    durationMax.empty() or duration.exists()
  • tim-8: If there's a countMax, there must be a count
    countMax.empty() or count.exists()
  • tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV)
    offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not()))
  • tim-10: If there's a timeOfDay, there cannot be a when, or vice versa
    timeOfDay.empty() or when.empty()
Mappings
  • rim: Implies PIVL or EIVL
MedicationDispense.dosageInstruction.timing.repeat.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.timing.repeat.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.timing.repeat.extension:nllSubSequenceDuration
DefinitionThe duration of the subsequence. This can only be used if there is a subsequence within the sequence. The length of a subsequence is always in the form of a quantity (never a range) and it can only be expressed in days, not hours, weeks or months.
Cardinality0...1
TypeExtension(Quantity)
Must SupportTrue
Aliasextensions, user content
Requirements

Used for the dosage type "tillfällesdosering".

Comments

_

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
  • EHM: Längd doseringsdelsteg
MedicationDispense.dosageInstruction.timing.repeat.bounds[x]
DefinitionEither a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.
Cardinality0...1
TypeDuration
Must SupportTrue
SummaryTrue
SlicingUnordered, Open, by $this(Type)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: IVL(TS) used in a QSI
MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsDuration
DefinitionA duration for the length of the timing schedule.
Cardinality0...1
TypeDuration
Must SupportTrue
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: IVL(TS) used in a QSI
  • EHM: Längd doseringssteg
MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.value
DefinitionThe value of the measured amount. The value includes an implicit precision in the presentation of the value.
Cardinality1...1
Typedecimal
Must SupportTrue
SummaryTrue
Requirements

Precision is handled implicitly in almost all cases of measurement.

Comments

The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: SN.2 / CQ - N/A
  • rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
  • EHM: Längd doseringssteg
MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.comparator
DefinitionHow the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.
Cardinality0...1
Typecode
Binding

How the Quantity should be understood and represented.

QuantityComparator (required)
ModifierTrue
SummaryTrue
Requirements

Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: SN.1 / CQ.1
  • rim: IVL properties
MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.unit
DefinitionA human-readable form of the unit.
Cardinality0...1
Typestring
SummaryTrue
Requirements

There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.unit
MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.system
DefinitionThe identification of the system that provides the coded form of the unit.
Cardinality0...1
Typeuri
Must SupportTrue
SummaryTrue
Requirements

Need to know the system that defines the coded form of the unit.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: CO.codeSystem, PQ.translation.codeSystem
MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.code
DefinitionA computer processable form of the unit in some unit representation system.
Cardinality1...1
Typecode
Bindingsequence-length-units (required)
Must SupportTrue
SummaryTrue
Requirements

Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

Comments

The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value

d

Mappings
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.code, MO.currency, PQ.translation.code
  • EHM: Enhet längd doseringssteg
MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange
DefinitionA range of possible length.
Cardinality0...1
TypeRange
Must SupportTrue
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: IVL(TS) used in a QSI
  • EHM: Längd doseringssteg min/max
MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low
DefinitionThe low limit. The boundary is inclusive.
Cardinality1...1
TypeSimpleQuantity
Must SupportTrue
SummaryTrue
Comments

If the low element is missing, the low boundary is not known.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: NR.1
  • rim: ./low
  • EHM: Min längd doseringssteg
MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.value
DefinitionThe value of the measured amount. The value includes an implicit precision in the presentation of the value.
Cardinality1...1
Typedecimal
Must SupportTrue
SummaryTrue
Requirements

Precision is handled implicitly in almost all cases of measurement.

Comments

The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: SN.2 / CQ - N/A
  • rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
  • EHM: Min längd doseringssteg
MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.comparator
DefinitionNot allowed to be used in this context
Cardinality0...0
Typecode
Binding

How the Quantity should be understood and represented.

QuantityComparator (required)
ModifierTrue
SummaryTrue
Requirements

Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: SN.1 / CQ.1
  • rim: IVL properties
MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.unit
DefinitionA human-readable form of the unit.
Cardinality0...1
Typestring
SummaryTrue
Requirements

There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.unit
MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.system
DefinitionThe identification of the system that provides the coded form of the unit.
Cardinality0...1
Typeuri
Must SupportTrue
SummaryTrue
Requirements

Need to know the system that defines the coded form of the unit.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: CO.codeSystem, PQ.translation.codeSystem
MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.code
DefinitionA computer processable form of the unit in some unit representation system.
Cardinality1...1
Typecode
Bindingsequence-length-units (required)
Must SupportTrue
SummaryTrue
Requirements

Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

Comments

The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value

d

Mappings
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.code, MO.currency, PQ.translation.code
  • EHM: Enhet min längd doseringssteg
MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high
DefinitionThe high limit. The boundary is inclusive.
Cardinality1...1
TypeSimpleQuantity
Must SupportTrue
SummaryTrue
Comments

If the high element is missing, the high boundary is not known.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: NR.2
  • rim: ./high
  • EHM: Max längd doseringssteg
MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.value
DefinitionThe value of the measured amount. The value includes an implicit precision in the presentation of the value.
Cardinality1...1
Typedecimal
Must SupportTrue
SummaryTrue
Requirements

Precision is handled implicitly in almost all cases of measurement.

Comments

The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: SN.2 / CQ - N/A
  • rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
  • EHM: Max längd doseringssteg
MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.comparator
DefinitionNot allowed to be used in this context
Cardinality0...0
Typecode
Binding

How the Quantity should be understood and represented.

QuantityComparator (required)
ModifierTrue
SummaryTrue
Requirements

Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: SN.1 / CQ.1
  • rim: IVL properties
MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.unit
DefinitionA human-readable form of the unit.
Cardinality0...1
Typestring
SummaryTrue
Requirements

There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.unit
MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.system
DefinitionThe identification of the system that provides the coded form of the unit.
Cardinality0...1
Typeuri
Must SupportTrue
SummaryTrue
Requirements

Need to know the system that defines the coded form of the unit.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: CO.codeSystem, PQ.translation.codeSystem
MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.code
DefinitionA computer processable form of the unit in some unit representation system.
Cardinality1...1
Typecode
Bindingsequence-length-units (required)
Must SupportTrue
SummaryTrue
Requirements

Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

Comments

The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value

d

Mappings
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.code, MO.currency, PQ.translation.code
  • EHM: Enhet max längd doseringssteg
MedicationDispense.dosageInstruction.timing.repeat.count
DefinitionA total count of the desired number of repetitions across the duration of the entire timing specification.
Cardinality0...1
TypepositiveInt
Must SupportTrue
SummaryTrue
Requirements

In the Swedish National Medication List count is used for describing single dosages that occur one (1) time. The only value allowed is count=1

Comments

If you have both bounds and count, then this should be understood as within the bounds period, until count times happens.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: PIVL.count
  • EHM: Antal upprepningar
MedicationDispense.dosageInstruction.timing.repeat.countMax
DefinitionIf present, indicates that the count is a range - so to perform the action between [count] and [countMax] times.
Cardinality0...1
TypepositiveInt
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: PIVL.count
MedicationDispense.dosageInstruction.timing.repeat.duration
DefinitionDuration of the administration of the medication
Cardinality0...1
Typedecimal
Must SupportTrue
SummaryTrue
Requirements
Comments

Duration is handled with a maximum precision of 4 decimals. Corresponding regex: (0|[1-9][0-9]*)(.[0-9][0-9][0-9][0-9])

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: PIVL.phase
  • EHM: Administreringstillfällets varaktighet
MedicationDispense.dosageInstruction.timing.repeat.durationMax
DefinitionIf present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length.
Cardinality0...1
Typedecimal
SummaryTrue
Requirements

Some activities are not instantaneous and need to be maintained for a period of time.

Comments

For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: PIVL.phase
MedicationDispense.dosageInstruction.timing.repeat.durationUnit
DefinitionThe units of time for the duration, in UCUM units.
Cardinality0...1
Typecode
Binding

A unit of time (units from UCUM).

dose-duration-units (required)
Must SupportTrue
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: PIVL.phase.unit
  • EHM: Enhet för administreringstillfällets varaktighet
MedicationDispense.dosageInstruction.timing.repeat.frequency
DefinitionThe number of times to repeat the action within the specified period. If frequencyMax is present, this element indicates the lower bound of the allowed range of the frequency.
Cardinality0...1
TypepositiveInt
Must SupportTrue
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: PIVL.phase
  • EHM: Antal administreringar
MedicationDispense.dosageInstruction.timing.repeat.frequencyMax
DefinitionIf present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range.
Cardinality0...1
TypepositiveInt
Must SupportTrue
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: PIVL.phase
  • EHM: Antal administreringar max
MedicationDispense.dosageInstruction.timing.repeat.period
DefinitionIndicates the duration of time over which repetitions are to occur; e.g. to express "3 times per day", 3 would be the frequency and "1 day" would be the period. If periodMax is present, this element indicates the lower bound of the allowed range of the period length.
Cardinality0...1
Typedecimal
Must SupportTrue
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: PIVL.phase
  • EHM: Period
MedicationDispense.dosageInstruction.timing.repeat.periodMax
DefinitionIf present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as "do this once every 3-5 days.
Cardinality0...1
Typedecimal
Must SupportTrue
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: PIVL.phase
  • EHM: Period max
MedicationDispense.dosageInstruction.timing.repeat.periodUnit
DefinitionThe units of time for the period in UCUM units.
Cardinality0...1
Typecode
Binding

A unit of time (units from UCUM).

dose-period-units (required)
Must SupportTrue
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: PIVL.phase.unit
  • EHM: Periodenhet
MedicationDispense.dosageInstruction.timing.repeat.dayOfWeek
DefinitionIf one or more days of week is provided, then the action happens only on the specified day(s).
Cardinality0...*
Typecode
BindingDaysOfWeek (required)
Must SupportTrue
SummaryTrue
Comments

If no days are specified, the action is assumed to happen every day as otherwise specified. The elements frequency and period cannot be used as well as dayOfWeek.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • EHM: Veckodag
MedicationDispense.dosageInstruction.timing.repeat.timeOfDay
DefinitionSpecified time of day for action to take place. Must currently be expressed on the hour, i.e. 11:00 or 15:00. This may be changed after the transition period (övergångs-perioden) so that half hours, i.e. 11:30, are allowed, as well. When time of day is specified, it is inferred that the action happens every day (as filtered by dayofWeek) on the specified times.
Cardinality0...*
Typetime
Must SupportTrue
SummaryTrue
Requirements

Used for the dosage type "tillfällesdosering". The elements “when, frequency and period” cannot be used with the element “timeOfDay” simultaneously.

