The Swedish National Medication List, development branch

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

Mappings

EHM: Logiskt id för uttag

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

Constraints

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

0..1

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

Mappings

rim: n/a

extension

0..*

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

Slicing

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

versionId

S Σ

0..1

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

Constraints

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

Mappings

EHM: Uttagsversion

lastUpdated

0..1

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

Constraints

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

source

0..1

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

canonical(StructureDefinition)

Constraints

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

profile

0..*

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())

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

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())

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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

system

S Σ

0..1

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

Constraints

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

Mappings

v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

S Σ

0..1

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

Constraints

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

Mappings

v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

S Σ

0..1

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.

Data type

Constraints

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

Mappings

v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

display

0..1

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.

Data type

Constraints

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

Mappings

v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

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

Constraints

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

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

tag

0..*

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

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())

implicitRules

Σ ?!

0..1

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

Constraints

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

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

Binding

A human language.

CommonLanguages (preferred)

Binding extensions

maxValueSet	AllLanguages

Constraints

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

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: 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: N/A

extension

3..*

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

Data type

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

Slicing

Unordered, Open, by url(Value)

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

nllNumberOfPackagesDispensed

S C

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

Data type

Extension(positiveInt)

Extension URL

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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 C

1..1

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

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

Extension URL

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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 C

0..1

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

Data type

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

Extension URL

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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 C

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

Data type

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

Extension URL

Binding

benefit-choices (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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 C

1..1

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

Data type

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

Extension URL

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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 C

0..1

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

Data type

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

Extension URL

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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 C

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

Data type

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

Extension URL

Binding

complete-prescription-choices (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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 C

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

Data type

Extension(Complex)

Extension URL

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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

0..1

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

Mappings

rim: n/a

extension

2..*

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

Comments

Data type

Slicing

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

creditDate

S C

1..1

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

Data type

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
EHM: Krediteringstidpunkt

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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

url

1..1

uriAuto 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

Auto 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

valueDateTime

There are no (further) constraints on this element

Data type

creditDispatchId

S C

1..1

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

Data type

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
EHM: Krediterande expeditions-id

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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

url

1..1

uriAuto 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

Data type

Auto 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

valueString

There are no (further) constraints on this element

Data type

creditDispatchRowNo

S C

0..1

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

Data type

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
EHM: Aktörens krediterande expeditionsradnummer

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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

url

1..1

uriAuto 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

Data type

Auto 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

valueBase64Binary

base64Binary

There are no (further) constraints on this element

Data type

base64Binary

valueBoolean

There are no (further) constraints on this element

Data type

valueCanonical

canonical()

There are no (further) constraints on this element

Data type

canonical()

valueCode

There are no (further) constraints on this element

Data type

valueDate

date

There are no (further) constraints on this element

Data type

date

valueDateTime

There are no (further) constraints on this element

Data type

valueDecimal

There are no (further) constraints on this element

Data type

valueId

There are no (further) constraints on this element

Data type

valueInstant

There are no (further) constraints on this element

Data type

valueInteger

There are no (further) constraints on this element

Data type

valueMarkdown

There are no (further) constraints on this element

Data type

valueOid

oid

There are no (further) constraints on this element

Data type

oid

valuePositiveInt

There are no (further) constraints on this element

Data type

valueString

There are no (further) constraints on this element

Data type

valueTime

There are no (further) constraints on this element

Data type

valueUnsignedInt

There are no (further) constraints on this element

Data type

valueUri

There are no (further) constraints on this element

Data type

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

There are no (further) constraints on this element

Data type

valueAttachment

Attachment

There are no (further) constraints on this element

Data type

Attachment

valueCodeableConcept

There are no (further) constraints on this element

Data type

valueCoding

There are no (further) constraints on this element

Data type

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

There are no (further) constraints on this element

Data type

valueHumanName

HumanName

There are no (further) constraints on this element

Data type

HumanName

valueIdentifier

There are no (further) constraints on this element

Data type

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

There are no (further) constraints on this element

Data type

valueRange

There are no (further) constraints on this element

Data type

valueRatio

There are no (further) constraints on this element

Data type

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

There are no (further) constraints on this element

Data type

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

There are no (further) constraints on this element

Data type

valueReference

Reference()

There are no (further) constraints on this element

Data type

Reference()

url

1..1

uriAuto 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

Data type

Auto 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

modifierExtension

?! C

0..*

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

Data type

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

identifier

0..*

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

Constraints

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

Mappings

workflow: Event.identifier
w5: FiveWs.identifier
rim: .id
rx-dispense-rmim: CombinedMedicationDispense.id

partOf

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.

