Page Status: updated 2024-10-28

NLLMedicationDispense (MedicationDispense)

Page index

Introduction
Overview
Details
Supported operations

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

NLLMedicationDispense (MedicationDispense)	I		MedicationDispense	Element id MedicationDispense Short description 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 NLLDetachedDipsense. Data type MedicationDispense Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.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-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-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` 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]
id	S Σ	0..1	string	Element id MedicationDispense.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. 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. Data type string Mappings EHM: Logiskt id för uttag
meta	S Σ	0..1	Meta	There are no (further) constraints on this element Element id MedicationDispense.meta Short description Metadata about the resource Definition The 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. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.meta.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.meta.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
versionId	S Σ	0..1	id	Element id MedicationDispense.meta.versionId Short description Version specific identifier Definition The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. 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. Data type id Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a EHM: Uttagsversion
lastUpdated	Σ	0..1	instant	There are no (further) constraints on this element Element id MedicationDispense.meta.lastUpdated Short description When the resource version last changed Definition When the resource last changed - e.g. when the version changed. 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. Data type instant Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
source	Σ	0..1	uri	There are no (further) constraints on this element Element id MedicationDispense.meta.source Short description Identifies where the resource comes from Definition A uri that identifies the source system of the resource. This provides a minimal amount of Provenance 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. 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. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
profile	Σ	0..*	canonical(StructureDefinition)	There are no (further) constraints on this element Element id MedicationDispense.meta.profile Short description Profiles this resource claims to conform to Definition A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. 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. Data type canonical(StructureDefinition) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
security	S Σ	0..*	CodingBinding	Element id MedicationDispense.meta.security Short description Security Labels applied to this resource Definition Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. 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. Data type Coding Binding Security Labels from the Healthcare Privacy and Security Classification System. security-labels (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.meta.security.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.meta.security.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
system	S Σ	0..1	uri	There are no (further) constraints on this element Element id MedicationDispense.meta.security.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. 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. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	S Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.meta.security.version Short description Version of the system - if relevant Definition The 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. 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	S Σ	0..1	code	There are no (further) constraints on this element Element id MedicationDispense.meta.security.code Short description Symbol in syntax defined by the system Definition A 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). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.meta.security.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id MedicationDispense.meta.security.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a 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 ]
tag	Σ	0..*	Coding	There are no (further) constraints on this element Element id MedicationDispense.meta.tag Short description Tags applied to this resource Definition Tags 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. 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. Data type Coding Binding Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". CommonTags (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id MedicationDispense.implicitRules Short description A set of rules under which this content was created Definition A 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. 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. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
language		0..1	codeBinding	There are no (further) constraints on this element Element id MedicationDispense.language Short description Language of the resource content Definition The base language in which the resource is written. 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). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
text		0..1	Narrative	There are no (further) constraints on this element Element id MedicationDispense.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A 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. 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. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id MedicationDispense.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These 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. 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. Data type Resource Mappings rim: Entity. Role, or Act rim: N/A
extension	I	3..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
nllNumberOfPackagesDispensed	S I	0..1	Extension(positiveInt)	Element id MedicationDispense.extension:nllNumberOfPackagesDispensed Short description Number of packages dispensed Alternate names extensions, user content Definition The number of packages that were included in the dispense. Shall not be set for dose dispensed dispenses. 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. Data type Extension(positiveInt) Extension URL http://electronichealth.se/fhir/StructureDefinition/NLLNumberOfPackagesDispensed Constraints 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
nllActorDispatchId	S I	1..1	Extension(string)	Element id MedicationDispense.extension:nllActorDispatchId Short description The identifier of the actor's dispatch in which the dispense was made Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments Maximum string length: 12 Data type Extension(string) Extension URL http://electronichealth.se/fhir/StructureDefinition/NLLActorDispatchId Constraints 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
nllDispatchId	S I	0..1	Extension(string)	Element id MedicationDispense.extension:nllDispatchId Short description The identifier of the dispatch in which the dispense was made Alternate names extensions, user content Definition Value 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. 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. Data type Extension(string) Extension URL http://electronichealth.se/fhir/StructureDefinition/NLLDispatchId Constraints 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
nllBenefitChoiceCode	S I	1..1	Extension(code)Binding	Element id MedicationDispense.extension:nllBenefitChoiceCode Short description Benefit choice Alternate names extensions, user content Definition Type of benefit for the dispense. 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. Data type Extension(code) Extension URL http://electronichealth.se/fhir/StructureDefinition/NLLBenefitChoiceCode Binding Förmånsval (benefit-choices) (required) Constraints 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
nllDispatchRowNo	S I	1..1	Extension(decimal)	Element id MedicationDispense.extension:nllDispatchRowNo Short description Identier for MedicationDispense within dispatch Alternate names extensions, user content Definition Used when communicationg an error or warning for a MedicationDispense within a dispatch. The DispatchRowNo (ExpeditionsRadNummer) uniquely identifies a MediationDispense within a dispatch. 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. Data type Extension(decimal) Extension URL http://electronichealth.se/fhir/StructureDefinition/NLLDispatchRowNo Constraints 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
nllDeductedQuantity	S I	0..1	Extension(decimal)	Element id MedicationDispense.extension:nllDeductedQuantity Short description Deducted quantity Alternate names extensions, user content Definition The quantity that is deducted form the prescription's remaining quantity. Only used if the deducted quantity should differ from the dispensed quantity. 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. Data type Extension(decimal) Extension URL http://electronichealth.se/fhir/StructureDefinition/NLLDeductedQuantity Constraints 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
nllCompletePrescriptionChoice	S I	0..1	Extension(code)Binding	Element id MedicationDispense.extension:nllCompletePrescriptionChoice Short description Prescription completion choice Alternate names extensions, user content Definition Only 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". 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. Data type Extension(code) Extension URL http://electronichealth.se/fhir/StructureDefinition/NLLCompletePrescriptionChoice Binding Beslut slutexpediering (complete-prescription-choices) (required) Constraints 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
nllDispenseCrediting	S I	0..1	Extension(Complex)	Element id MedicationDispense.extension:nllDispenseCrediting Short description Crediting details Alternate names extensions, user content Definition Crediting details for a dispense 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. Data type Extension(Complex) Extension URL http://electronichealth.se/fhir/StructureDefinition/NLLDispenseCrediting Constraints 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
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.extension:nllDispenseCrediting.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	2..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.extension:nllDispenseCrediting.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
creditDate	S I	1..1	Extension	Element id MedicationDispense.extension:nllDispenseCrediting.extension:creditDate Short description Credit date and time Alternate names extensions, user content Definition The date and time when the dispense was credited. 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. Data type Extension Constraints 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: Krediteringstidpunkt
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.extension:nllDispenseCrediting.extension:creditDate.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.extension:nllDispenseCrediting.extension:creditDate.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id MedicationDispense.extension:nllDispenseCrediting.extension:creditDate.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. 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. Data type uri Fixed value creditDate Mappings rim: N/A
value[x]		1..1		There are no (further) constraints on this element Element id MedicationDispense.extension:nllDispenseCrediting.extension:creditDate.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
valueDateTime			dateTime	There are no (further) constraints on this element Data type dateTime
creditDispatchId	S I	1..1	Extension	There are no (further) constraints on this element Element id MedicationDispense.extension:nllDispenseCrediting.extension:creditDispatchId Short description Credit dispatch id Alternate names extensions, user content Definition The id of the crediting dispatch. 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. Data type Extension Constraints 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: Krediterande expeditions-id
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.extension:nllDispenseCrediting.extension:creditDispatchId.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.extension:nllDispenseCrediting.extension:creditDispatchId.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id MedicationDispense.extension:nllDispenseCrediting.extension:creditDispatchId.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. 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. Data type uri Fixed value creditDispatchId Mappings rim: N/A