Comments

When time of day is specified, it is inferred that the action happens every day (as filtered by dayofWeek) on the specified times. The elements when, frequency and period cannot be used as well as timeOfDay.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • EHM: Klockslag
MedicationDispense.dosageInstruction.timing.repeat.when
DefinitionAn approximate time period during the day, potentially linked to an event of daily living that indicates when the action should occur.
Cardinality0...*
Typecode
Binding

Real world event relating to the schedule.

nll-event-timing (required)
Must SupportTrue
SummaryTrue
Requirements

Timings are frequently determined by occurrences such as waking, eating and sleep.

Comments

_

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: EIVL.event
  • EHM: Period på dygnet
MedicationDispense.dosageInstruction.timing.repeat.offset
DefinitionThe number of minutes from the event. If the event code does not indicate whether the minutes is before or after the event, then the offset is assumed to be after the event.
Cardinality0...1
TypeunsignedInt
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: EIVL.offset
MedicationDispense.dosageInstruction.timing.code
DefinitionA code for the timing schedule (or just text in code.text). Some codes such as BID are ubiquitous, but many institutions define their own additional codes. If a code is provided, the code is understood to be a complete statement of whatever is specified in the structured timing data, and either the code or the data may be used to interpret the Timing, with the exception that .repeat.bounds still applies over the code (and is not contained in the code).
Cardinality0...1
TypeCodeableConcept
Binding

Code for a known / defined timing pattern.

TimingAbbreviation (preferred)
SummaryTrue
Comments

BID etc. are defined as 'at institutionally specified times'. For example, an institution may choose that BID is "always at 7am and 6pm". If it is inappropriate for this choice to be made, the code BID should not be used. Instead, a distinct organization-specific code should be used in place of the HL7-defined BID code and/or a structured representation should be used (in this case, specifying the two event times).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: QSC.code
MedicationDispense.dosageInstruction.asNeeded[x]
DefinitionIndicates that the medication only should be taken when needed.
Cardinality0...1
Typeboolean
Must SupportTrue
SummaryTrue
Comments

NB! The same value must be provided in this element on each sequence / subsequence.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: TQ1-9
  • rim: .outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept
  • EHM: Vid behov
MedicationDispense.dosageInstruction.site
DefinitionSite of administration.
Cardinality0...1
TypeCodeableConcept
Binding

A coded concept describing the site location the medicine enters into or onto the body.

SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example)
Must SupportTrue
SummaryTrue
Requirements

A coded specification of the anatomic site where the medication first enters the body. If there is no appropriate coded value, then the code OTH=Other should be used together with the free text attribute "text".

Comments

NB! The same value must be provided in this element on each sequence / subsequence.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: RXR-2
  • rim: .approachSiteCode
  • EHM: Administreringsställe
MedicationDispense.dosageInstruction.site.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.site.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.site.coding
DefinitionA reference to a code defined by a terminology system.
Cardinality1...1
TypeCoding
Binding

Snomed CT codes for administration site, as stipulated by NLL (terminology server).

http://electronichealth.se/fhir/ValueSet/nll-snomed-site (required)
Must SupportTrue
SummaryTrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

_

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
MedicationDispense.dosageInstruction.site.coding.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.site.coding.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.site.coding.system
DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Cardinality0...1
Typeuri
Must SupportTrue
SummaryTrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
MedicationDispense.dosageInstruction.site.coding.version
DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality0...1
Typestring
Must SupportTrue
SummaryTrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
MedicationDispense.dosageInstruction.site.coding.code
DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality1...1
Typecode
Must SupportTrue
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
MedicationDispense.dosageInstruction.site.coding.display
DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Cardinality0...1
Typestring
SummaryTrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
MedicationDispense.dosageInstruction.site.coding.userSelected
DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Cardinality0...1
Typeboolean
SummaryTrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
MedicationDispense.dosageInstruction.site.text
DefinitionA human language representation of the administration site. Used when no specific code can describe the site and the code 'OTH' has been selected.
Cardinality0...1
Typestring
Must SupportTrue
SummaryTrue
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Maximum string length: 256

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
  • EHM: Beskrivning annat administreringsställe
MedicationDispense.dosageInstruction.route
DefinitionHow the medication should enter the body.
Cardinality0...1
TypeCodeableConcept
Binding

A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

SNOMEDCTRouteCodes (example)
Must SupportTrue
SummaryTrue
Requirements

A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body. If there is no appropriate coded value, then the code OTH=Other must be used together with the free text attribute "text".

Comments

NB! The same value must be provided in this element on each sequence / subsequence.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: RXR-1
  • rim: .routeCode
  • EHM: Administreringsväg
MedicationDispense.dosageInstruction.route.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.route.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.route.coding
DefinitionA reference to a code defined by a terminology system.
Cardinality1...1
TypeCoding
Binding

Snomed CT codes for administration route, as stipulated by NLL

http://electronichealth.se/fhir/ValueSet/nll-snomed-route (required)
Must SupportTrue
SummaryTrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

_

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
MedicationDispense.dosageInstruction.route.coding.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.route.coding.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.route.coding.system
DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Cardinality0...1
Typeuri
Must SupportTrue
SummaryTrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
MedicationDispense.dosageInstruction.route.coding.version
DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality0...1
Typestring
Must SupportTrue
SummaryTrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
MedicationDispense.dosageInstruction.route.coding.code
DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality1...1
Typecode
Must SupportTrue
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
MedicationDispense.dosageInstruction.route.coding.display
DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Cardinality0...1
Typestring
SummaryTrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
MedicationDispense.dosageInstruction.route.coding.userSelected
DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Cardinality0...1
Typeboolean
SummaryTrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
MedicationDispense.dosageInstruction.route.text
DefinitionA human language representation of the administration route. Used when no specific code can describe the route and the code 'OTH' has been selected.
Cardinality0...1
Typestring
Must SupportTrue
SummaryTrue
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Maximum string length: 256

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
  • EHM: Beskrivning annan administreringsväg
MedicationDispense.dosageInstruction.method
DefinitionMethod used for administering the medication.
Cardinality0...1
TypeCodeableConcept
Binding

A coded concept describing the technique by which the medicine is administered.

SNOMEDCTAdministrationMethodCodes (example)
Must SupportTrue
SummaryTrue
Requirements

A coded value indicating the method by which the medication is introduced into or onto the body. If there is no appropriate coded value, then the code OTH=Other should be used together with the free text attribute "text".

Comments

NB! The same value must be provided in this element on each sequence / subsequence.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: RXR-4
  • rim: .doseQuantity
  • EHM: Administreringsmetod
MedicationDispense.dosageInstruction.method.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.method.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.method.coding
DefinitionA reference to a code defined by a terminology system.
Cardinality1...1
TypeCoding
Binding

Snomed CT codes for administration method, as stipulated by NLL (terminology server).

http://electronichealth.se/fhir/ValueSet/nll-snomed-method (required)
Must SupportTrue
SummaryTrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

_

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
MedicationDispense.dosageInstruction.method.coding.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.method.coding.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.method.coding.system
DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Cardinality0...1
Typeuri
Must SupportTrue
SummaryTrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
MedicationDispense.dosageInstruction.method.coding.version
DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality0...1
Typestring
Must SupportTrue
SummaryTrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
MedicationDispense.dosageInstruction.method.coding.code
DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality1...1
Typecode
Must SupportTrue
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
MedicationDispense.dosageInstruction.method.coding.display
DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Cardinality0...1
Typestring
SummaryTrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
MedicationDispense.dosageInstruction.method.coding.userSelected
DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Cardinality0...1
Typeboolean
SummaryTrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
MedicationDispense.dosageInstruction.method.text
DefinitionA human language representation of the administration method. Used when no specific code can describe the method and the code 'OTH' has been selected.
Cardinality0...1
Typestring
Must SupportTrue
SummaryTrue
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Maximum string length: 256

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
  • EHM: Beskrivning annan administreringsmetod
MedicationDispense.dosageInstruction.doseAndRate
DefinitionThe amount of medication administered.
Cardinality0...1
TypeElement
Must SupportTrue
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: TQ1-2
MedicationDispense.dosageInstruction.doseAndRate.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.doseAndRate.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.doseAndRate.type
DefinitionThe kind of dose or rate specified, for example, ordered or calculated.
Cardinality0...1
TypeCodeableConcept
Binding

The kind of dose or rate specified.

DoseAndRateType (example)
SummaryTrue
Requirements

If the type is not populated, assume to be "ordered".

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: RXO-21; RXE-23
MedicationDispense.dosageInstruction.doseAndRate.dose[x]
DefinitionAmount of medication per dose.
Cardinality0...1
TypeRange
Bindingnll-ucum-unit (required)
Must SupportTrue
SummaryTrue
Requirements

The amount of therapeutic or other substance given at one administration event.

Comments

_

SlicingUnordered, Open, by $this(Type)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: RXO-2, RXE-3
  • rim: .doseQuantity
MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange
DefinitionAmount of medication per dose.
Cardinality0...1
TypeRange
Must SupportTrue
SummaryTrue
Requirements

The amount of therapeutic or other substance given at one administration event.