Data type

Reference(Procedure)

Constraints

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

Mappings

workflow: Event.partOf
rim: .outboundRelationship[typeCode=COMP]/target[classCode=PROC,moodCode=EVN]

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

medication-dispense-status (required)

Binding

A coded concept specifying the state of the dispense event.

Constraints

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

Mappings

workflow: Event.status
w5: FiveWs.status
rim: .statusCode
rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.statusCode
EHM: Uttagsstatus

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

workflow: Event.statusReason
rim: .outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code="not done reason"].value

statusReasonCodeableConcept

There are no (further) constraints on this element

Data type

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

MedicationDispense Category Codes (preferred)

Binding

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

Constraints

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

Mappings

rim: .inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication dispense"].value

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

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

Data type

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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

coding

S Σ

1..*

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

Slicing

Unordered, Open, by system(Value)

Constraints

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

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

nplid

S Σ

0..1

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

Data type

Constraints

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

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
EHM: NPL-id

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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

system

S Σ

1..1

uriAuto 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

Data type

Constraints

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

Auto value

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

Mappings

v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

0..1

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

Comments

Data type

Constraints

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

Mappings

v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

S Σ

1..1

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

Constraints

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

Mappings

v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

display

0..1

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.

Data type

Constraints

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

Mappings

v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

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

Data type

Constraints

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

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

nplpackid

S Σ

0..1

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

Data type

Constraints

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

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
EHM: NPL-pack-id

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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

system

S Σ

1..1

uriAuto 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

Data type

Constraints

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

Auto value

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

Mappings

v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

0..1

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

Comments

Data type

Constraints

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

Mappings

v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

S Σ

1..1

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

Constraints

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

Mappings

v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

display

0..1

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.

Data type

Constraints

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

Mappings

v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

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

Data type

Constraints

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

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

varunr

S Σ

0..1

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

Data type

Constraints

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

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
EHM: Varunummer

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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

system

S Σ

1..1

uriAuto 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

Data type

Constraints

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

Auto value

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

Mappings

v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

0..1

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

Comments

Data type

Constraints

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

Mappings

v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

S Σ

1..1

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

Constraints

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

Mappings

v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

display

0..1

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.

Data type

Constraints

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

Mappings

v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

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

Data type

Constraints

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

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

text

0..1

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

Constraints

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

Mappings

v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

subject

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())

Mappings

workflow: Event.subject
w5: FiveWs.subject[x]
v2: PID-3-Patient ID List
rim: .participation[typeCode=SBJ].role[classCode=PAT]
w5: FiveWs.subject

context

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.

Data type

Reference(Encounter | EpisodeOfCare)

Constraints

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

Mappings

workflow: Event.context
rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]

supportingInformation

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.

Data type

Reference(Resource)

Constraints

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

Mappings

w5: FiveWs.context
rim: .outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]

performer

0..*

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

Constraints

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

Mappings

workflow: Event.performer
rim: .participation[typeCode=PRF]

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

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

modifierExtension

Σ ?! C

0..*

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

Comments

Data type

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

function

0..1

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.

Data type

MedicationDispense Performer Function Codes (example)

Binding

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

Constraints

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

Mappings

rim: participation[typeCode=PRF].functionCode

actor

1..1

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.

Data type

Constraints

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

Mappings

workflow: Event.performer.actor
rim: .role

location

0..1

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.

Data type

Reference(NLLMedicationRequest)

Constraints

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

Mappings

rim: .participation[typeCode=LOC].role

authorizingPrescription

1..1

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())

Mappings

workflow: Event.basedOn
v2: ORC-2 Placer Order Number
rim: .outboundRelationship[typeCode=FLFS].target[moodCode=RQO]
rx-dispense-rmim: CombinedMedicationDispense.inFulfillmentOf
EHM: Förskrivningsversion

type

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).