value[x]		1..1		There are no (further) constraints on this element Element id MedicationDispense.extension:nllDispenseCrediting.extension:creditDispatchId.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
valueString			string	There are no (further) constraints on this element Data type string
creditDispatchRowNo	S I	0..1	Extension	There are no (further) constraints on this element Element id MedicationDispense.extension:nllDispenseCrediting.extension:creditDispatchRowNo Short description Credit dispatch row number Alternate names extensions, user content Definition NB! 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'. 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. Data type Extension Constraints 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 krediterande expeditionsradnummer
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.extension:nllDispenseCrediting.extension:creditDispatchRowNo.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.extension:nllDispenseCrediting.extension:creditDispatchRowNo.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id MedicationDispense.extension:nllDispenseCrediting.extension:creditDispatchRowNo.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. 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. Data type uri Fixed value creditDispatchRowNo Mappings rim: N/A
value[x]		0..1		There are no (further) constraints on this element Element id MedicationDispense.extension:nllDispenseCrediting.extension:creditDispatchRowNo.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
valueBase64Binary			base64Binary	There are no (further) constraints on this element Data type base64Binary
valueBoolean			boolean	There are no (further) constraints on this element Data type boolean
valueCanonical			canonical()	There are no (further) constraints on this element Data type canonical()
valueCode			code	There are no (further) constraints on this element Data type code
valueDate			date	There are no (further) constraints on this element Data type date
valueDateTime			dateTime	There are no (further) constraints on this element Data type dateTime
valueDecimal			decimal	There are no (further) constraints on this element Data type decimal
valueId			id	There are no (further) constraints on this element Data type id
valueInstant			instant	There are no (further) constraints on this element Data type instant
valueInteger			integer	There are no (further) constraints on this element Data type integer
valueMarkdown			markdown	There are no (further) constraints on this element Data type markdown
valueOid			oid	There are no (further) constraints on this element Data type oid
valuePositiveInt			positiveInt	There are no (further) constraints on this element Data type positiveInt
valueString			string	There are no (further) constraints on this element Data type string
valueTime			time	There are no (further) constraints on this element Data type time
valueUnsignedInt			unsignedInt	There are no (further) constraints on this element Data type unsignedInt
valueUri			uri	There are no (further) constraints on this element Data type uri
valueUrl			url	There are no (further) constraints on this element Data type url
valueUuid			uuid	There are no (further) constraints on this element Data type uuid
valueAddress			Address	There are no (further) constraints on this element Data type Address
valueAge			Age	There are no (further) constraints on this element Data type Age
valueAnnotation			Annotation	There are no (further) constraints on this element Data type Annotation
valueAttachment			Attachment	There are no (further) constraints on this element Data type Attachment
valueCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data type CodeableConcept
valueCoding			Coding	There are no (further) constraints on this element Data type Coding
valueContactPoint			ContactPoint	There are no (further) constraints on this element Data type ContactPoint
valueCount			Count	There are no (further) constraints on this element Data type Count
valueDistance			Distance	There are no (further) constraints on this element Data type Distance
valueDuration			Duration	There are no (further) constraints on this element Data type Duration
valueHumanName			HumanName	There are no (further) constraints on this element Data type HumanName
valueIdentifier			Identifier	There are no (further) constraints on this element Data type Identifier
valueMoney			Money	There are no (further) constraints on this element Data type Money
valuePeriod			Period	There are no (further) constraints on this element Data type Period
valueQuantity			Quantity	There are no (further) constraints on this element Data type Quantity
valueRange			Range	There are no (further) constraints on this element Data type Range
valueRatio			Ratio	There are no (further) constraints on this element Data type Ratio
valueSampledData			SampledData	There are no (further) constraints on this element Data type SampledData
valueSignature			Signature	There are no (further) constraints on this element Data type Signature
valueTiming			Timing	There are no (further) constraints on this element Data type Timing
valueContactDetail			ContactDetail	There are no (further) constraints on this element Data type ContactDetail
valueContributor			Contributor	There are no (further) constraints on this element Data type Contributor
valueDataRequirement			DataRequirement	There are no (further) constraints on this element Data type DataRequirement
valueExpression			Expression	There are no (further) constraints on this element Data type Expression
valueParameterDefinition			ParameterDefinition	There are no (further) constraints on this element Data type ParameterDefinition
valueRelatedArtifact			RelatedArtifact	There are no (further) constraints on this element Data type RelatedArtifact
valueTriggerDefinition			TriggerDefinition	There are no (further) constraints on this element Data type TriggerDefinition
valueUsageContext			UsageContext	There are no (further) constraints on this element Data type UsageContext
valueDosage			Dosage	There are no (further) constraints on this element Data type Dosage
valueMeta			Meta	There are no (further) constraints on this element Data type Meta
valueReference			Reference()	There are no (further) constraints on this element Data type Reference()
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id MedicationDispense.extension:nllDispenseCrediting.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. 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. Data type uri Fixed value http://electronichealth.se/fhir/StructureDefinition/NLLDispenseCrediting Mappings rim: N/A
value[x]		0..0		There are no (further) constraints on this element Element id MedicationDispense.extension:nllDispenseCrediting.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May 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). 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
identifier		0..*	Identifier	There are no (further) constraints on this element Element id MedicationDispense.identifier Short description External identifier Definition Identifiers 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. Comments This is a business identifier, not a resource identifier. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier workflow: Event.identifier w5: FiveWs.identifier rim: .id rx-dispense-rmim: CombinedMedicationDispense.id
partOf	I	0..*	Reference(Procedure)	There are no (further) constraints on this element Element id MedicationDispense.partOf Short description Event that dispense is part of Definition The procedure that trigger the dispense. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Procedure) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.partOf rim: .outboundRelationship[typeCode=COMP]/target[classCode=PROC,moodCode=EVN]
status	S Σ ?!	1..1	codeBinding	Element id MedicationDispense.status Short description cancelled \| completed Definition A code specifying the state of the set of dispense events. Comments This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. Data type code Binding A coded concept specifying the state of the dispense event. Uttagsstatus (medication-dispense-status) (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Event.status w5: FiveWs.status rim: .statusCode rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.statusCode EHM: Uttagsstatus
statusReason[x]		0..1		There are no (further) constraints on this element Element id MedicationDispense.statusReason[x] Short description Why a dispense was not performed Definition Indicates the reason why a dispense was not performed. Binding A code describing why a dispense was not performed. MedicationDispense Status Reason Codes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Event.statusReason rim: .outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code="not done reason"].value
statusReasonCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data type CodeableConcept
statusReasonReference			Reference(DetectedIssue)	There are no (further) constraints on this element Data type Reference(DetectedIssue)
category		0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id MedicationDispense.category Short description Type of medication dispense Definition Indicates the type of medication dispense (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)). 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. Data type CodeableConcept Binding A code describing where the dispensed medication is expected to be consumed or administered. MedicationDispense Category Codes (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD rim: .inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication dispense"].value
medication[x]	S Σ	1..1	Binding	Element id MedicationDispense.medication[x] Short description Dispensed medication or reimbursed consumable Definition Identifies 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. Comments If more information is required, then the use of the medication resource is recommended. Binding A coded concept identifying which substance or product can be dispensed. SNOMEDCTMedicationCodes (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a 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
medicationCodeableConcept			CodeableConcept	Data type CodeableConcept
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.medication[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.medication[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
coding	S Σ	1..*	Coding	Element id MedicationDispense.medication[x].coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. 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. Data type Coding Sliced: Unordered, Open, by system(Value) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
nplid	S Σ	0..1	Coding	Element id MedicationDispense.medication[x].coding:nplid Short description 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) 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. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding EHM: NPL-id
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.medication[x].coding:nplid.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.medication[x].coding:nplid.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
system	S Σ	1..1	uriFixed Value	Element id MedicationDispense.medication[x].coding:nplid.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. 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. Data type uri Constraints 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 rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.medication[x].coding:nplid.version Short description Version of the system - if relevant Definition The 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. 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	S Σ	1..1	code	Element id MedicationDispense.medication[x].coding:nplid.code Short description Symbol in syntax defined by the system Definition A 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). Requirements Need to refer to a particular code in the system. Comments Maximum string length: 14 Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.medication[x].coding:nplid.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id MedicationDispense.medication[x].coding:nplid.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a 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 ]
nplpackid	S Σ	0..1	Coding	Element id MedicationDispense.medication[x].coding:nplpackid Short description 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). 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. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding EHM: NPL-pack-id
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.medication[x].coding:nplpackid.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.medication[x].coding:nplpackid.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