Comments

Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: RXO-2, RXE-3
  • rim: .doseQuantity
MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.low
DefinitionThe low limit. The boundary is inclusive.
Cardinality1...1
TypeSimpleQuantity
Must SupportTrue
SummaryTrue
Comments

If the low element is missing, the low boundary is not known.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: NR.1
  • rim: ./low
  • EHM: Dos min
MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.low.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.low.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.low.value
DefinitionDose range low value
Cardinality1...1
Typedecimal
Must SupportTrue
SummaryTrue
Requirements
Comments

Dose range low value is handled with a maximum precision of 4 decimals. Corresponding regex: (0|[1-9][0-9]*)(.[0-9][0-9][0-9][0-9])

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: SN.2 / CQ - N/A
  • rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
  • EHM: Dos min
MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.low.comparator
DefinitionNot allowed to be used in this context
Cardinality0...0
Typecode
Binding

How the Quantity should be understood and represented.

QuantityComparator (required)
ModifierTrue
SummaryTrue
Requirements

Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: SN.1 / CQ.1
  • rim: IVL properties
MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.low.unit
DefinitionA human-readable form of the unit.
Cardinality0...1
Typestring
SummaryTrue
Requirements

There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.unit
MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.low.system
DefinitionThe identification of the system that provides the coded form of the unit.
Cardinality0...1
Typeuri
Must SupportTrue
SummaryTrue
Requirements

Need to know the system that defines the coded form of the unit.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: CO.codeSystem, PQ.translation.codeSystem
MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.low.code
DefinitionA computer processable form of the unit in some unit representation system.
Cardinality1...1
Typecode
Must SupportTrue
SummaryTrue
Requirements

Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

Comments

The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.code, MO.currency, PQ.translation.code
  • EHM: Dosenhet min
MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.high
DefinitionThe high limit. The boundary is inclusive.
Cardinality1...1
TypeSimpleQuantity
Must SupportTrue
SummaryTrue
Comments

If the high element is missing, the high boundary is not known.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: NR.2
  • rim: ./high
  • EHM: Dos max
MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.high.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.high.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.high.value
DefinitionDose range high value
Cardinality1...1
Typedecimal
Must SupportTrue
SummaryTrue
Requirements
Comments

Dose range high value is handled with a maximum precision of 4 decimals. Corresponding regex: (0|[1-9][0-9]*)(.[0-9][0-9][0-9][0-9])

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: SN.2 / CQ - N/A
  • rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
  • EHM: Dos max
MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.high.comparator
DefinitionNot allowed to be used in this context
Cardinality0...0
Typecode
Binding

How the Quantity should be understood and represented.

QuantityComparator (required)
ModifierTrue
SummaryTrue
Requirements

Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: SN.1 / CQ.1
  • rim: IVL properties
MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.high.unit
DefinitionA human-readable form of the unit.
Cardinality0...1
Typestring
SummaryTrue
Requirements

There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.unit
MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.high.system
DefinitionThe identification of the system that provides the coded form of the unit.
Cardinality0...1
Typeuri
Must SupportTrue
SummaryTrue
Requirements

Need to know the system that defines the coded form of the unit.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: CO.codeSystem, PQ.translation.codeSystem
MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.high.code
DefinitionA computer processable form of the unit in some unit representation system.
Cardinality1...1
Typecode
Must SupportTrue
SummaryTrue
Requirements

Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

Comments

The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.code, MO.currency, PQ.translation.code
  • EHM: Dosenhet max
MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity
DefinitionAmount of medication per dose.
Cardinality0...1
TypeSimpleQuantity
Must SupportTrue
SummaryTrue
Requirements

The amount of therapeutic or other substance given at one administration event.

Comments

Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: RXO-2, RXE-3
  • rim: .doseQuantity
MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.value
DefinitionDose quantity value.
Cardinality0...1
Typedecimal
Must SupportTrue
SummaryTrue
Requirements
Comments

Dose quantity value is handled with a maximum precision of 4 decimals. Corresponding regex: (0|[1-9][0-9]*)(.[0-9][0-9][0-9][0-9])

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: SN.2 / CQ - N/A
  • rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
  • EHM: Dos
MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.comparator
DefinitionNot allowed to be used in this context
Cardinality0...0
Typecode
Binding

How the Quantity should be understood and represented.

QuantityComparator (required)
ModifierTrue
SummaryTrue
Requirements

Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: SN.1 / CQ.1
  • rim: IVL properties
MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.unit
DefinitionA human-readable form of the unit.
Cardinality0...1
Typestring
SummaryTrue
Requirements

There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.unit
MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.system
DefinitionThe identification of the system that provides the coded form of the unit.
Cardinality0...1
Typeuri
Must SupportTrue
SummaryTrue
Requirements

Need to know the system that defines the coded form of the unit.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: CO.codeSystem, PQ.translation.codeSystem
MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.code
DefinitionA computer processable form of the unit in some unit representation system.
Cardinality0...1
Typecode
Must SupportTrue
SummaryTrue
Requirements

Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

Comments

The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.code, MO.currency, PQ.translation.code
  • EHM: Dosenhet
MedicationDispense.dosageInstruction.doseAndRate.rate[x]
DefinitionAmount of medication per unit of time.
Cardinality0...1
TypeSimpleQuantity
Bindingnll-ucum-rate-unit (required)
Must SupportTrue
SummaryTrue
Requirements

_

Comments

_

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: RXE22, RXE23, RXE-24
  • rim: .rateQuantity
  • EHM: Doseringshastighet
MedicationDispense.dosageInstruction.doseAndRate.rate[x].id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.doseAndRate.rate[x].extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.doseAndRate.rate[x].value
DefinitionRate value
Cardinality0...1
Typedecimal
Must SupportTrue
SummaryTrue
Requirements
Comments

Rate value is handled with a maximum precision of 4 decimals. Corresponding regex: (0|[1-9][0-9]*)(.[0-9][0-9][0-9][0-9])

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: SN.2 / CQ - N/A
  • rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
  • EHM: Doseringshastighet
MedicationDispense.dosageInstruction.doseAndRate.rate[x].comparator
DefinitionNot allowed to be used in this context
Cardinality0...0
Typecode
Binding

How the Quantity should be understood and represented.

QuantityComparator (required)
ModifierTrue
SummaryTrue
Requirements

Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: SN.1 / CQ.1
  • rim: IVL properties
MedicationDispense.dosageInstruction.doseAndRate.rate[x].unit
DefinitionA human-readable form of the unit.
Cardinality0...1
Typestring
SummaryTrue
Requirements

There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.unit
MedicationDispense.dosageInstruction.doseAndRate.rate[x].system
DefinitionThe identification of the system that provides the coded form of the unit.
Cardinality0...1
Typeuri
Must SupportTrue
SummaryTrue
Requirements

Need to know the system that defines the coded form of the unit.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: CO.codeSystem, PQ.translation.codeSystem
MedicationDispense.dosageInstruction.doseAndRate.rate[x].code
DefinitionA computer processable form of the unit in some unit representation system.
Cardinality1...1
Typecode
Must SupportTrue
SummaryTrue
Requirements

Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

Comments

NB! The same value must be provided in this element on each sequence / subsequence.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.code, MO.currency, PQ.translation.code
  • EHM: Doseringshastighetsenhet
MedicationDispense.dosageInstruction.maxDosePerPeriod
DefinitionUpper limit on medication per day.
Cardinality0...1
TypeRatio
Must SupportTrue
SummaryTrue
Requirements

The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours.

Comments

NB! The same value must be provided in this element on each sequence / subsequence.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: RXO-23, RXE-19
  • rim: .maxDoseQuantity
  • EHM: Maxdos
MedicationDispense.dosageInstruction.maxDosePerPeriod.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.maxDosePerPeriod.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator
DefinitionThe value of the numerator.
Cardinality0...1
TypeQuantity
Bindingnll-ucum-unit (required)
Must SupportTrue
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .numerator
  • EHM: Maxdos
MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.value
DefinitionMax dose therapeutic substance value
Cardinality0...1
Typedecimal
Must SupportTrue
SummaryTrue
Requirements
Comments

NB! If maxDosePerPeriod contains a value, it must be > 0 (greater than zero); i.e 0 and negative numbers are not allowed. Max dose therapeutic substance value is handled with a maximum precision of 4 decimals. Corresponing regex: ^(?!0*[.,]0*$|[.,]0*$|0*$)\d+[,.]?\d{0,4}$

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: SN.2 / CQ - N/A
  • rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
  • EHM: Maxdos
MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.comparator
DefinitionHow the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.
Cardinality0...1
Typecode
Binding

How the Quantity should be understood and represented.

QuantityComparator (required)
ModifierTrue
SummaryTrue
Requirements

Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: SN.1 / CQ.1
  • rim: IVL properties
MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.unit
DefinitionA human-readable form of the unit.
Cardinality0...1
Typestring
SummaryTrue
Requirements

There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.unit
MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.system
DefinitionThe identification of the system that provides the coded form of the unit.
Cardinality0...1
Typeuri
Must SupportTrue
SummaryTrue
Requirements

Need to know the system that defines the coded form of the unit.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: CO.codeSystem, PQ.translation.codeSystem
MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.code
DefinitionA computer processable form of the unit in some unit representation system.
Cardinality1...1
Typecode
Must SupportTrue
SummaryTrue
Requirements

Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

Comments

The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.code, MO.currency, PQ.translation.code
  • EHM: Maxdosenhet
MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator
DefinitionThe value of the denominator.
Cardinality0...1
TypeQuantity
Must SupportTrue
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value

{
  "value": 1,
  "system": "http://unitsofmeasure.org",
  "code": "d"
}

Mappings
  • rim: .denominator
  • EHM: Maxdosperiod
MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.value
DefinitionThe value of the measured amount. The value includes an implicit precision in the presentation of the value.
Cardinality0...1
Typedecimal
Must SupportTrue
SummaryTrue
Requirements

Precision is handled implicitly in almost all cases of measurement.

Comments

The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value

1

Mappings
  • v2: SN.2 / CQ - N/A
  • rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
  • EHM: Maxdosperiod
MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.comparator
DefinitionHow the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.
Cardinality0...1
Typecode
Binding

How the Quantity should be understood and represented.