Data type

Binding

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

dispense-types (required)

Constraints

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

Mappings

v2: RXD-33-Dispense Type
rim: .code
rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.code
EHM: Uttagstyp

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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

coding

S Σ

1..1

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

Data type

Constraints

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

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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

system

S Σ

0..1

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

Data type

Constraints

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

Mappings

v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

S Σ

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.type.coding.version

Short description

Version of the system - if relevant

Definition

Comments

Data type

Constraints

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

Mappings

v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

S Σ

1..1

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.

Data type

Constraints

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

Mappings

v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

display

0..1

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.

Data type

Constraints

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

Mappings

v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

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

Data type

Constraints

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

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

text

0..1

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

Comments

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

Data type

Constraints

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

Mappings

v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

quantity

0..1

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. 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). 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.

Data type

Constraints

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

Mappings

v2: RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense Units.name of coding system
rim: .quantity
rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.quantity
EHM: Expedierad mängd

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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

value

S Σ

1..1

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

Constraints

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

Mappings

v2: SN.2 / CQ - N/A
rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value

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.

Meaning when missing

If there is no comparator, then there is no modification of the value

Data type

Binding

How the Quantity should be understood and represented.

Constraints

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

Mappings

v2: SN.1 / CQ.1
rim: IVL properties

unit

0..1

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.

Data type

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.unit

system

Σ C

0..1

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.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: qty-3

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: CO.codeSystem, PQ.translation.codeSystem

code

0..1

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

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.code, MO.currency, PQ.translation.code

daysSupply

0..1

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.

Data type

Constraints

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

Mappings

v2: TQ1.6 Timing/Quantity Segment Service Duration. Prior to v2.5, ORC.7.3 Common Order Segment / Quantity/Timing / Duration component. This is a formatted string, first character for the time unit (e.g., D=days), followed by the value. For example, “D14” represents “14 days supply” From v2.5 on, TQ1.6 Timing/Quantity Segment / Service Duration. This is a CQ data type (<Quantity (NM)> ^ <Units (CWE)>), thus for days supply, assuming the unit of measure is “days”, the numeric value is TQ1.6.1 (…|14^ For backwards compatibility, ORC.7 was permitted through v2.6. Both forms (field and segment) may be present in v2.5, v2.5.1, and v2.6
rim: effectiveUseTime

whenPrepared

0..1

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

Constraints

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

Mappings

v2: RXD-3-Date/Time Dispensed
rim: .effectiveTime[xmi:type=IVL_TS].low
rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.effectiveTime

whenHandedOver

0..1

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

Constraints

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

Mappings

workflow: Event.occurrence[x]
v2: RXD-3-Date/Time Dispensed
rim: .effectiveTime[xmi:type=IVL_TS].high
rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.effectiveTime
EHM: Expeditionstidpunkt

destination

0..1

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.

Data type

Constraints

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

Mappings

v2: RXD-13 Dispense-to Location; RXD-30 Dispense to Pharmacy; RXD-31 Dispense to Pharmacy Address
rim: .participation[typeCode=DST].role
rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.destination

receiver

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.

Data type

Reference(Patient | Practitioner)

Constraints

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

Mappings

rim: .participation[typeCode=RCV].role
rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.receiver

note

0..1

Element id

MedicationDispense.note

Short description

Pharmacists note

Definition

The pharmacists note about the dispense.

Comments

Maximum string length: 1016

Data type

Constraints

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

Mappings

workflow: Event.note
v2: RXD-9 Dispense Notes
rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=ACT,moodCode=EVN]
EHM: Uttagsnotering

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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

author[x]

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

v2: N/A
rim: Act.participant[typeCode=AUT].role

authorString

There are no (further) constraints on this element

Data type

authorReference

Reference(Practitioner | Patient | RelatedPerson | Organization)

There are no (further) constraints on this element

Data type

Reference(Practitioner | Patient | RelatedPerson | Organization)

time

0..1

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

Constraints

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

Mappings

v2: N/A
rim: Act.effectiveTime

text

S Σ

1..1

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.