system	S Σ	1..1	uriFixed Value	Element id MedicationDispense.medication[x].coding:nplpackid.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. 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. Data type uri Constraints 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 rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.medication[x].coding:nplpackid.version Short description Version of the system - if relevant Definition The 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. 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	S Σ	1..1	code	Element id MedicationDispense.medication[x].coding:nplpackid.code Short description Symbol in syntax defined by the system Definition A 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). Requirements Need to refer to a particular code in the system. Comments Maximum string length: 14 Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.medication[x].coding:nplpackid.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id MedicationDispense.medication[x].coding:nplpackid.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a 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 ]
varunr	S Σ	0..1	Coding	Element id MedicationDispense.medication[x].coding:varunr Short description Varunummer Definition A 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. 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. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding EHM: Varunummer
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.medication[x].coding:varunr.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.medication[x].coding:varunr.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
system	S Σ	1..1	uriFixed Value	Element id MedicationDispense.medication[x].coding:varunr.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. 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. Data type uri Constraints 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 rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.medication[x].coding:varunr.version Short description Version of the system - if relevant Definition The 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. 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	S Σ	1..1	code	Element id MedicationDispense.medication[x].coding:varunr.code Short description Symbol in syntax defined by the system Definition A 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). Requirements Need to refer to a particular code in the system. Comments Minimum string length: 6 Maximum string length: 6 Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.medication[x].coding:varunr.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id MedicationDispense.medication[x].coding:varunr.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a 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 ]
text	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.medication[x].text Short description Plain text representation of the concept Definition A 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. 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
subject	Σ I	0..1	Reference(Patient \| Group)	There are no (further) constraints on this element Element id MedicationDispense.subject Short description Who the dispense is for Definition A link to a resource representing the person or the group to whom the medication will be given. Comments SubstanceAdministration->subject->Patient. Data type Reference(Patient \| Group) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.subject w5: FiveWs.subject[x] v2: PID-3-Patient ID List rim: .participation[typeCode=SBJ].role[classCode=PAT] w5: FiveWs.subject
context	I	0..1	Reference(Encounter \| EpisodeOfCare)	There are no (further) constraints on this element Element id MedicationDispense.context Short description Encounter / Episode associated with event Definition The encounter or episode of care that establishes the context for this event. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Encounter \| EpisodeOfCare) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.context rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]
supportingInformation	I	0..*	Reference(Resource)	There are no (further) constraints on this element Element id MedicationDispense.supportingInformation Short description Information that supports the dispensing of the medication Definition Additional information that supports the medication being dispensed. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Resource) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) 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)]
performer		0..*	BackboneElement	There are no (further) constraints on this element Element id MedicationDispense.performer Short description Who performed event Definition Indicates who or what performed the event. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Event.performer rim: .participation[typeCode=PRF]
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.performer.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.performer.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.performer.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May 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). 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. Data type Extension Constraints 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
function		0..1	CodeableConcept	There are no (further) constraints on this element Element id MedicationDispense.performer.function Short description Who performed the dispense and what they did Definition Distinguishes the type of performer in the dispense. For example, date enterer, packager, final checker. Requirements Allows disambiguation of the types of involvement of different performers. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding A code describing the role an individual played in dispensing a medication. MedicationDispense Performer Function Codes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD rim: participation[typeCode=PRF].functionCode
actor	I	1..1	Reference(Practitioner \| PractitionerRole \| Organization \| Patient \| Device \| RelatedPerson)	There are no (further) constraints on this element Element id MedicationDispense.performer.actor Short description Individual who was performing Definition The device, practitioner, etc. who performed the action. It should be assumed that the actor is the dispenser of the medication. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Practitioner \| PractitionerRole \| Organization \| Patient \| Device \| RelatedPerson) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.performer.actor rim: .role
location	I	0..1	Reference(Location)	There are no (further) constraints on this element Element id MedicationDispense.location Short description Where the dispense occurred Definition The principal physical location where the dispense was performed. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Location) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: .participation[typeCode=LOC].role
authorizingPrescription	S I	1..1	Reference(NLLMedicationRequest)	Element id MedicationDispense.authorizingPrescription Short description 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. Comments Maps to basedOn in Event logical model. Data type Reference(NLLMedicationRequest) Allowed aggregation: referenced Versioning rules: The reference must be version specific. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.basedOn v2: ORC-2 Placer Order Number rim: .outboundRelationship[typeCode=FLFS].target[moodCode=RQO] rx-dispense-rmim: CombinedMedicationDispense.inFulfillmentOf EHM: Förskrivningsversion
type	S	1..1	CodeableConceptBinding	Element id MedicationDispense.type Short description 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). Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding Indicates the type of dispensing event that is performed, e.g. Standard packing fill, Trial fill or Dose dispense refill Uttagstyp (dispense-types) (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: RXD-33-Dispense Type rim: .code rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.code EHM: Uttagstyp
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.type.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.type.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
coding	S Σ	1..1	Coding	There are no (further) constraints on this element Element id MedicationDispense.type.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. 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. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.type.coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.type.coding.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
system	S Σ	0..1	uri	There are no (further) constraints on this element Element id MedicationDispense.type.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. 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. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	S Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.type.coding.version Short description Version of the system - if relevant Definition The 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. 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	S Σ	1..1	code	There are no (further) constraints on this element Element id MedicationDispense.type.coding.code Short description Symbol in syntax defined by the system Definition A 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). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.type.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id MedicationDispense.type.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a 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 ]
text	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.type.text Short description Plain text representation of the concept Definition A 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. 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
quantity	S I	0..1	SimpleQuantity	Element id MedicationDispense.quantity Short description Amount dispensed Definition The amount of the article that has been dispensed. 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> Data type SimpleQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values 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
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.quantity.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.quantity.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
value	S Σ	1..1	decimal	There are no (further) constraints on this element Element id MedicationDispense.quantity.value Short description Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value. 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). Data type decimal Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: SN.2 / CQ - N/A rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
comparator	Σ ?!	0..0	codeBinding	There are no (further) constraints on this element Element id MedicationDispense.quantity.comparator Short description < \| <= \| >= \| > - how to understand the value Definition Not allowed to be used in this context Requirements Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Meaning when missing If there is no comparator, then there is no modification of the value Data type code Binding How the Quantity should be understood and represented. QuantityComparator (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: SN.1 / CQ.1 rim: IVL properties
unit	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.quantity.unit Short description Unit representation Definition A human-readable form of the unit. Requirements There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: PQ.unit
system	Σ I	0..1	uri	There are no (further) constraints on this element Element id MedicationDispense.quantity.system Short description System that defines coded unit form Definition The identification of the system that provides the coded form of the unit. Requirements Need to know the system that defines the coded form of the unit. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: CO.codeSystem, PQ.translation.codeSystem
code	Σ	0..1	code	There are no (further) constraints on this element Element id MedicationDispense.quantity.code Short description Coded form of the unit Definition A computer processable form of the unit in some unit representation system. 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. Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: PQ.code, MO.currency, PQ.translation.code
daysSupply	I	0..1	SimpleQuantity	There are no (further) constraints on this element Element id MedicationDispense.daysSupply Short description Amount of medication expressed as a timing amount Definition The amount of medication expressed as a timing amount. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data type SimpleQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values 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
whenPrepared	Σ	0..1	dateTime	There are no (further) constraints on this element Element id MedicationDispense.whenPrepared Short description When product was packaged and reviewed Definition The time when the dispensed product was packaged and reviewed. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: RXD-3-Date/Time Dispensed rim: .effectiveTime[xmi:type=IVL_TS].low rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.effectiveTime