QuantityComparator (required)
ModifierTrue
SummaryTrue
Requirements

Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: SN.1 / CQ.1
  • rim: IVL properties
MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.unit
DefinitionA human-readable form of the unit.
Cardinality0...1
Typestring
SummaryTrue
Requirements

There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.unit
MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.system
DefinitionThe identification of the system that provides the coded form of the unit.
Cardinality0...1
Typeuri
Must SupportTrue
SummaryTrue
Requirements

Need to know the system that defines the coded form of the unit.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value

http://unitsofmeasure.org

Mappings
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: CO.codeSystem, PQ.translation.codeSystem
MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.code
DefinitionA computer processable form of the unit in some unit representation system.
Cardinality0...1
Typecode
Must SupportTrue
SummaryTrue
Requirements

Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

Comments

The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value

d

Mappings
  • v2: (see OBX.6 etc.) / CQ.2
  • rim: PQ.code, MO.currency, PQ.translation.code
  • EHM: Maxdosperiodenhet
MedicationDispense.dosageInstruction.maxDosePerAdministration
DefinitionUpper limit on medication per administration.
Cardinality0...1
TypeSimpleQuantity
SummaryTrue
Requirements

The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.

Comments

This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: not supported
MedicationDispense.dosageInstruction.maxDosePerLifetime
DefinitionUpper limit on medication per lifetime of the patient.
Cardinality0...1
TypeSimpleQuantity
SummaryTrue
Requirements

The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: not supported
MedicationDispense.substitution
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. If nothing is specified, substitution was not done.
Cardinality0...1
TypeBackboneElement
Must SupportTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP].target[classCode=SUBST, moodCode=EVN]
  • rx-dispense-rmim: CombinedMedicationDispense.substitutionMade
  • EHM: Generikautbyte utfört
MedicationDispense.substitution.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
MedicationDispense.substitution.extension
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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
MedicationDispense.substitution.modifierExtension
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).
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Requirements

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.

Comments

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: N/A
MedicationDispense.substitution.wasSubstituted
DefinitionTrue if the dispenser dispensed a different drug or product from what was prescribed.
Cardinality1...1
Typeboolean
Must SupportTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .actionNegationInd
  • EHM: Generikautbyte utfört
MedicationDispense.substitution.type
DefinitionA code signifying whether a different drug was dispensed from what was prescribed.
Cardinality0...1
TypeCodeableConcept
Binding

A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription.

v3.ActSubstanceAdminSubstitutionCode (example)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: RXO-9-Allow Substitutions / RXE-9-Substitution Status
  • rim: .code
  • rx-dispense-rmim: CombinedMedicationDispense.substitutionMade.code
MedicationDispense.substitution.reason
DefinitionIndicates the reason for the substitution (or lack of substitution) from what was prescribed.
Cardinality0...*
TypeCodeableConcept
Binding

A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.

v3.SubstanceAdminSubstitutionReason (example)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .reasonCode
  • rx-dispense-rmim: CombinedMedicationDispense.substitutionMade.reasonCode
MedicationDispense.substitution.responsibleParty
DefinitionThe person or organization that has primary responsibility for the substitution.
Cardinality0...*
TypeReference(Practitioner | PractitionerRole)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .participation[typeCode=PFM].role[classCode=ASSIGN]
  • rx-dispense-rmim: CombinedMedicationDispense.substitutionMade.ResponsibleParty
MedicationDispense.detectedIssue
DefinitionAccepted warnings can be provided when creating a MedicationDispense. Automatic Format and Constitution Control (AFF) accepted by the pharmacist. NB! The DetectedIssues are never saved by the Swedish eHealth Agency.
Cardinality0...*
TypeReference(NLLDetectedIssue)
Must SupportTrue
AliasContraindication, Drug Utilization Review (DUR), Alert
Comments

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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value
  • EHM: Accepterade varningar
MedicationDispense.eventHistory
DefinitionA summary of the events of interest that have occurred, such as when the dispense was verified.
Cardinality0...*
TypeReference(Provenance)
Comments