Data type

Constraints

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

Mappings

v2: N/A
rim: Act.text

dosageInstruction

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. 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. 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. 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. 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: .outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]
rim: n/a

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

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

Slicing

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

nllObservandumDose

S C

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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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 C

0..1

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

Data type

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

Extension URL

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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 C

0..1

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

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

Extension URL

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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

url

1..1

uriAuto 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

Data type

Auto value

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

Mappings

rim: N/A

value[x]

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

valueCodeableConcept

There are no (further) constraints on this element

Data type

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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

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

Data type

http://electronichealth.se/fhir/ValueSet/nll-snomed-medical-device (required)

Binding

Constraints

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

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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

system

S Σ

0..1

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

Data type

Constraints

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

Mappings

v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

S Σ

0..1

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

Comments

Data type

Constraints

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

Mappings

v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

S Σ

1..1

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.

Data type

Constraints

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

Mappings

v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

display

0..1

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.

Data type

Constraints

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

Mappings

v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

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

Data type

Constraints

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

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

text

S Σ

0..1

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

Comments

Maximum string length: 256

Data type

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

Constraints

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

Maximum string length

256

Mappings

v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
EHM: Beskrivning annan medicinteknisk produkt

nllSubSequence

S C

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. 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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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 C

0..1

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

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

Extension URL

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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 C

0..1

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

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

Extension URL

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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

url

1..1

uriAuto 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

Data type

Auto value

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

Mappings

rim: N/A

value[x]

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

valueCodeableConcept

There are no (further) constraints on this element

Data type

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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

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

Data type

http://electronichealth.se/fhir/ValueSet/nll-snomed-qualifier (required)

Binding

Constraints

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

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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

system

S Σ

0..1

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

Data type

Constraints

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

Mappings

v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

S Σ

0..1

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

Comments

Data type

Constraints

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

Mappings

v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

S Σ

1..1

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.

Data type

Constraints

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

Mappings

v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
EHM: Precisering av administreringsställe

display

0..1

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.

Data type

Constraints

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

Mappings

v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

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

Data type

Constraints

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

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

text

S Σ

0..1

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

Comments

Maximum string length: 256

Data type

Constraints

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

Maximum string length

256

Mappings

v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
EHM: Beskrivning annan precisering av administreringsställe

modifierExtension

Σ ?! C

0..*

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

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Comments

Data type

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

sequence

S Σ

1..1

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

Constraints

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

Mappings

v2: TQ1-1
rim: .text
EHM: Sekvens

text

S Σ

0..1

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

Constraints

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

Maximum string length

512

Mappings

v2: RXO-6; RXE-21
rim: .text
EHM: Fritextdosering

additionalInstruction

S Σ

0..1

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

SNOMEDCTAdditionalDosageInstructions (example)

Binding

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

Constraints

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

Mappings

v2: RXO-7
rim: .text

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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

coding

0..*

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

Data type

Constraints

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

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

text

S Σ

0..1

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

Constraints

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

Maximum string length

512

Mappings

v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
EHM: Annan instruktion

patientInstruction

S Σ

1..1

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

Data type

Constraints

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

Maximum string length

512

Mappings

v2: RXO-7
rim: .text
EHM: Doseringsinstruktion

timing

S Σ

0..1

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

Constraints

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

Mappings

rim: .effectiveTime

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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

modifierExtension

Σ ?! C

0..*

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

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Comments

Data type

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

event

0..*

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

Constraints

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

Mappings

rim: QLIST<TS>

repeat

S Σ C

0..1

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

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
tim-1: if there's a duration, there needs to be duration units
duration.empty() or durationUnit.exists()
tim-2: if there's a period, there needs to be period units
period.empty() or periodUnit.exists()
tim-4: duration SHALL be a non-negative value
duration.exists() implies duration >= 0
tim-5: period SHALL be a non-negative value
period.exists() implies period >= 0
tim-6: If there's a periodMax, there must be a period
periodMax.empty() or period.exists()
tim-7: If there's a durationMax, there must be a duration
durationMax.empty() or duration.exists()
tim-8: If there's a countMax, there must be a count
countMax.empty() or count.exists()
tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV)
offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not()))
tim-10: If there's a timeOfDay, there cannot be a when, or vice versa
timeOfDay.empty() or when.empty()

Mappings

rim: Implies PIVL or EIVL

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

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

Slicing

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

nllSubSequenceDuration

S C

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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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.