whenHandedOver	S	0..1	dateTime	Element id MedicationDispense.whenHandedOver Short description When product was given out Definition The time the dispensed product was provided to the patient or their representative. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a 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
destination	I	0..1	Reference(Location)	There are no (further) constraints on this element Element id MedicationDispense.destination Short description Where the medication was sent Definition Identification of the facility/location where the medication was shipped to, as part of the dispense event. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Location) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) 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
receiver	I	0..*	Reference(Patient \| Practitioner)	There are no (further) constraints on this element Element id MedicationDispense.receiver Short description Who collected the medication Definition Identifies the person who picked up the medication. This will usually be a patient or their caregiver, but some cases exist where it can be a healthcare professional. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Patient \| Practitioner) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: .participation[typeCode=RCV].role rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.receiver
note	S	0..1	Annotation	Element id MedicationDispense.note Short description Pharmacists note Definition The pharmacists note about the dispense. Comments Maximum string length: 1016 Data type Annotation Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: N/A rim: Act workflow: Event.note v2: RXD-9 Dispense Notes rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=ACT,moodCode=EVN] EHM: Uttagsnotering
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.note.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.note.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
author[x]	Σ	0..1		There are no (further) constraints on this element Element id MedicationDispense.note.author[x] Short description Individual responsible for the annotation Definition The individual responsible for making the annotation. Comments Organization is used when there's no need for specific attribution as to who made the comment. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: N/A rim: Act.participant[typeCode=AUT].role
authorString			string	There are no (further) constraints on this element Data type string
authorReference			Reference(Practitioner \| Patient \| RelatedPerson \| Organization)	There are no (further) constraints on this element Data type Reference(Practitioner \| Patient \| RelatedPerson \| Organization)
time	Σ	0..1	dateTime	There are no (further) constraints on this element Element id MedicationDispense.note.time Short description When the annotation was made Definition Indicates when this particular annotation was made. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: N/A rim: Act.effectiveTime
text	S Σ	1..1	markdown	There are no (further) constraints on this element Element id MedicationDispense.note.text Short description The annotation - text content (as markdown) Definition The text of the annotation in markdown format. Comments Systems are not required to have markdown support, so the text should be readable without markdown processing. The markdown syntax is GFM - see https://github.github.com/gfm/ Data type markdown Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: N/A rim: Act.text
dosageInstruction	S	0..*	NLLDosage	Element id MedicationDispense.dosageInstruction Short description How the medication is/was taken or should be taken Definition Indicates how the medication is/was taken or should be taken by the patient. 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. Data type NLLDosage Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: .outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
nllObservandumDose	S I	0..1	Extension(boolean)	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.extension:nllObservandumDose Short description Dose exceeds recommended dose Alternate names extensions, user content Definition Indicates that the prescriber has made a conscious choice where the dose exceeds what is recommended for the prescribed medication. Comments NB! The same value must be provided in this element on each sequence / subsequence. Data type Extension(boolean) Extension URL http://electronichealth.se/fhir/StructureDefinition/NLLObservandumDose Constraints 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
nllAdministeringInstruction	S I	0..1	Extension(string)	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.extension:nllAdministeringInstruction Short description Patient oriented administration instructions Alternate names extensions, user content Definition Administration instructions put in terms that are comprehensible to the patient. This shall be generated from the structured administration information attributes. Comments Maximum string length: 512 <br> NB! The same value must be provided in this element on each sequence / subsequence. Data type Extension(string) Extension URL http://electronichealth.se/fhir/StructureDefinition/NLLAdministeringInstruction Constraints 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
nllMedicalDevice	S I	0..1	Extension(CodeableConcept)	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.extension:nllMedicalDevice Short description Medical device to use for administration. Alternate names extensions, user content Definition Medical device to use for administration. 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. Data type Extension(CodeableConcept) Extension URL http://electronichealth.se/fhir/StructureDefinition/NLLMedicalDevice Constraints 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
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.extension:nllMedicalDevice.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.extension:nllMedicalDevice.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.extension:nllMedicalDevice.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. 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. Data type uri Fixed value http://electronichealth.se/fhir/StructureDefinition/NLLMedicalDevice Mappings rim: N/A
value[x]	S	1..1		There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.extension:nllMedicalDevice.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
valueCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data type CodeableConcept
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.extension:nllMedicalDevice.value[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.extension:nllMedicalDevice.value[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
coding	S Σ	0..1	CodingBinding	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.extension:nllMedicalDevice.value[x].coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. 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. Data type Coding Binding http://electronichealth.se/fhir/ValueSet/nll-snomed-medical-device (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.extension:nllMedicalDevice.value[x].coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.extension:nllMedicalDevice.value[x].coding.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
system	S Σ	0..1	uri	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.extension:nllMedicalDevice.value[x].coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. 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. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	S Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.extension:nllMedicalDevice.value[x].coding.version Short description Version of the system - if relevant Definition The 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. 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	S Σ	1..1	code	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.extension:nllMedicalDevice.value[x].coding.code Short description Symbol in syntax defined by the system Definition A 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). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.extension:nllMedicalDevice.value[x].coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.extension:nllMedicalDevice.value[x].coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a 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 ]
text	S Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.extension:nllMedicalDevice.value[x].text Short description Plain text representation of the concept Definition A 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. 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 Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Maximum string length 256 Mappings rim: n/a v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText EHM: Beskrivning annan medicinteknisk produkt
nllSubSequence	S I	0..1	Extension(integer)	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.extension:nllSubSequence Short description Subsequence Alternate names extensions, user content Definition Indicates the order of subqeuences within a sequence. 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. Data type Extension(integer) Extension URL http://electronichealth.se/fhir/StructureDefinition/NLLSubSequence Constraints 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
nllDosageType	S I	0..1	Extension(code)	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.extension:nllDosageType Short description Dosage type Alternate names extensions, user content Definition Calculated by the Swedish eHealth Agency. The dosage type that matches the provided set of dosage data. Comments _ Data type Extension(code) Extension URL http://electronichealth.se/fhir/StructureDefinition/NLLDosageType Constraints 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
nllSiteQualifier	S I	0..1	Extension(CodeableConcept)	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.extension:nllSiteQualifier Short description More precise administration site Alternate names extensions, user content Definition Qualified adminsitration site is used when more exact information about the site is needed. 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. Data type Extension(CodeableConcept) Extension URL http://electronichealth.se/fhir/StructureDefinition/NLLSiteQualifier Constraints 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
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.extension:nllSiteQualifier.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.extension:nllSiteQualifier.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
url		1..1	uriFixed Value	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.extension:nllSiteQualifier.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. 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. Data type uri Fixed value http://electronichealth.se/fhir/StructureDefinition/NLLSiteQualifier Mappings rim: N/A
value[x]	S	1..1		There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.extension:nllSiteQualifier.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
valueCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data type CodeableConcept
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.extension:nllSiteQualifier.value[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.extension:nllSiteQualifier.value[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
coding	S Σ	1..1	CodingBinding	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.extension:nllSiteQualifier.value[x].coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. 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. Data type Coding Binding http://electronichealth.se/fhir/ValueSet/nll-snomed-qualifier (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.extension:nllSiteQualifier.value[x].coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.extension:nllSiteQualifier.value[x].coding.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
system	S Σ	0..1	uri	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.extension:nllSiteQualifier.value[x].coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. 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. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	S Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.extension:nllSiteQualifier.value[x].coding.version Short description Version of the system - if relevant Definition The 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. 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	S Σ	1..1	code	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.extension:nllSiteQualifier.value[x].coding.code Short description Symbol in syntax defined by the system Definition A 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). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code EHM: Precisering av administreringsställe