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.).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]
<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="f06c6e96-4495-4afa-b688-02bef19f2d6d" />
    <meta>
        <versionId value="1" />
        <lastUpdated value="2025-01-14T09:38:18.4148619+00:00" />
    </meta>
    <url value="http://electronichealth.se/fhir/StructureDefinition/NLLMedicationDispense" />
    <version value="1.2.1" />
    <name value="NLLMedicationDispense" />
    <status value="active" />
    <date value="2025-01-14" />
    <publisher value="Swedish eHealth Agency" />
    <fhirVersion value="4.0.1" />
    <mapping>
        <identity value="EHM" />
        <name value="E-h&#228;lsomyndigheten concept" />
    </mapping>
    <kind value="resource" />
    <abstract value="false" />
    <type value="MedicationDispense" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/MedicationDispense" />
    <derivation value="constraint" />
    <differential>
        <element id="MedicationDispense">
            <path value="MedicationDispense" />
            <short value="A medication dispense to a specific patient authorzied by a prescription" />
            <definition value="A medication dispense to a specific patient authorzied by a prescription in electronic format. Medication dispenses authorized by paper based prescriptions must use the profile NLLDispensePaperPrescription." />
        </element>
        <element id="MedicationDispense.id">
            <path value="MedicationDispense.id" />
            <comment value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation.\nThis id is identified by the URI http://electronichealth.se/identifier/nllmedicationdispenseid in documentation and external systems." />
            <mustSupport value="true" />
            <mapping>
                <identity value="EHM" />
                <map value="Logiskt id f&#246;r uttag" />
            </mapping>
        </element>
        <element id="MedicationDispense.meta">
            <path value="MedicationDispense.meta" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationDispense.meta.versionId">
            <path value="MedicationDispense.meta.versionId" />
            <mustSupport value="true" />
            <mapping>
                <identity value="EHM" />
                <map value="Uttagsversion" />
            </mapping>
        </element>
        <element id="MedicationDispense.meta.security">
            <path value="MedicationDispense.meta.security" />
            <mustSupport value="true" />
            <binding>
                <strength value="extensible" />
                <valueSet value="http://ehalsomyndigheten.se/fhir/ValueSet/security-labels" />
            </binding>
        </element>
        <element id="MedicationDispense.meta.security.system">
            <path value="MedicationDispense.meta.security.system" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationDispense.meta.security.version">
            <path value="MedicationDispense.meta.security.version" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationDispense.meta.security.code">
            <path value="MedicationDispense.meta.security.code" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationDispense.extension">
            <path value="MedicationDispense.extension" />
            <min value="3" />
        </element>
        <element id="MedicationDispense.extension:nllNumberOfPackagesDispensed">
            <path value="MedicationDispense.extension" />
            <sliceName value="nllNumberOfPackagesDispensed" />
            <short value="Number of packages dispensed" />
            <definition value="The number of packages that were included in the dispense. Shall not be set for dose dispensed dispenses." />
            <max value="1" />
            <type>
                <code value="Extension" />
                <profile value="http://electronichealth.se/fhir/StructureDefinition/NLLNumberOfPackagesDispensed" />
            </type>
            <mustSupport value="true" />
            <mapping>
                <identity value="EHM" />
                <map value="Antal expedierade f&#246;rpackningar" />
            </mapping>
        </element>
        <element id="MedicationDispense.extension:nllActorDispatchId">
            <path value="MedicationDispense.extension" />
            <sliceName value="nllActorDispatchId" />
            <short value="The identifier of the actor&#39;s dispatch in which the dispense was made" />
            <comment value="Maximum string length: 12" />
            <min value="1" />
            <type>
                <code value="Extension" />
                <profile value="http://electronichealth.se/fhir/StructureDefinition/NLLActorDispatchId" />
            </type>
            <mustSupport value="true" />
            <mapping>
                <identity value="EHM" />
                <map value="Akt&#246;rens expeditions-id" />
            </mapping>
        </element>
        <element id="MedicationDispense.extension:nllDispatchId">
            <path value="MedicationDispense.extension" />
            <sliceName value="nllDispatchId" />
            <short value="The identifier of the dispatch in which the dispense was made" />
            <definition value="Value is treated as an integer, i.e the String can only contain numbers.\nMay be entered by the pharmacy, otherwise it is calculated by the Swedish E-health Agency .\nThe identifier of the dispatch in which the dispense was made." />
            <type>
                <code value="Extension" />
                <profile value="http://electronichealth.se/fhir/StructureDefinition/NLLDispatchId" />
            </type>
            <mustSupport value="true" />
            <mapping>
                <identity value="EHM" />
                <map value="Expeditions-id" />
            </mapping>
        </element>
        <element id="MedicationDispense.extension:nllBenefitChoiceCode">
            <path value="MedicationDispense.extension" />
            <sliceName value="nllBenefitChoiceCode" />
            <short value="Benefit choice" />
            <definition value="Type of benefit for the dispense." />
            <min value="1" />
            <max value="1" />
            <type>
                <code value="Extension" />
                <profile value="http://electronichealth.se/fhir/StructureDefinition/NLLBenefitChoiceCode" />
            </type>
            <mustSupport value="true" />
            <binding>
                <strength value="required" />
                <valueSet value="http://ehalsomyndigheten.se/fhir/ValueSet/benefit-choices" />
            </binding>
            <mapping>
                <identity value="EHM" />
                <map value="F&#246;rm&#229;nsval" />
            </mapping>
        </element>
        <element id="MedicationDispense.extension:nllDispatchRowNo">
            <path value="MedicationDispense.extension" />
            <sliceName value="nllDispatchRowNo" />
            <short value="Identier for MedicationDispense within dispatch" />
            <definition value="Used when communicationg an error or warning for a MedicationDispense within a dispatch. The DispatchRowNo (ExpeditionsRadNummer) uniquely identifies a MediationDispense within a dispatch." />
            <min value="1" />
            <max value="1" />
            <type>
                <code value="Extension" />
                <profile value="http://electronichealth.se/fhir/StructureDefinition/NLLDispatchRowNo" />
            </type>
            <mustSupport value="true" />
            <mapping>
                <identity value="EHM" />
                <map value="Akt&#246;rens expeditionsradnummer" />
            </mapping>
        </element>
        <element id="MedicationDispense.extension:nllDeductedQuantity">
            <path value="MedicationDispense.extension" />
            <sliceName value="nllDeductedQuantity" />
            <short value="Deducted quantity" />
            <definition value="The quantity that is deducted form the prescription&#39;s remaining quantity.\nOnly used if the deducted quantity should differ from the dispensed quantity." />
            <type>
                <code value="Extension" />
                <profile value="http://electronichealth.se/fhir/StructureDefinition/NLLDeductedQuantity" />
            </type>
            <mustSupport value="true" />
            <mapping>
                <identity value="EHM" />
                <map value="Avr&#228;knad m&#228;ngd" />
            </mapping>
        </element>
        <element id="MedicationDispense.extension:nllCompletePrescriptionChoice">
            <path value="MedicationDispense.extension" />
            <sliceName value="nllCompletePrescriptionChoice" />
            <short value="Prescription completion choice" />
            <definition value="Only used for input.\nWhen 12% or less of the total quantity of the prescribed medication is left, the prescription will automatically be set to status &quot;Completed&quot;. \nA pharmacist can make a descision to overrule the automatic rules by either choosing to set the prescription status to &quot;Completed&quot; or to keep the status &quot;Active&quot;." />
            <max value="1" />
            <type>
                <code value="Extension" />
                <profile value="http://electronichealth.se/fhir/StructureDefinition/NLLCompletePrescriptionChoice" />
            </type>
            <mustSupport value="true" />
            <binding>
                <strength value="required" />
                <valueSet value="http://ehalsomyndigheten.se/fhir/ValueSet/complete-prescription-choices" />
            </binding>
            <mapping>
                <identity value="EHM" />
                <map value="Beslut slutexpediering" />
            </mapping>
        </element>
        <element id="MedicationDispense.extension:nllDispenseCrediting">
            <path value="MedicationDispense.extension" />
            <sliceName value="nllDispenseCrediting" />
            <type>
                <code value="Extension" />
                <profile value="http://electronichealth.se/fhir/StructureDefinition/NLLDispenseCrediting" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="MedicationDispense.extension:nllDispenseCrediting.extension:creditDate">
            <path value="MedicationDispense.extension.extension" />
            <sliceName value="creditDate" />
            <short value="Credit date and time" />
            <definition value="The date and time when the dispense was credited." />
            <mustSupport value="true" />
        </element>
        <element id="MedicationDispense.extension:nllDispenseCrediting.extension:creditDispatchId">
            <path value="MedicationDispense.extension.extension" />
            <sliceName value="creditDispatchId" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationDispense.extension:nllDispenseCrediting.extension:creditDispatchRowNo">
            <path value="MedicationDispense.extension.extension" />
            <sliceName value="creditDispatchRowNo" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationDispense.status">
            <path value="MedicationDispense.status" />
            <short value="cancelled | completed" />
            <mustSupport value="true" />
            <binding>
                <strength value="required" />
                <valueSet value="http://electronichealth.se/fhir/ValueSet/medication-dispense-status" />
            </binding>
            <mapping>
                <identity value="EHM" />
                <map value="Uttagsstatus" />
            </mapping>
        </element>
        <element id="MedicationDispense.medication[x]">
            <path value="MedicationDispense.medication[x]" />
            <short value="Dispensed medication or reimbursed consumable" />
            <definition value="Identifies the medication or reimbursed consumable being dispensed. \nThe codes used are Swedish NplId for medical products, NplPackId for medicine packages and Varunr for reimbursed consumables. \nFor a medicine package, both the NplId and the NplPackId shall be provided. Varunr is not allowed to use when dispensing a medication.\nFor a reimbursed consumable, only Varunr shall be provided." />
            <comment value="If more information is required, then the use of the medication resource is recommended." />
            <type>
                <code value="CodeableConcept" />
            </type>
            <mustSupport value="true" />
            <binding>
                <strength value="required" />
            </binding>
            <mapping>
                <identity value="EHM" />
                <map value="Expedierad artikel" />
            </mapping>
        </element>
        <element id="MedicationDispense.medication[x].coding">
            <path value="MedicationDispense.medication[x].coding" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="system" />
                </discriminator>
                <rules value="open" />
            </slicing>
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationDispense.medication[x].coding:nplid">
            <path value="MedicationDispense.medication[x].coding" />
            <sliceName value="nplid" />
            <short value="NPL-id" />
            <definition value="A unique identifier of a medical product according to &quot;Nationellt produktregister f&#246;r l&#228;kemedel&quot; provided by the Swedish Medical Products Agency (sv L&#228;kemedelsverket)" />
            <max value="1" />
            <mustSupport value="true" />
            <mapping>
                <identity value="EHM" />
                <map value="NPL-id" />
            </mapping>
        </element>
        <element id="MedicationDispense.medication[x].coding:nplid.system">
            <path value="MedicationDispense.medication[x].coding.system" />
            <min value="1" />
            <fixedUri value="http://electronichealth.se/fhir/NamingSystem/nplid" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationDispense.medication[x].coding:nplid.code">
            <path value="MedicationDispense.medication[x].coding.code" />
            <comment value="Maximum string length: 14" />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationDispense.medication[x].coding:nplpackid">
            <path value="MedicationDispense.medication[x].coding" />
            <sliceName value="nplpackid" />
            <short value="NPL-pack-id" />
            <definition value="A unique identifier of a medical product package according to &quot;Nationellt produktregister f&#246;r l&#228;kemedel&quot; provided by the Swedish Medical Products Agency (sv L&#228;kemedelsverket)." />
            <max value="1" />
            <mustSupport value="true" />
            <mapping>
                <identity value="EHM" />
                <map value="NPL-pack-id" />
            </mapping>
        </element>
        <element id="MedicationDispense.medication[x].coding:nplpackid.system">
            <path value="MedicationDispense.medication[x].coding.system" />
            <min value="1" />
            <fixedUri value="http://electronichealth.se/fhir/NamingSystem/nplpackid" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationDispense.medication[x].coding:nplpackid.code">
            <path value="MedicationDispense.medication[x].coding.code" />
            <comment value="Maximum string length: 14" />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationDispense.medication[x].coding:varunr">
            <path value="MedicationDispense.medication[x].coding" />
            <sliceName value="varunr" />
            <short value="Varunummer" />
            <definition value="A unique identifier of a medical consumable according to &quot;Nationellt produktregister f&#246;r l&#228;kemedel&quot; provided by the Swedish Medical Products Agency (sv L&#228;kemedelsverket)\nAlso a non-unique identifier of a medical product package." />
            <max value="1" />
            <mustSupport value="true" />
            <mapping>
                <identity value="EHM" />
                <map value="Varunummer" />
            </mapping>
        </element>
        <element id="MedicationDispense.medication[x].coding:varunr.system">
            <path value="MedicationDispense.medication[x].coding.system" />
            <min value="1" />
            <fixedUri value="http://electronichealth.se/fhir/NamingSystem/varunr" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationDispense.medication[x].coding:varunr.code">
            <path value="MedicationDispense.medication[x].coding.code" />
            <comment value="Minimum string length: 6\nMaximum string length: 6" />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationDispense.authorizingPrescription">