Slicing

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: IVL(TS) used in a QSI

boundsDuration

S Σ

0..1

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

Constraints

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

Mappings

rim: IVL(TS) used in a QSI
EHM: Längd doseringssteg

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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

value

S Σ

1..1

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

Constraints

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

Mappings

v2: SN.2 / CQ - N/A
rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
EHM: Längd doseringssteg

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.

Meaning when missing

If there is no comparator, then there is no modification of the value

Data type

Binding

How the Quantity should be understood and represented.

Constraints

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

Mappings

v2: SN.1 / CQ.1
rim: IVL properties

unit

0..1

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.

Data type

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.unit

system

S Σ C

0..1

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.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: qty-3

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: CO.codeSystem, PQ.translation.codeSystem

code

S Σ

1..1

codeBindingAuto 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

Binding

Constraints

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

Auto value

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.code, MO.currency, PQ.translation.code
EHM: Enhet längd doseringssteg

boundsRange

S Σ

0..1

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

Constraints

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

Mappings

rim: IVL(TS) used in a QSI
EHM: Längd doseringssteg min/max

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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

low

S Σ

1..1

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

Constraints

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

Mappings

v2: NR.1
rim: ./low
EHM: Min längd doseringssteg

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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

value

S Σ

1..1

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

Constraints

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

Mappings

v2: SN.2 / CQ - N/A
rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
EHM: Min längd doseringssteg

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.

Meaning when missing

If there is no comparator, then there is no modification of the value

Data type

Binding

How the Quantity should be understood and represented.

Constraints

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

Mappings

v2: SN.1 / CQ.1
rim: IVL properties

unit

0..1

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.

Data type

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.unit

system

S Σ C

0..1

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.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: qty-3

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: CO.codeSystem, PQ.translation.codeSystem

code

S Σ

1..1

codeBindingAuto 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

Binding

Constraints

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

Auto value

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.code, MO.currency, PQ.translation.code
EHM: Enhet min längd doseringssteg

high

S Σ

1..1

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

Constraints

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

Mappings

v2: NR.2
rim: ./high
EHM: Max längd doseringssteg

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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

value

S Σ

1..1

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

Constraints

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

Mappings

v2: SN.2 / CQ - N/A
rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
EHM: Max längd doseringssteg

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.

Meaning when missing

If there is no comparator, then there is no modification of the value

Data type

Binding

How the Quantity should be understood and represented.

Constraints

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

Mappings

v2: SN.1 / CQ.1
rim: IVL properties

unit

0..1

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.

Data type

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.unit

system

S Σ C

0..1

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.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: qty-3

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: CO.codeSystem, PQ.translation.codeSystem

code

S Σ

1..1

codeBindingAuto 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

Binding

Constraints

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

Auto value

Mappings

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

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

Constraints

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

Mappings

rim: PIVL.count
EHM: Antal upprepningar

countMax

0..1

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.

Data type

Constraints

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

Mappings

rim: PIVL.count

duration

S Σ

0..1

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

Constraints

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

Mappings

rim: PIVL.phase
EHM: Administreringstillfällets varaktighet

durationMax

0..1

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

Constraints

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

Mappings

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.

Data type

dose-duration-units (required)

Binding

A unit of time (units from UCUM).

Constraints

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

Mappings

rim: PIVL.phase.unit
EHM: Enhet för administreringstillfällets varaktighet

frequency

S Σ

0..1

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.

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

Constraints

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

Mappings

rim: PIVL.phase
EHM: Antal administreringar

frequencyMax

S Σ

0..1

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.

Data type

Constraints

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

Mappings

rim: PIVL.phase
EHM: Antal administreringar max

period

S Σ

0..1

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.