display	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.extension:nllSiteQualifier.value[x].coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.extension:nllSiteQualifier.value[x].coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a 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 ]
text	S Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.extension:nllSiteQualifier.value[x].text Short description Plain text representation of the concept Definition A 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. 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 Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Maximum string length 256 Mappings rim: n/a v2: CE.9. But note many systems use CE.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
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May 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). 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. Data type Extension Constraints 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
sequence	S Σ	1..1	integer	Element id MedicationDispense.dosageInstruction.sequence Short description The order of the dosage instructions Definition Indicates the order in which the dosage instructions should be applied or interpreted . 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. Data type integer Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: TQ1-1 rim: .text EHM: Sekvens
text	S Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.text Short description Free text dosage Definition Free text dosage 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 Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Maximum string length 512 Mappings rim: n/a v2: RXO-6; RXE-21 rim: .text EHM: Fritextdosering
additionalInstruction	S Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.additionalInstruction Short description Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Definition Supplemental 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"). 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. Data type CodeableConcept Binding A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". SNOMEDCTAdditionalDosageInstructions (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: RXO-7 rim: .text
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.additionalInstruction.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.additionalInstruction.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
coding	Σ	0..*	Coding	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.additionalInstruction.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. 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. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
text	S Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.additionalInstruction.text Short description Plain text representation of the concept Definition A 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. Requirements In the Swedish National Medication List Additional instruction is written in free text. Comments Maximum string length: 512 Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Maximum string length 512 Mappings rim: n/a v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText EHM: Annan instruktion
patientInstruction	S Σ	1..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.patientInstruction Short description Patient oriented dosage instructions Definition Dosage instructions in terms that are understood by the patient. This shall be generated from the structured dosage information attributes. Comments Maximum string length: 512 <br> NB! The same value must be provided in this element on each sequence / subsequence. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Maximum string length 512 Mappings rim: n/a v2: RXO-7 rim: .text EHM: Doseringsinstruktion
timing	S Σ	0..1	Timing	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing Short description When medication should be administered Definition When medication should be administered. 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 _ Data type Timing Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: N/A rim: QSET<TS> (GTS) rim: .effectiveTime
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May 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). 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. Data type Extension Constraints 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
event	Σ	0..*	dateTime	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.event Short description When the event occurs Definition Identifies specific times when the event occurs. Requirements In a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: QLIST<TS>
repeat	S Σ I	0..1	Element	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat Short description When the event is to occur Definition A set of rules that describe when the event is scheduled. Requirements Many timing schedules are determined by regular repetitions. Data type Element Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` 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-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-1: if there's a duration, there needs to be duration units `duration.empty() or durationUnit.exists()` tim-10: If there's a timeOfDay, there cannot be a when, or vice versa `timeOfDay.empty() or when.empty()` 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` Mappings rim: n/a rim: Implies PIVL or EIVL
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
nllSubSequenceDuration	S I	0..1	Extension(Quantity)	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.extension:nllSubSequenceDuration Short description SubSequence duration Alternate names extensions, user content Definition The 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. Requirements Used for the dosage type "tillfällesdosering". Comments _ Data type Extension(Quantity) Extension URL http://electronichealth.se/fhir/StructureDefinition/NLLSubSequenceDuration Constraints 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
bounds[x]	S Σ	0..1		There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.bounds[x] Short description Length/Range of lengths Definition Either 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. Sliced: Unordered, Open, by $this(Type) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: IVL(TS) used in a QSI
boundsDuration	S Σ	0..1	Duration	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsDuration Short description Sequence length Definition A duration for the length of the timing schedule. Data type Duration Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: IVL(TS) used in a QSI EHM: Längd doseringssteg
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
value	S Σ	1..1	decimal	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.value Short description Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value. 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). Data type decimal Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a 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
comparator	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.comparator Short description < \| <= \| >= \| > - how to understand the value Definition How 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. Requirements Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Meaning when missing If there is no comparator, then there is no modification of the value Data type code Binding How the Quantity should be understood and represented. QuantityComparator (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: SN.1 / CQ.1 rim: IVL properties
unit	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.unit Short description Unit representation Definition A human-readable form of the unit. Requirements There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: PQ.unit
system	S Σ I	0..1	uri	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.system Short description System that defines coded unit form Definition The identification of the system that provides the coded form of the unit. Requirements Need to know the system that defines the coded form of the unit. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: CO.codeSystem, PQ.translation.codeSystem
code	S Σ	1..1	codeBindingFixed Value	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.code Short description Coded form of the unit Definition A computer processable form of the unit in some unit representation system. 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. Data type code Binding Längdenhet doseringssteg (sequence-length-units) (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value d Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: PQ.code, MO.currency, PQ.translation.code EHM: Enhet längd doseringssteg
boundsRange	S Σ	0..1	Range	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange Short description Range of lengths Definition A range of possible length. Data type Range Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: IVL(TS) used in a QSI EHM: Längd doseringssteg min/max
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
low	S Σ I	1..1	SimpleQuantity	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low Short description Low limit Definition The low limit. The boundary is inclusive. Comments If the low element is missing, the low boundary is not known. Data type SimpleQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values v2: NR.1 rim: ./low EHM: Min längd doseringssteg
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
value	S Σ	1..1	decimal	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.value Short description Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value. 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). Data type decimal Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a 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
comparator	Σ ?!	0..0	codeBinding	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.comparator Short description < \| <= \| >= \| > - how to understand the value Definition Not allowed to be used in this context Requirements Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Meaning when missing If there is no comparator, then there is no modification of the value Data type code Binding How the Quantity should be understood and represented. QuantityComparator (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: SN.1 / CQ.1 rim: IVL properties
unit	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.unit Short description Unit representation Definition A human-readable form of the unit. Requirements There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: PQ.unit
system	S Σ I	0..1	uri	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.system Short description System that defines coded unit form Definition The identification of the system that provides the coded form of the unit. Requirements Need to know the system that defines the coded form of the unit. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: CO.codeSystem, PQ.translation.codeSystem
code	S Σ	1..1	codeBindingFixed Value	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.code Short description Coded form of the unit Definition A computer processable form of the unit in some unit representation system. 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. Data type code Binding Längdenhet doseringssteg (sequence-length-units) (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value d Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: PQ.code, MO.currency, PQ.translation.code EHM: Enhet min längd doseringssteg
high	S Σ I	1..1	SimpleQuantity	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high Short description High limit Definition The high limit. The boundary is inclusive. Comments If the high element is missing, the high boundary is not known. Data type SimpleQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values v2: NR.2 rim: ./high EHM: Max längd doseringssteg
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
value	S Σ	1..1	decimal	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.value Short description Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value. 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). Data type decimal Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a 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
comparator	Σ ?!	0..0	codeBinding	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.comparator Short description < \| <= \| >= \| > - how to understand the value Definition Not allowed to be used in this context Requirements Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Meaning when missing If there is no comparator, then there is no modification of the value Data type code Binding How the Quantity should be understood and represented. QuantityComparator (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: SN.1 / CQ.1 rim: IVL properties
unit	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.unit Short description Unit representation Definition A human-readable form of the unit. Requirements There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: PQ.unit