            <path value="MedicationDispense.authorizingPrescription" />
            <short value="MedicationRequest that authorizes the dispense" />
            <definition value="Reference to the MedicationRequest that was dispatched. Note that authorizingprescription must include the version of the medication request. That is done by using the /_history/&#160;suffix." />
            <min value="1" />
            <max value="1" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://electronichealth.se/fhir/StructureDefinition/NLLMedicationRequest" />
                <aggregation value="referenced" />
                <versioning value="specific" />
            </type>
            <mustSupport value="true" />
            <mapping>
                <identity value="EHM" />
                <map value="F&#246;rskrivningsversion" />
            </mapping>
        </element>
        <element id="MedicationDispense.type">
            <path value="MedicationDispense.type" />
            <short value="Type of dispense" />
            <definition value="Type is used for specifing if the dispense was a &quot;Standard packing fill&quot; , &quot;Trial fill&quot; (startf&#246;rpackning) or &quot;Dose dispensed fill&quot; in the Swedish National Medication List. (Trial fill is not used for dose dispensed fills)." />
            <min value="1" />
            <mustSupport value="true" />
            <binding>
                <strength value="required" />
                <description value="Indicates the type of dispensing event that is performed, e.g. Standard packing fill, Trial fill or Dose dispense refill" />
                <valueSet value="http://electronichealth.se/fhir/ValueSet/dispense-types" />
            </binding>
            <mapping>
                <identity value="EHM" />
                <map value="Uttagstyp" />
            </mapping>
        </element>
        <element id="MedicationDispense.type.coding">
            <path value="MedicationDispense.type.coding" />
            <min value="1" />
            <max value="1" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationDispense.type.coding.system">
            <path value="MedicationDispense.type.coding.system" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationDispense.type.coding.version">
            <path value="MedicationDispense.type.coding.version" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationDispense.type.coding.code">
            <path value="MedicationDispense.type.coding.code" />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationDispense.quantity">
            <path value="MedicationDispense.quantity" />
            <definition value="The amount of the article that has been dispensed." />
            <comment value="When dispensing an article (not for dose dispenses), this will be either set by the pharmacy or calculated based on the number of packages and the package size. &lt;br&gt;\nIf complete packages are dispensed, the quantity is calculated by the Swedish eHealth Agency. In this scenarion only the number of packages should be entered (no quantity).&lt;br&gt;\nIf only a part of a package is dispensed (sv bruten helf&#246;rpackning), the pharmacy must enter both the quantity and the number of packages that was dispensed. &lt;br&gt;" />
            <mustSupport value="true" />
            <mapping>
                <identity value="EHM" />
                <map value="Expedierad m&#228;ngd" />
            </mapping>
        </element>
        <element id="MedicationDispense.quantity.value">
            <path value="MedicationDispense.quantity.value" />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationDispense.whenHandedOver">
            <path value="MedicationDispense.whenHandedOver" />
            <mustSupport value="true" />
            <mapping>
                <identity value="EHM" />
                <map value="Expeditionstidpunkt" />
            </mapping>
        </element>
        <element id="MedicationDispense.note">
            <path value="MedicationDispense.note" />
            <short value="Pharmacists note" />
            <definition value="The pharmacists note about the dispense." />
            <comment value="Maximum string length: 1016" />
            <max value="1" />
            <mustSupport value="true" />
            <mapping>
                <identity value="EHM" />
                <map value="Uttagsnotering" />
            </mapping>
        </element>
        <element id="MedicationDispense.note.text">
            <path value="MedicationDispense.note.text" />
            <mustSupport value="true" />
        </element>
        <element id="MedicationDispense.dosageInstruction">
            <path value="MedicationDispense.dosageInstruction" />
            <comment value="A medication dispense is always based/dispatched on a specific version of a medication request. &lt;br&gt;\nA dosage instruction must be provided of there is a unique dosage for the medication dispense which differs from the dosage instruction on the medication request version. &lt;br&gt;\nThe dosage instruction on the medication request version is used as the valid dosage if no other dosage instruction is provided on the medication dispense. &lt;br&gt;\nIf a new dosage instruction should be in effect for the current and following medication dispenses, the medication request needs to be updated before the medication dispense is made.&lt;br&gt;\nFor a read-operation on a medication dispense, the dosage instruction must be read from the medication request version if there is no dosage instruction on the specific medication dispense resource." />
            <type>
                <code value="Dosage" />
                <profile value="http://electronichealth.se/fhir/StructureDefinition/NLLDosage" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="MedicationDispense.dosageInstruction.sequence">
            <path value="MedicationDispense.dosageInstruction.sequence" />
            <definition value="Indicates the order in which the dosage instructions should be applied or interpreted ." />
        </element>
        <element id="MedicationDispense.substitution">
            <path value="MedicationDispense.substitution" />
            <definition value="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.  If nothing is specified, substitution was not done." />
            <mustSupport value="true" />
            <mapping>
                <identity value="EHM" />
                <map value="Generikautbyte utf&#246;rt" />
            </mapping>
        </element>
        <element id="MedicationDispense.substitution.wasSubstituted">
            <path value="MedicationDispense.substitution.wasSubstituted" />
            <mustSupport value="true" />
            <mapping>
                <identity value="EHM" />
                <map value="Generikautbyte utf&#246;rt" />
            </mapping>
        </element>
        <element id="MedicationDispense.detectedIssue">
            <path value="MedicationDispense.detectedIssue" />
            <short value="Automatic Format and Constitution Control warning (AFF varning)" />
            <definition value="Accepted warnings can be provided when creating a MedicationDispense.\nAutomatic Format and Constitution Control (AFF) accepted by the pharmacist.\nNB! The DetectedIssues are never saved by the Swedish eHealth Agency." />
            <type>
                <code value="Reference" />
                <targetProfile value="http://electronichealth.se/fhir/StructureDefinition/NLLDetectedIssue" />
                <aggregation value="contained" />
            </type>
            <mustSupport value="true" />
            <mapping>
                <identity value="EHM" />
                <map value="Accepterade varningar" />
            </mapping>
        </element>
    </differential>
</StructureDefinition>
{
    "resourceType": "StructureDefinition",
    "id": "f06c6e96-4495-4afa-b688-02bef19f2d6d",
    "meta": {
        "versionId": "1",
        "lastUpdated": "01/14/2025 09:38:18"
    },
    "url": "http://electronichealth.se/fhir/StructureDefinition/NLLMedicationDispense",
    "version": "1.2.1",
    "name": "NLLMedicationDispense",
    "status": "active",
    "date": "2025-01-14",
    "publisher": "Swedish eHealth Agency",
    "fhirVersion": "4.0.1",
    "mapping":  [
        {
            "identity": "EHM",
            "name": "E-hälsomyndigheten concept"
        }
    ],
    "kind": "resource",
    "abstract": false,
    "type": "MedicationDispense",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/MedicationDispense",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "MedicationDispense",
                "path": "MedicationDispense",
                "short": "A medication dispense to a specific patient authorzied by a prescription",
                "definition": "A medication dispense to a specific patient authorzied by a prescription in electronic format. Medication dispenses authorized by paper based prescriptions must use the profile NLLDispensePaperPrescription."
            },
            {
                "id": "MedicationDispense.id",
                "path": "MedicationDispense.id",
                "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.\nThis id is identified by the URI http://electronichealth.se/identifier/nllmedicationdispenseid in documentation and external systems.",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "Logiskt id för uttag"
                    }
                ]
            },
            {
                "id": "MedicationDispense.meta",
                "path": "MedicationDispense.meta",
                "mustSupport": true
            },
            {
                "id": "MedicationDispense.meta.versionId",
                "path": "MedicationDispense.meta.versionId",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "Uttagsversion"
                    }
                ]
            },
            {
                "id": "MedicationDispense.meta.security",
                "path": "MedicationDispense.meta.security",
                "mustSupport": true,
                "binding": {
                    "strength": "extensible",
                    "valueSet": "http://ehalsomyndigheten.se/fhir/ValueSet/security-labels"
                }
            },
            {
                "id": "MedicationDispense.meta.security.system",
                "path": "MedicationDispense.meta.security.system",
                "mustSupport": true
            },
            {
                "id": "MedicationDispense.meta.security.version",
                "path": "MedicationDispense.meta.security.version",
                "mustSupport": true
            },
            {
                "id": "MedicationDispense.meta.security.code",
                "path": "MedicationDispense.meta.security.code",
                "mustSupport": true
            },
            {
                "id": "MedicationDispense.extension",
                "path": "MedicationDispense.extension",
                "min": 3
            },
            {
                "id": "MedicationDispense.extension:nllNumberOfPackagesDispensed",
                "path": "MedicationDispense.extension",
                "sliceName": "nllNumberOfPackagesDispensed",
                "short": "Number of packages dispensed",
                "definition": "The number of packages that were included in the dispense. Shall not be set for dose dispensed dispenses.",
                "max": "1",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://electronichealth.se/fhir/StructureDefinition/NLLNumberOfPackagesDispensed"
                        ]
                    }
                ],
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "Antal expedierade förpackningar"
                    }
                ]
            },
            {
                "id": "MedicationDispense.extension:nllActorDispatchId",
                "path": "MedicationDispense.extension",
                "sliceName": "nllActorDispatchId",
                "short": "The identifier of the actor's dispatch in which the dispense was made",
                "comment": "Maximum string length: 12",
                "min": 1,
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://electronichealth.se/fhir/StructureDefinition/NLLActorDispatchId"
                        ]
                    }
                ],
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "Aktörens expeditions-id"
                    }
                ]
            },
            {
                "id": "MedicationDispense.extension:nllDispatchId",
                "path": "MedicationDispense.extension",
                "sliceName": "nllDispatchId",
                "short": "The identifier of the dispatch in which the dispense was made",
                "definition": "Value is treated as an integer, i.e the String can only contain numbers.\nMay be entered by the pharmacy, otherwise it is calculated by the Swedish E-health Agency .\nThe identifier of the dispatch in which the dispense was made.",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://electronichealth.se/fhir/StructureDefinition/NLLDispatchId"
                        ]
                    }
                ],
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "Expeditions-id"
                    }
                ]
            },
            {
                "id": "MedicationDispense.extension:nllBenefitChoiceCode",
                "path": "MedicationDispense.extension",
                "sliceName": "nllBenefitChoiceCode",
                "short": "Benefit choice",
                "definition": "Type of benefit for the dispense.",
                "min": 1,
                "max": "1",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://electronichealth.se/fhir/StructureDefinition/NLLBenefitChoiceCode"
                        ]
                    }
                ],
                "mustSupport": true,
                "binding": {
                    "strength": "required",
                    "valueSet": "http://ehalsomyndigheten.se/fhir/ValueSet/benefit-choices"
                },
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "Förmånsval"
                    }
                ]
            },
            {
                "id": "MedicationDispense.extension:nllDispatchRowNo",
                "path": "MedicationDispense.extension",
                "sliceName": "nllDispatchRowNo",
                "short": "Identier for MedicationDispense within dispatch",
                "definition": "Used when communicationg an error or warning for a MedicationDispense within a dispatch. The DispatchRowNo (ExpeditionsRadNummer) uniquely identifies a MediationDispense within a dispatch.",
                "min": 1,
                "max": "1",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://electronichealth.se/fhir/StructureDefinition/NLLDispatchRowNo"
                        ]
                    }
                ],
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "Aktörens expeditionsradnummer"
                    }
                ]
            },
            {
                "id": "MedicationDispense.extension:nllDeductedQuantity",
                "path": "MedicationDispense.extension",
                "sliceName": "nllDeductedQuantity",
                "short": "Deducted quantity",
                "definition": "The quantity that is deducted form the prescription's remaining quantity.\nOnly used if the deducted quantity should differ from the dispensed quantity.",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://electronichealth.se/fhir/StructureDefinition/NLLDeductedQuantity"
                        ]
                    }
                ],
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "Avräknad mängd"
                    }
                ]
            },
            {
                "id": "MedicationDispense.extension:nllCompletePrescriptionChoice",
                "path": "MedicationDispense.extension",
                "sliceName": "nllCompletePrescriptionChoice",
                "short": "Prescription completion choice",
                "definition": "Only used for input.\nWhen 12% or less of the total quantity of the prescribed medication is left, the prescription will automatically be set to status \"Completed\". \nA pharmacist can make a descision to overrule the automatic rules by either choosing to set the prescription status to \"Completed\" or to keep the status \"Active\".",
                "max": "1",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://electronichealth.se/fhir/StructureDefinition/NLLCompletePrescriptionChoice"
                        ]
                    }
                ],
                "mustSupport": true,
                "binding": {