Data type

Constraints

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

Mappings

rim: PIVL.phase
EHM: Period

periodMax

S Σ

0..1

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.

Data type

Constraints

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

Mappings

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.

Data type

Binding

A unit of time (units from UCUM).

dose-period-units (required)

Constraints

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

Mappings

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

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..*

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

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

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: EIVL.event
EHM: Period på dygnet

offset

0..1

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.

Data type

Constraints

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

Mappings

rim: EIVL.offset

code

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

TimingAbbreviation (preferred)

Binding

Code for a known / defined timing pattern.

Constraints

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

Mappings

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

v2: TQ1-9
rim: .outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept
EHM: Vid behov

asNeededBoolean

There are no (further) constraints on this element

Data type

site

S Σ

0..1

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

SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example)

Binding

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

Constraints

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

Mappings

v2: RXR-2
rim: .approachSiteCode
EHM: Administreringsställe

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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

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

http://electronichealth.se/fhir/ValueSet/nll-snomed-site (required)

Binding

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

Constraints

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

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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

system

S Σ

0..1

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

Data type

Constraints

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

Mappings

v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

S Σ

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.site.coding.version

Short description

Version of the system - if relevant

Definition

Comments

Data type

Constraints

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

Mappings

v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

S Σ

1..1

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.

Data type

Constraints

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

Mappings

v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

display

0..1

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.

Data type

Constraints

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

Mappings

v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

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

Data type

Constraints

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

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

text

S Σ

0..1

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

Comments

Maximum string length: 256

Data type

Constraints

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

Mappings

v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
EHM: Beskrivning annat administreringsställe

route

S Σ

0..1

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

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

v2: RXR-1
rim: .routeCode
EHM: Administreringsväg

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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

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

http://electronichealth.se/fhir/ValueSet/nll-snomed-route (required)

Binding

Snomed CT codes for administration route, as stipulated by NLL

Constraints

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

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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

system

S Σ

0..1

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

Data type

Constraints

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

Mappings

v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

S Σ

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.route.coding.version

Short description

Version of the system - if relevant

Definition

Comments

Data type

Constraints

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

Mappings

v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

S Σ

1..1

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.

Data type

Constraints

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

Mappings

v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

display

0..1

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.

Data type

Constraints

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

Mappings

v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

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

Data type

Constraints

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

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

text

S Σ

0..1

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

Comments

Maximum string length: 256

Data type

Constraints

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

Maximum string length

256

Mappings

v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
EHM: Beskrivning annan administreringsväg

method

S Σ

0..1

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

SNOMEDCTAdministrationMethodCodes (example)

Binding

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

Constraints

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

Mappings

v2: RXR-4
rim: .doseQuantity
EHM: Administreringsmetod

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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

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

http://electronichealth.se/fhir/ValueSet/nll-snomed-method (required)

Binding

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

Constraints

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

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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

system

S Σ

0..1

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

Data type

Constraints

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

Mappings

v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

S Σ

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.method.coding.version

Short description

Version of the system - if relevant

Definition

Comments

Data type

Constraints

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

Mappings

v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

S Σ

1..1

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.

Data type

Constraints

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

Mappings

v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

display

0..1

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.

Data type

Constraints

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

Mappings

v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

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

Data type

Constraints

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

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

text

S Σ

0..1

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

Comments

Maximum string length: 256

Data type

Constraints

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

Maximum string length

256

Mappings

v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
EHM: Beskrivning annan administreringsmetod

doseAndRate

S Σ

0..1

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

Constraints

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

Mappings

v2: TQ1-2

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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

type

0..1

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".

Data type

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

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

Slicing

Unordered, Open, by $this(Type)

Binding

Constraints

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

Mappings

v2: RXO-2, RXE-3
rim: .doseQuantity

doseRange

S Σ

0..1

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

Constraints

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

Mappings

v2: RXO-2, RXE-3
rim: .doseQuantity

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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

low

S Σ

1..1

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

Constraints

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

Mappings

v2: NR.1
rim: ./low
EHM: Dos min

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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

value

S Σ

1..1

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

Constraints

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

Mappings

v2: SN.2 / CQ - N/A
rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
EHM: Dos min

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.