system	S Σ I	0..1	uri	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.system Short description System that defines coded unit form Definition The identification of the system that provides the coded form of the unit. Requirements Need to know the system that defines the coded form of the unit. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: CO.codeSystem, PQ.translation.codeSystem
code	S Σ	1..1	codeBindingFixed Value	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.code Short description Coded form of the unit Definition A computer processable form of the unit in some unit representation system. 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. Data type code Binding Längdenhet doseringssteg (sequence-length-units) (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value d Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: PQ.code, MO.currency, PQ.translation.code EHM: Enhet max längd doseringssteg
count	S Σ	0..1	positiveInt	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.count Short description Single dose Definition A total count of the desired number of repetitions across the duration of the entire timing specification. 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. Data type positiveInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: PIVL.count EHM: Antal upprepningar
countMax	Σ	0..1	positiveInt	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.countMax Short description Maximum number of times to repeat Definition If present, indicates that the count is a range - so to perform the action between [count] and [countMax] times. Comments 32 bit number; for values larger than this, use decimal Data type positiveInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: PIVL.count
duration	S Σ	0..1	decimal	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.duration Short description Duration of the administration Definition Duration of the administration of the medication 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]) Data type* decimal Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: PIVL.phase EHM: Administreringstillfällets varaktighet
durationMax	Σ	0..1	decimal	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.durationMax Short description How long when it happens (Max) Definition If present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length. 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). Data type decimal Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: PIVL.phase
durationUnit	S Σ	0..1	codeBinding	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.durationUnit Short description min \| h - unit of time (UCUM) Definition The units of time for the duration, in UCUM units. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Binding A unit of time (units from UCUM). Enhet för administreringstillfällets varaktighet (dose-duration-units) (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: PIVL.phase.unit EHM: Enhet för administreringstillfällets varaktighet
frequency	S Σ	0..1	positiveInt	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.frequency Short description Event occurs frequency times per period Definition The 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. Comments 32 bit number; for values larger than this, use decimal Meaning when missing If no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this Data type positiveInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: PIVL.phase EHM: Antal administreringar
frequencyMax	S Σ	0..1	positiveInt	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.frequencyMax Short description Event occurs up to frequencyMax times per period Definition If present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range. Comments 32 bit number; for values larger than this, use decimal Data type positiveInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: PIVL.phase EHM: Antal administreringar max
period	S Σ	0..1	decimal	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.period Short description Event occurs frequency times per period Definition Indicates 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. Comments Do not use an IEEE type floating point type, instead use something that works like a true decimal, with inbuilt precision (e.g. Java BigInteger) Data type decimal Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: PIVL.phase EHM: Period
periodMax	S Σ	0..1	decimal	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.periodMax Short description Upper limit of period (3-4 hours) Definition If present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as "do this once every 3-5 days. Comments Do not use an IEEE type floating point type, instead use something that works like a true decimal, with inbuilt precision (e.g. Java BigInteger) Data type decimal Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: PIVL.phase EHM: Period max
periodUnit	S Σ	0..1	codeBinding	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.periodUnit Short description h \| d - unit of time (UCUM) Definition The units of time for the period in UCUM units. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Binding A unit of time (units from UCUM). Periodenhet (dose-period-units) (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: PIVL.phase.unit EHM: Periodenhet
dayOfWeek	S Σ	0..*	codeBinding	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.dayOfWeek Short description mon \| tue \| wed \| thu \| fri \| sat \| sun Definition If one or more days of week is provided, then the action happens only on the specified day(s). 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. Data type code Binding DaysOfWeek (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a EHM: Veckodag
timeOfDay	S Σ	0..*	time	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.timeOfDay Short description Time of day for action Definition Specified 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. 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. Data type time Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a EHM: Klockslag
when	S Σ	0..*	codeBinding	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.when Short description Code for time period of occurrence Definition An approximate time period during the day, potentially linked to an event of daily living that indicates when the action should occur. Requirements Timings are frequently determined by occurrences such as waking, eating and sleep. Comments _ Data type code Binding Real world event relating to the schedule. nll-event-timing (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: EIVL.event EHM: Period på dygnet
offset	Σ	0..1	unsignedInt	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.repeat.offset Short description Minutes from event (before or after) Definition The 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. Comments 32 bit number; for values larger than this, use decimal Data type unsignedInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: EIVL.offset
code	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.timing.code Short description BID \| TID \| QID \| AM \| PM \| QD \| QOD \| + Definition A 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). 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). Data type CodeableConcept Binding Code for a known / defined timing pattern. TimingAbbreviation (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD rim: QSC.code
asNeeded[x]	S Σ	0..1		There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.asNeeded[x] Short description Take "as needed" Definition Indicates that the medication only should be taken when needed. Comments NB! The same value must be provided in this element on each sequence / subsequence. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: TQ1-9 rim: .outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept EHM: Vid behov
asNeededBoolean			boolean	There are no (further) constraints on this element Data type boolean
site	S Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.site Short description Site of administration Definition Site of administration. 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. Data type CodeableConcept Binding A coded concept describing the site location the medicine enters into or onto the body. SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: RXR-2 rim: .approachSiteCode EHM: Administreringsställe
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.site.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.site.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
coding	S Σ	1..1	CodingBinding	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.site.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments _ Data type Coding Binding Snomed CT codes for administration site, as stipulated by NLL (terminology server). http://electronichealth.se/fhir/ValueSet/nll-snomed-site (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.site.coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.site.coding.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
system	S Σ	0..1	uri	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.site.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. 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. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	S Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.site.coding.version Short description Version of the system - if relevant Definition The 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. 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	S Σ	1..1	code	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.site.coding.code Short description Symbol in syntax defined by the system Definition A 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). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.site.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.site.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a 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 ]
text	S Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.site.text Short description Plain text representation of the concept Definition A human language representation of the administration site. Used when no specific code can describe the site and the code 'OTH' has been selected. 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 Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText EHM: Beskrivning annat administreringsställe
route	S Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.route Short description How the medication should enter the body Definition How the medication should enter the body. 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. Data type CodeableConcept 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) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: RXR-1 rim: .routeCode EHM: Administreringsväg
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.route.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.route.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
coding	S Σ	1..1	CodingBinding	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.route.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments _ Data type Coding Binding Snomed CT codes for administration route, as stipulated by NLL http://electronichealth.se/fhir/ValueSet/nll-snomed-route (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.route.coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.route.coding.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
system	S Σ	0..1	uri	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.route.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. 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. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	S Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.route.coding.version Short description Version of the system - if relevant Definition The 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. 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	S Σ	1..1	code	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.route.coding.code Short description Symbol in syntax defined by the system Definition A 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). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.route.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.route.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a 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 ]
text	S Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.route.text Short description Plain text representation of the concept Definition A human language representation of the administration route. Used when no specific code can describe the route and the code 'OTH' has been selected. 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 Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Maximum string length 256 Mappings rim: n/a v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText EHM: Beskrivning annan administreringsväg