                    "strength": "required",
                    "valueSet": "http://ehalsomyndigheten.se/fhir/ValueSet/complete-prescription-choices"
                },
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "Beslut slutexpediering"
                    }
                ]
            },
            {
                "id": "MedicationDispense.extension:nllDispenseCrediting",
                "path": "MedicationDispense.extension",
                "sliceName": "nllDispenseCrediting",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://electronichealth.se/fhir/StructureDefinition/NLLDispenseCrediting"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "MedicationDispense.extension:nllDispenseCrediting.extension:creditDate",
                "path": "MedicationDispense.extension.extension",
                "sliceName": "creditDate",
                "short": "Credit date and time",
                "definition": "The date and time when the dispense was credited.",
                "mustSupport": true
            },
            {
                "id": "MedicationDispense.extension:nllDispenseCrediting.extension:creditDispatchId",
                "path": "MedicationDispense.extension.extension",
                "sliceName": "creditDispatchId",
                "mustSupport": true
            },
            {
                "id": "MedicationDispense.extension:nllDispenseCrediting.extension:creditDispatchRowNo",
                "path": "MedicationDispense.extension.extension",
                "sliceName": "creditDispatchRowNo",
                "mustSupport": true
            },
            {
                "id": "MedicationDispense.status",
                "path": "MedicationDispense.status",
                "short": "cancelled | completed",
                "mustSupport": true,
                "binding": {
                    "strength": "required",
                    "valueSet": "http://electronichealth.se/fhir/ValueSet/medication-dispense-status"
                },
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "Uttagsstatus"
                    }
                ]
            },
            {
                "id": "MedicationDispense.medication[x]",
                "path": "MedicationDispense.medication[x]",
                "short": "Dispensed medication or reimbursed consumable",
                "definition": "Identifies the medication or reimbursed consumable being dispensed. \nThe codes used are Swedish NplId for medical products, NplPackId for medicine packages and Varunr for reimbursed consumables. \nFor a medicine package, both the NplId and the NplPackId shall be provided. Varunr is not allowed to use when dispensing a medication.\nFor a reimbursed consumable, only Varunr shall be provided.",
                "comment": "If more information is required, then the use of the medication resource is recommended.",
                "type":  [
                    {
                        "code": "CodeableConcept"
                    }
                ],
                "mustSupport": true,
                "binding": {
                    "strength": "required"
                },
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "Expedierad artikel"
                    }
                ]
            },
            {
                "id": "MedicationDispense.medication[x].coding",
                "path": "MedicationDispense.medication[x].coding",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "system"
                        }
                    ],
                    "rules": "open"
                },
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "MedicationDispense.medication[x].coding:nplid",
                "path": "MedicationDispense.medication[x].coding",
                "sliceName": "nplid",
                "short": "NPL-id",
                "definition": "A unique identifier of a medical product according to \"Nationellt produktregister för läkemedel\" provided by the Swedish Medical Products Agency (sv Läkemedelsverket)",
                "max": "1",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "NPL-id"
                    }
                ]
            },
            {
                "id": "MedicationDispense.medication[x].coding:nplid.system",
                "path": "MedicationDispense.medication[x].coding.system",
                "min": 1,
                "fixedUri": "http://electronichealth.se/fhir/NamingSystem/nplid",
                "mustSupport": true
            },
            {
                "id": "MedicationDispense.medication[x].coding:nplid.code",
                "path": "MedicationDispense.medication[x].coding.code",
                "comment": "Maximum string length: 14",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "MedicationDispense.medication[x].coding:nplpackid",
                "path": "MedicationDispense.medication[x].coding",
                "sliceName": "nplpackid",
                "short": "NPL-pack-id",
                "definition": "A unique identifier of a medical product package according to \"Nationellt produktregister för läkemedel\" provided by the Swedish Medical Products Agency (sv Läkemedelsverket).",
                "max": "1",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "NPL-pack-id"
                    }
                ]
            },
            {
                "id": "MedicationDispense.medication[x].coding:nplpackid.system",
                "path": "MedicationDispense.medication[x].coding.system",
                "min": 1,
                "fixedUri": "http://electronichealth.se/fhir/NamingSystem/nplpackid",
                "mustSupport": true
            },
            {
                "id": "MedicationDispense.medication[x].coding:nplpackid.code",
                "path": "MedicationDispense.medication[x].coding.code",
                "comment": "Maximum string length: 14",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "MedicationDispense.medication[x].coding:varunr",
                "path": "MedicationDispense.medication[x].coding",
                "sliceName": "varunr",
                "short": "Varunummer",
                "definition": "A unique identifier of a medical consumable according to \"Nationellt produktregister för läkemedel\" provided by the Swedish Medical Products Agency (sv Läkemedelsverket)\nAlso a non-unique identifier of a medical product package.",
                "max": "1",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "Varunummer"
                    }
                ]
            },
            {
                "id": "MedicationDispense.medication[x].coding:varunr.system",
                "path": "MedicationDispense.medication[x].coding.system",
                "min": 1,
                "fixedUri": "http://electronichealth.se/fhir/NamingSystem/varunr",
                "mustSupport": true
            },
            {
                "id": "MedicationDispense.medication[x].coding:varunr.code",
                "path": "MedicationDispense.medication[x].coding.code",
                "comment": "Minimum string length: 6\nMaximum string length: 6",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "MedicationDispense.authorizingPrescription",
                "path": "MedicationDispense.authorizingPrescription",
                "short": "MedicationRequest that authorizes the dispense",
                "definition": "Reference to the MedicationRequest that was dispatched. Note that authorizingprescription must include the version of the medication request. That is done by using the /_history/ suffix.",
                "min": 1,
                "max": "1",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://electronichealth.se/fhir/StructureDefinition/NLLMedicationRequest"
                        ],
                        "aggregation":  [
                            "referenced"
                        ],
                        "versioning": "specific"
                    }
                ],
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "Förskrivningsversion"
                    }
                ]
            },
            {
                "id": "MedicationDispense.type",
                "path": "MedicationDispense.type",
                "short": "Type of dispense",
                "definition": "Type is used for specifing if the dispense was a \"Standard packing fill\" , \"Trial fill\" (startförpackning) or \"Dose dispensed fill\" in the Swedish National Medication List. (Trial fill is not used for dose dispensed fills).",
                "min": 1,
                "mustSupport": true,
                "binding": {
                    "strength": "required",
                    "description": "Indicates the type of dispensing event that is performed, e.g. Standard packing fill, Trial fill or Dose dispense refill",
                    "valueSet": "http://electronichealth.se/fhir/ValueSet/dispense-types"
                },
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "Uttagstyp"
                    }
                ]
            },
            {
                "id": "MedicationDispense.type.coding",
                "path": "MedicationDispense.type.coding",
                "min": 1,
                "max": "1",
                "mustSupport": true
            },
            {
                "id": "MedicationDispense.type.coding.system",
                "path": "MedicationDispense.type.coding.system",
                "mustSupport": true
            },
            {
                "id": "MedicationDispense.type.coding.version",
                "path": "MedicationDispense.type.coding.version",
                "mustSupport": true
            },
            {
                "id": "MedicationDispense.type.coding.code",
                "path": "MedicationDispense.type.coding.code",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "MedicationDispense.quantity",
                "path": "MedicationDispense.quantity",
                "definition": "The amount of the article that has been dispensed.",
                "comment": "When dispensing an article (not for dose dispenses), this will be either set by the pharmacy or calculated based on the number of packages and the package size. <br>\nIf complete packages are dispensed, the quantity is calculated by the Swedish eHealth Agency. In this scenarion only the number of packages should be entered (no quantity).<br>\nIf only a part of a package is dispensed (sv bruten helförpackning), the pharmacy must enter both the quantity and the number of packages that was dispensed. <br>",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "Expedierad mängd"
                    }
                ]
            },
            {
                "id": "MedicationDispense.quantity.value",
                "path": "MedicationDispense.quantity.value",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "MedicationDispense.whenHandedOver",
                "path": "MedicationDispense.whenHandedOver",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "Expeditionstidpunkt"
                    }
                ]
            },
            {
                "id": "MedicationDispense.note",
                "path": "MedicationDispense.note",
                "short": "Pharmacists note",
                "definition": "The pharmacists note about the dispense.",
                "comment": "Maximum string length: 1016",
                "max": "1",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "Uttagsnotering"
                    }
                ]
            },
            {
                "id": "MedicationDispense.note.text",
                "path": "MedicationDispense.note.text",
                "mustSupport": true
            },
            {
                "id": "MedicationDispense.dosageInstruction",
                "path": "MedicationDispense.dosageInstruction",
                "comment": "A medication dispense is always based/dispatched on a specific version of a medication request. <br>\nA dosage instruction must be provided of there is a unique dosage for the medication dispense which differs from the dosage instruction on the medication request version. <br>\nThe dosage instruction on the medication request version is used as the valid dosage if no other dosage instruction is provided on the medication dispense. <br>\nIf a new dosage instruction should be in effect for the current and following medication dispenses, the medication request needs to be updated before the medication dispense is made.<br>\nFor a read-operation on a medication dispense, the dosage instruction must be read from the medication request version if there is no dosage instruction on the specific medication dispense resource.",
                "type":  [
                    {
                        "code": "Dosage",
                        "profile":  [
                            "http://electronichealth.se/fhir/StructureDefinition/NLLDosage"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "MedicationDispense.dosageInstruction.sequence",
                "path": "MedicationDispense.dosageInstruction.sequence",
                "definition": "Indicates the order in which the dosage instructions should be applied or interpreted ."
            },
            {
                "id": "MedicationDispense.substitution",
                "path": "MedicationDispense.substitution",
                "definition": "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.  If nothing is specified, substitution was not done.",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "Generikautbyte utfört"
                    }
                ]
            },
            {
                "id": "MedicationDispense.substitution.wasSubstituted",
                "path": "MedicationDispense.substitution.wasSubstituted",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "Generikautbyte utfört"
                    }
                ]
            },
            {
                "id": "MedicationDispense.detectedIssue",
                "path": "MedicationDispense.detectedIssue",
                "short": "Automatic Format and Constitution Control warning (AFF varning)",
                "definition": "Accepted warnings can be provided when creating a MedicationDispense.\nAutomatic Format and Constitution Control (AFF) accepted by the pharmacist.\nNB! The DetectedIssues are never saved by the Swedish eHealth Agency.",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://electronichealth.se/fhir/StructureDefinition/NLLDetectedIssue"
                        ],
                        "aggregation":  [
                            "contained"
                        ]
                    }
                ],
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "EHM",
                        "map": "Accepterade varningar"
                    }
                ]
            }
        ]
    }
}
MedicationDispense..
MedicationDispense.id..
MedicationDispense.meta..
MedicationDispense.meta.versionId..
MedicationDispense.meta.security..
MedicationDispense.meta.security.system..
MedicationDispense.meta.security.version..
MedicationDispense.meta.security.code..
MedicationDispense.extension3..
MedicationDispense.extensionExtension..1
MedicationDispense.extensionExtension1..
MedicationDispense.extensionExtension..
MedicationDispense.extensionExtension1..1
MedicationDispense.extensionExtension1..1
MedicationDispense.extensionExtension..
MedicationDispense.extensionExtension..1
MedicationDispense.extensionExtension..
MedicationDispense.extension.extension..
MedicationDispense.extension.extension..
MedicationDispense.extension.extension..
MedicationDispense.status..
MedicationDispense.medication[x]CodeableConcept..
MedicationDispense.medication[x].coding1..
MedicationDispense.medication[x].coding..1
MedicationDispense.medication[x].coding.system1..
MedicationDispense.medication[x].coding.code1..
MedicationDispense.medication[x].coding..1
MedicationDispense.medication[x].coding.system1..
MedicationDispense.medication[x].coding.code1..
MedicationDispense.medication[x].coding..1
MedicationDispense.medication[x].coding.system1..
MedicationDispense.medication[x].coding.code1..
MedicationDispense.authorizingPrescriptionReference(NLLMedicationRequest)1..1
MedicationDispense.type1..
MedicationDispense.type.coding1..1
MedicationDispense.type.coding.system..
MedicationDispense.type.coding.version..
MedicationDispense.type.coding.code1..
MedicationDispense.quantity..
MedicationDispense.quantity.value1..
MedicationDispense.whenHandedOver..
MedicationDispense.note..1
MedicationDispense.note.text..
MedicationDispense.dosageInstructionNLLDosage..
MedicationDispense.dosageInstruction.sequence..
MedicationDispense.substitution..
MedicationDispense.substitution.wasSubstituted..
MedicationDispense.detectedIssueReference(NLLDetectedIssue)..