Meaning when missing

If there is no comparator, then there is no modification of the value

Data type

Binding

How the Quantity should be understood and represented.

Constraints

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

Mappings

v2: SN.1 / CQ.1
rim: IVL properties

unit

0..1

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.

Data type

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.unit

system

S Σ C

0..1

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.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: qty-3

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: CO.codeSystem, PQ.translation.codeSystem

code

S Σ

1..1

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

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.code, MO.currency, PQ.translation.code
EHM: Dosenhet min

high

S Σ

1..1

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

Constraints

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

Mappings

v2: NR.2
rim: ./high
EHM: Dos max

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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

value

S Σ

1..1

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

Constraints

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

Mappings

v2: SN.2 / CQ - N/A
rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
EHM: Dos max

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.

Meaning when missing

If there is no comparator, then there is no modification of the value

Data type

Binding

How the Quantity should be understood and represented.

Constraints

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

Mappings

v2: SN.1 / CQ.1
rim: IVL properties

unit

0..1

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.

Data type

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.unit

system

S Σ C

0..1

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.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: qty-3

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: CO.codeSystem, PQ.translation.codeSystem

code

S Σ

1..1

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

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.code, MO.currency, PQ.translation.code
EHM: Dosenhet max

doseQuantity

S Σ

0..1

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

Data type

Constraints

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

Mappings

v2: RXO-2, RXE-3
rim: .doseQuantity

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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

value

S Σ

0..1

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

Constraints

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

Mappings

v2: SN.2 / CQ - N/A
rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
EHM: Dos

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.

Meaning when missing

If there is no comparator, then there is no modification of the value

Data type

Binding

How the Quantity should be understood and represented.

Constraints

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

Mappings

v2: SN.1 / CQ.1
rim: IVL properties

unit

0..1

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.

Data type

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.unit

system

S Σ C

0..1

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.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: qty-3

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: CO.codeSystem, PQ.translation.codeSystem

code

S Σ

0..1

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

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.code, MO.currency, PQ.translation.code
EHM: Dosenhet

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

v2: RXE22, RXE23, RXE-24
rim: .rateQuantity
EHM: Doseringshastighet

rateQuantity

There are no (further) constraints on this element

Data type

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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

value

S Σ

0..1

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

Constraints

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

Mappings

v2: SN.2 / CQ - N/A
rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
EHM: Doseringshastighet

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.

Meaning when missing

If there is no comparator, then there is no modification of the value

Data type

Binding

How the Quantity should be understood and represented.

Constraints

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

Mappings

v2: SN.1 / CQ.1
rim: IVL properties

unit

0..1

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.

Data type

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.unit

system

S Σ C

0..1

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.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: qty-3

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: CO.codeSystem, PQ.translation.codeSystem

code

S Σ

1..1

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

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.code, MO.currency, PQ.translation.code
EHM: Doseringshastighetsenhet

maxDosePerPeriod

S Σ

0..1

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

Constraints

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

Mappings

v2: RXO-23, RXE-19
rim: .maxDoseQuantity
EHM: Maxdos

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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

numerator

S Σ

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.

Data type

Binding

Constraints

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

Mappings

rim: .numerator
EHM: Maxdos

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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

value

S Σ

0..1

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

Constraints

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

Mappings

v2: SN.2 / CQ - N/A
rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
EHM: Maxdos

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

Requirements

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

Meaning when missing

If there is no comparator, then there is no modification of the value

Data type

Binding

How the Quantity should be understood and represented.

Constraints

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

Mappings

v2: SN.1 / CQ.1
rim: IVL properties

unit

0..1

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.

Data type

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.unit

system

S Σ C

0..1

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.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: qty-3

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: CO.codeSystem, PQ.translation.codeSystem

code

S Σ

1..1

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

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.code, MO.currency, PQ.translation.code
EHM: Maxdosenhet

denominator

S Σ

0..1

QuantityAuto 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.