method	S Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.method Short description Method used for administering the medication Definition Method used for administering the medication. 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. Data type CodeableConcept Binding A coded concept describing the technique by which the medicine is administered. SNOMEDCTAdministrationMethodCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: RXR-4 rim: .doseQuantity EHM: Administreringsmetod
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.method.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.method.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
coding	S Σ	1..1	CodingBinding	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.method.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments _ Data type Coding Binding Snomed CT codes for administration method, as stipulated by NLL (terminology server). http://electronichealth.se/fhir/ValueSet/nll-snomed-method (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.method.coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.method.coding.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
system	S Σ	0..1	uri	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.method.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. 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. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	S Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.method.coding.version Short description Version of the system - if relevant Definition The 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. 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	S Σ	1..1	code	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.method.coding.code Short description Symbol in syntax defined by the system Definition A 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). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.method.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.method.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a 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 ]
text	S Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.method.text Short description Plain text representation of the concept Definition A human language representation of the administration method. Used when no specific code can describe the method and the code 'OTH' has been selected. 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 Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Maximum string length 256 Mappings rim: n/a v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText EHM: Beskrivning annan administreringsmetod
doseAndRate	S Σ	0..1	Element	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate Short description Amount of medication administered Definition The amount of medication administered. Data type Element Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: TQ1-2
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
type	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate.type Short description The kind of dose or rate specified Definition The kind of dose or rate specified, for example, ordered or calculated. Requirements If the type is not populated, assume to be "ordered". Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding The kind of dose or rate specified. DoseAndRateType (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: RXO-21; RXE-23
dose[x]	S Σ	0..1	Binding	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate.dose[x] Short description Amount of medication per dose Definition Amount of medication per dose. Requirements The amount of therapeutic or other substance given at one administration event. Comments _ Sliced: Unordered, Open, by $this(Type) Binding nll-ucum-unit (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: RXO-2, RXE-3 rim: .doseQuantity
doseRange	S Σ	0..1	Range	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange Short description Amount of medication per dose Definition Amount of medication per dose. 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. Data type Range Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: RXO-2, RXE-3 rim: .doseQuantity
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
low	S Σ I	1..1	SimpleQuantity	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.low Short description Low limit Definition The low limit. The boundary is inclusive. Comments If the low element is missing, the low boundary is not known. Data type SimpleQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values v2: NR.1 rim: ./low EHM: Dos min
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.low.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.low.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
value	S Σ	1..1	decimal	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.low.value Short description Dose range low value Definition Dose range low value 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]) Data type* decimal Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a 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
comparator	Σ ?!	0..0	codeBinding	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.low.comparator Short description < \| <= \| >= \| > - how to understand the value Definition Not allowed to be used in this context Requirements Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Meaning when missing If there is no comparator, then there is no modification of the value Data type code Binding How the Quantity should be understood and represented. QuantityComparator (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: SN.1 / CQ.1 rim: IVL properties
unit	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.low.unit Short description Unit representation Definition A human-readable form of the unit. Requirements There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: PQ.unit
system	S Σ I	0..1	uri	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.low.system Short description System that defines coded unit form Definition The identification of the system that provides the coded form of the unit. Requirements Need to know the system that defines the coded form of the unit. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: CO.codeSystem, PQ.translation.codeSystem
code	S Σ	1..1	code	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.low.code Short description Coded form of the unit Definition A computer processable form of the unit in some unit representation system. 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. Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: PQ.code, MO.currency, PQ.translation.code EHM: Dosenhet min
high	S Σ I	1..1	SimpleQuantity	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.high Short description High limit Definition The high limit. The boundary is inclusive. Comments If the high element is missing, the high boundary is not known. Data type SimpleQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values v2: NR.2 rim: ./high EHM: Dos max
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.high.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.high.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
value	S Σ	1..1	decimal	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.high.value Short description Dose range high value Definition Dose range high value 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]) Data type* decimal Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a 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
comparator	Σ ?!	0..0	codeBinding	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.high.comparator Short description < \| <= \| >= \| > - how to understand the value Definition Not allowed to be used in this context Requirements Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Meaning when missing If there is no comparator, then there is no modification of the value Data type code Binding How the Quantity should be understood and represented. QuantityComparator (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: SN.1 / CQ.1 rim: IVL properties
unit	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.high.unit Short description Unit representation Definition A human-readable form of the unit. Requirements There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: PQ.unit
system	S Σ I	0..1	uri	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.high.system Short description System that defines coded unit form Definition The identification of the system that provides the coded form of the unit. Requirements Need to know the system that defines the coded form of the unit. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: CO.codeSystem, PQ.translation.codeSystem
code	S Σ	1..1	code	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.high.code Short description Coded form of the unit Definition A computer processable form of the unit in some unit representation system. 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. Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: PQ.code, MO.currency, PQ.translation.code EHM: Dosenhet max
doseQuantity	S Σ	0..1	SimpleQuantity	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity Short description Amount of medication per dose Definition Amount of medication per dose. 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. Data type SimpleQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: RXO-2, RXE-3 rim: .doseQuantity
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
value	S Σ	0..1	decimal	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.value Short description Dose quantity value Definition Dose quantity value. 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]) Data type* decimal Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: SN.2 / CQ - N/A rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value EHM: Dos
comparator	Σ ?!	0..0	codeBinding	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.comparator Short description < \| <= \| >= \| > - how to understand the value Definition Not allowed to be used in this context Requirements Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Meaning when missing If there is no comparator, then there is no modification of the value Data type code Binding How the Quantity should be understood and represented. QuantityComparator (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: SN.1 / CQ.1 rim: IVL properties
unit	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.unit Short description Unit representation Definition A human-readable form of the unit. Requirements There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: PQ.unit
system	S Σ I	0..1	uri	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.system Short description System that defines coded unit form Definition The identification of the system that provides the coded form of the unit. Requirements Need to know the system that defines the coded form of the unit. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: CO.codeSystem, PQ.translation.codeSystem
code	S Σ	0..1	code	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.code Short description Coded form of the unit Definition A computer processable form of the unit in some unit representation system. 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. Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: PQ.code, MO.currency, PQ.translation.code EHM: Dosenhet
rate[x]	S Σ	0..1	Binding	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate.rate[x] Short description Amount of medication per unit of time Definition Amount of medication per unit of time. Requirements _ Comments _ Binding nll-ucum-rate-unit (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: RXE22, RXE23, RXE-24 rim: .rateQuantity EHM: Doseringshastighet
rateQuantity			SimpleQuantity	There are no (further) constraints on this element Data type SimpleQuantity
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate.rate[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate.rate[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
value	S Σ	0..1	decimal	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate.rate[x].value Short description Rate value Definition Rate value 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]) Data type* decimal Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: SN.2 / CQ - N/A rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value EHM: Doseringshastighet
comparator	Σ ?!	0..0	codeBinding	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate.rate[x].comparator Short description < \| <= \| >= \| > - how to understand the value Definition Not allowed to be used in this context Requirements Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Meaning when missing If there is no comparator, then there is no modification of the value Data type code Binding How the Quantity should be understood and represented. QuantityComparator (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: SN.1 / CQ.1 rim: IVL properties