Details

Description of all elements can be found here, Element descriptions.

Mapping of FHIR element names to the National Medication List names can be found here, Element language mappings.

Dosage

The dosageInstruction on a MedicationDispense authorized by a MedicationRequest in electronic format, should only be used if the dosageInstruction on the MedicationDispense differs from the dosageInstruction on the MedicationRequest. Otherwise the dosageInstruction on the MedicationDispense must be empty, which means that the dosageInstruction on the MedicationRequest will be used.

How to use the elements in dosageInstruction (the BackBoneElement Dosage) is described on the page Dosage and in the Handbok för vård- och apotekstjänster. Message examples for dosages are available on the page Dosage - Create

Medication dispense statuses

The following statuses are used within NLL for dispenses.

ValueSet medication-dispense-status

Parameter Comment
Completed The dispensed product has been picked up (sv: Expedierat).
Cancelled The dispensed product is not picked up by the patient (sv: Borttaget).

Medication dispense types

The following types are used within NLL for dispenses.

ValueSet dispense-types

Code Display
DD Dose dispensed fill (sv: Dosdispenserat uttag).
SP Standard packing fill (sv: Helförpackningsuttag).
TF Trial fill (sv: Startförpackning).

Supported operations

HTTP methods

Operation Supported Comment
Search (GET, POST) yes See below for supported search options.
Insert (POST) yes Create a new dispense. NB! When dispatching more than one dispense at the same occasion, a Bundle conforming to the NLLDispatch profile must be used.
Update (PUT) yes Change a dispense by either adjusting quantity, medication or reversing previous dispense.
Delete (DEL) no
Operation (GET, POST) yes See below for supported extended operations.

When interacting with this resource a set of HTTP-headers must be included in the request, see HTTP Header and Authorization.

Query operations

Supported queries

The following query alternatives are available for this resource.

  1. ../nllDispatchId/[id]

  2. ../MedicationDispense/[id]

  3. ../MedicationDispense/[id]/_history{/[vid]}

  4. ../MedicationDispense?[parameters]
    Parameter chains:

    Chain 1
    patient._id=[id]
    {&hasAuthorizingPrescription=true}
    {&nllDispatchId=[string]}
    {&whenhandedover=ge[date]}

    Chain 2
    medicationrequest._id=[id]
    {&whenhandedover=ge[date]}

    Chain 3
    authorizingPrescriptions=[id]{,[id]...}

Compartment searches

Supported searches on a compartment. This kind of search returns a bundle with the related resources.

  1. ../MedicationDispense/[id]/Provenance returns all related provenances.
  2. ../MedicationRequest/[id]/MedicationDispense returns all related medication dispenses (NLLMedicationDispenses).

Include & reverse includes

Supported usage of include and revinclude. This kind of search returns a bundle of both the base resource and the related resources specified in the parameter.

  1. ../MedicationDispense?[parameters]&_revinclude=Provenance:target:MedicationDispense returns one or more MedicationDispenses together with their Provenances. The Provenance returned is the one pointing at the returned version of the MedicationDispense. See above for a list of valid parameters.

Example: ../MedicationDispense?patient._id=<uuid>&whenhandedover=ge[date]&_revinclude=Provenance:target:MedicationDispense returns the patient's medication dispenses made on or after the selected date including one provenance per medication dispense.

For generic information about how to search in FHIR look here.

Search parameters

The table below shows all supported search parameters.

Search parameter Description Comment
MedicationDispense/[id] A read based on the logical ID (UUID) of a medication dispense
../MedicationDispense/<uuid>
_history A vread to get all versions of a medication dispense
../MedicationDispense/<uuid>/_history
_history/[vid] A vread to get a specific version of a medication dispense
../MedicationDispense/<uuid>/_history/3
patient._id UUID of the patient. Either patient reference or medication request reference must be part of the query and they are mutually exclusive
..?patient._id=<uuid>
medicationrequest._id UUID of the authorizing prescription (MedicationRequest). Either prescription reference or patient reference must be part of the query and they are mutually exclusive.
..?medicationrequest._id=<uuid>
hasAuthorizingPrescription Dispenses related to an electronic prescription
..&hasAuthorizingPrescription=true
If not specified all type of dispenses are returned
nllDispatchId Id of a dispatch
..&nllDispatchId=123
whenhandedover Date, greater than or equal, when the medication was dispensed at the pharmacy
..&whenhandedover=ge2021-08-31
Required prefix: ge
authorizingPrescriptions A list of UUIDs of authorizing prescriptions (MedicationRequests)
..?authorizingPrescriptions=4f0a61d5-c3d9-4803-b4c2-ea53732b086b,05b21687-fe0a-4311-b32f-a42108477b8f

Other operations

Operation Comment
$verify
NLLVerify

Invocations

URL: [base]/$verify

URL: [base]/MedicationRequest/$verify URL: [base]/MedicationDispense/$verify

This operation does NOT change content

Parameters (In)

NameCardinalityTypeDocumentation
resource0..1MedicationRequest(NLLMedicationRequest)

The MedicationRequest to be verified. This type of verification must be directed to the medication request end-point [base]/MedicationRequest/$verify.

resource0..1MedicationDispense(NLLMedicationDispense)

The MedicationDispense to be verified. This type of verification must be directed to the medication dispense end-point [base]/MedicationDispense/$verify.

resource0..1MedicationDispense(NLLDispensePaperPrescription)

The MedicationDispense to be verified. This type of verification must be directed to the medication dispense end-point [base]/MedicationDispense/$verify.

resource0..1Bundle(NLLDispatch)

A Bundle containing the MedicationDispenses to be verified. This type of verification must be directed to the service base end-point [base]/$verify.

resource0..1Bundle(NLLTransactionBundle)

A Bundle containing the resources to be verified. NB! Only MedicationDispenses to be verified according to the Automatic Format and Constitution Control (sv. Automatiska format- och författningskontroller AFF-kontroller). This type of verification must be directed to the service base end-point [base]/$verify.

Return Values (Out)

NameCardinalityTypeDocumentation
detectedIssues1..1boolean

Has the value 'true' if any AFF errors or warnings are detected, otherwise 'false'

issues0..1OperationOutcome(NLLOperationOutcome)

The OperationOutcome resource, shown in the profile NLLOperationOutcome is a collection of error, warning, or information messages. If the Automatic Format and Constitution Control (sv. Automatiska format- och författningskontroller AFF-kontroller) returns any errors or warnings, these are displayed as DetectedIssues in an OperationOutcome. No OperationOutcome will be returened if there are no issues.

Must be invoked with a HTTP POST. This operation is invoked on MedicationDispense and MedicationRequest resources to verify them according to the Automatic Format and Constitution Control (sv. Automatiska format- och författningskontroller AFF-kontroller). It is also possible to verify a set of MedicationDispenses by using $verify on the service base and providing a Bundle according to NLLDispatch or NLLTransactionBundle. NB! When providing a Bundle only MedicationDispenses will be verified accroding to the Automatic Format and Constitution Control. It is important that the content of the resource parameter matches the end-point of the request.

A Provenance object must be included in the HTTP header X-Provenance.