unit	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate.rate[x].unit Short description Unit representation Definition A human-readable form of the unit. Requirements There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: PQ.unit
system	S Σ I	0..1	uri	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate.rate[x].system Short description System that defines coded unit form Definition The identification of the system that provides the coded form of the unit. Requirements Need to know the system that defines the coded form of the unit. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: CO.codeSystem, PQ.translation.codeSystem
code	S Σ	1..1	code	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.doseAndRate.rate[x].code Short description Coded form of the unit Definition A computer processable form of the unit in some unit representation system. 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. Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: PQ.code, MO.currency, PQ.translation.code EHM: Doseringshastighetsenhet
maxDosePerPeriod	S Σ I	0..1	Ratio	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.maxDosePerPeriod Short description Upper limit on medication per day Definition Upper limit on medication per day. 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. Data type Ratio Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` rat-1: Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present `(numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())` Mappings rim: n/a v2: N/A rim: RTO v2: RXO-23, RXE-19 rim: .maxDoseQuantity EHM: Maxdos
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.maxDosePerPeriod.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.maxDosePerPeriod.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
numerator	S Σ I	0..1	QuantityBinding	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator Short description Numerator value Definition The value of the numerator. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data type Quantity Binding nll-ucum-unit (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` Mappings rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values rim: .numerator EHM: Maxdos
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
value	S Σ	0..1	decimal	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.value Short description Max dose therapeutic substance value Definition Max dose therapeutic substance value 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}$ Data type decimal Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: SN.2 / CQ - N/A rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value EHM: Maxdos
comparator	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.comparator Short description < \| <= \| >= \| > - how to understand the value Definition How 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. Requirements Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Meaning when missing If there is no comparator, then there is no modification of the value Data type code Binding How the Quantity should be understood and represented. QuantityComparator (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: SN.1 / CQ.1 rim: IVL properties
unit	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.unit Short description Unit representation Definition A human-readable form of the unit. Requirements There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: PQ.unit
system	S Σ I	0..1	uri	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.system Short description System that defines coded unit form Definition The identification of the system that provides the coded form of the unit. Requirements Need to know the system that defines the coded form of the unit. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: CO.codeSystem, PQ.translation.codeSystem
code	S Σ	1..1	code	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.code Short description Coded form of the unit Definition A computer processable form of the unit in some unit representation system. 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. Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: PQ.code, MO.currency, PQ.translation.code EHM: Maxdosenhet
denominator	S Σ I	0..1	QuantityFixed Value	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator Short description Denominator value Definition The value of the denominator. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data type Quantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` Fixed value { "value": 1, "system": "http://unitsofmeasure.org", "code": "d" } Mappings rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values rim: .denominator EHM: Maxdosperiod
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
value	S Σ	0..1	decimalFixed Value	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.value Short description Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value. 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). Data type decimal Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value 1 Mappings rim: n/a v2: SN.2 / CQ - N/A rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value EHM: Maxdosperiod
comparator	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.comparator Short description < \| <= \| >= \| > - how to understand the value Definition How 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. Requirements Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Meaning when missing If there is no comparator, then there is no modification of the value Data type code Binding How the Quantity should be understood and represented. QuantityComparator (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: SN.1 / CQ.1 rim: IVL properties
unit	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.unit Short description Unit representation Definition A human-readable form of the unit. Requirements There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: PQ.unit
system	S Σ I	0..1	uriFixed Value	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.system Short description System that defines coded unit form Definition The identification of the system that provides the coded form of the unit. Requirements Need to know the system that defines the coded form of the unit. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value http://unitsofmeasure.org Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: CO.codeSystem, PQ.translation.codeSystem
code	S Σ	0..1	codeFixed Value	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.code Short description Coded form of the unit Definition A computer processable form of the unit in some unit representation system. 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. Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value d Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: PQ.code, MO.currency, PQ.translation.code EHM: Maxdosperiodenhet
maxDosePerAdministration	Σ I	0..1	SimpleQuantity	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.maxDosePerAdministration Short description Upper limit on medication per administration Definition Upper limit on medication per administration. 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. Data type SimpleQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values rim: not supported
maxDosePerLifetime	Σ I	0..1	SimpleQuantity	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction.maxDosePerLifetime Short description Upper limit on medication per lifetime of the patient Definition Upper limit on medication per lifetime of the patient. Requirements The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data type SimpleQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values rim: not supported
substitution	S	0..1	BackboneElement	Element id MedicationDispense.substitution Short description Whether a substitution was performed on the dispense 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. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: .outboundRelationship[typeCode=COMP].target[classCode=SUBST, moodCode=EVN] rx-dispense-rmim: CombinedMedicationDispense.substitutionMade EHM: Generikautbyte utfört
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.substitution.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.substitution.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.substitution.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May 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). 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. Data type Extension Constraints 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
wasSubstituted	S	1..1	boolean	Element id MedicationDispense.substitution.wasSubstituted Short description Whether a substitution was or was not performed on the dispense Definition True if the dispenser dispensed a different drug or product from what was prescribed. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: .actionNegationInd EHM: Generikautbyte utfört
type		0..1	CodeableConcept	There are no (further) constraints on this element Element id MedicationDispense.substitution.type Short description Code signifying whether a different drug was dispensed from what was prescribed Definition A code signifying whether a different drug was dispensed from what was prescribed. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept 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) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: RXO-9-Allow Substitutions / RXE-9-Substitution Status rim: .code rx-dispense-rmim: CombinedMedicationDispense.substitutionMade.code
reason		0..*	CodeableConcept	There are no (further) constraints on this element Element id MedicationDispense.substitution.reason Short description Why was substitution made Definition Indicates the reason for the substitution (or lack of substitution) from what was prescribed. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed. v3.SubstanceAdminSubstitutionReason (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD rim: .reasonCode rx-dispense-rmim: CombinedMedicationDispense.substitutionMade.reasonCode
responsibleParty	I	0..*	Reference(Practitioner \| PractitionerRole)	There are no (further) constraints on this element Element id MedicationDispense.substitution.responsibleParty Short description Who is responsible for the substitution Definition The person or organization that has primary responsibility for the substitution. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Practitioner \| PractitionerRole) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: .participation[typeCode=PFM].role[classCode=ASSIGN] rx-dispense-rmim: CombinedMedicationDispense.substitutionMade.ResponsibleParty
detectedIssue	S I	0..*	Reference(NLLDetectedIssue)	Element id MedicationDispense.detectedIssue Short description Automatic Format and Constitution Control warning (AFF varning) Alternate names Contraindication, Drug Utilization Review (DUR), Alert Definition Accepted 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. 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. Data type Reference(NLLDetectedIssue) Allowed aggregation: contained Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value EHM: Accepterade varningar
eventHistory	I	0..*	Reference(Provenance)	There are no (further) constraints on this element Element id MedicationDispense.eventHistory Short description A list of relevant lifecycle events Definition A summary of the events of interest that have occurred, such as when the dispense was verified. 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.). Data type Reference(Provenance) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: .inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]

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.

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

../MedicationDispense/[id]/Provenance returns all related provenances.
../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.

../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)

Name	Cardinality	Type	Documentation
resource	0..1	MedicationRequest(NLLMedicationRequest)	The MedicationRequest to be verified. This type of verification must be directed to the medication request end-point [base]/MedicationRequest/$verify.
resource	0..1	MedicationDispense(NLLMedicationDispense)	The MedicationDispense to be verified. This type of verification must be directed to the medication dispense end-point [base]/MedicationDispense/$verify.
resource	0..1	MedicationDispense(NLLDispensePaperPrescription)	The MedicationDispense to be verified. This type of verification must be directed to the medication dispense end-point [base]/MedicationDispense/$verify.
resource	0..1	Bundle(NLLDispatch)	A Bundle containing the MedicationDispenses to be verified. This type of verification must be directed to the service base end-point [base]/$verify.

Return Values (Out)

Name	Cardinality	Type	Documentation
detectedIssues	1..1	boolean	Has the value 'true' if any AFF errors or warnings are detected, otherwise 'false'
issues	0..1	OperationOutcome(NLLOperationOutcome)	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 NLLDispatch. 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.