Data type

Constraints

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

Auto value

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

Mappings

rim: .denominator
EHM: Maxdosperiod

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

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

value

S Σ

0..1

decimalAuto 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

Constraints

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

Auto value

Mappings

v2: SN.2 / CQ - N/A
rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
EHM: Maxdosperiod

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

Requirements

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

Meaning when missing

If there is no comparator, then there is no modification of the value

Data type

Binding

How the Quantity should be understood and represented.

Constraints

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

Mappings

v2: SN.1 / CQ.1
rim: IVL properties

unit

0..1

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.

Data type

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.unit

system

S Σ C

0..1

uriAuto 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.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: qty-3

Constraints

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

Auto value

http://unitsofmeasure.org

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: CO.codeSystem, PQ.translation.codeSystem

code

S Σ

0..1

codeAuto 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

Constraints

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

Auto value

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.code, MO.currency, PQ.translation.code
EHM: Maxdosperiodenhet

maxDosePerAdministration

0..1

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

Constraints

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

Mappings

rim: not supported

maxDosePerLifetime

0..1

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.

Data type

Constraints

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

Mappings

rim: not supported

substitution

0..1

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

Constraints

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

Mappings

rim: .outboundRelationship[typeCode=COMP].target[classCode=SUBST, moodCode=EVN]
rx-dispense-rmim: CombinedMedicationDispense.substitutionMade
EHM: Generikautbyte utfört

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

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

modifierExtension

Σ ?! C

0..*

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

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Comments

Data type

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

wasSubstituted

1..1

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

Constraints

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

Mappings

rim: .actionNegationInd
EHM: Generikautbyte utfört

type

0..1

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.

Data type

v3.ActSubstanceAdminSubstitutionCode (example)

Binding

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

Constraints

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

Mappings

v2: RXO-9-Allow Substitutions / RXE-9-Substitution Status
rim: .code
rx-dispense-rmim: CombinedMedicationDispense.substitutionMade.code

reason

0..*

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.

Data type

v3.SubstanceAdminSubstitutionReason (example)

Binding

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

Constraints

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

Mappings

rim: .reasonCode
rx-dispense-rmim: CombinedMedicationDispense.substitutionMade.reasonCode

responsibleParty

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.

Data type

Reference(Practitioner | PractitionerRole)

Constraints

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

Mappings

rim: .participation[typeCode=PFM].role[classCode=ASSIGN]
rx-dispense-rmim: CombinedMedicationDispense.substitutionMade.ResponsibleParty

detectedIssue

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())

Mappings

rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value
EHM: Accepterade varningar

eventHistory

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())

Mappings

rim: .inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]

MedicationDispense

Short A medication dispense to a specific patient authorzied by a prescription

Definition

Cardinality 0..*

Constraints

dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
contained.contained.empty()
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
contained.meta.security.empty()
dom-6: A resource should have narrative for robust management
text.`div`.exists()
mdd-1: whenHandedOver cannot be before whenPrepared
whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared

Mappings

rim: Entity. Role, or Act
workflow: Event
rim: Supply[moodCode=EVN]

MedicationDispense.id

Short 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.

Cardinality 0..1

Must Support True

Summary True

Comments

Mappings

EHM: Logiskt id för uttag

MedicationDispense.meta

Short 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.

Cardinality 0..1

Must Support True

Summary True

Constraints

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

MedicationDispense.meta.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.meta.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.meta.versionId

Short 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.

Cardinality 0..1

Must Support True

Summary True

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.

Constraints

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

Mappings

EHM: Uttagsversion

MedicationDispense.meta.lastUpdated

Short When the resource version last changed

Definition

When the resource last changed - e.g. when the version changed.

Cardinality 0..1

Summary True

Comments

Constraints

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

MedicationDispense.meta.source

Short Identifies where the resource comes from

Definition

Cardinality 0..1

Summary True

Comments

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.

Constraints

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

MedicationDispense.meta.profile

Short 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.

Cardinality 0..*

Type canonical(StructureDefinition)

Summary True

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.

Constraints

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

MedicationDispense.meta.security

Short 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.

Cardinality 0..*

Security Labels from the Healthcare Privacy and Security Classification System.

security-labels (extensible)

Must Support True

Summary True

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.

Constraints

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

MedicationDispense.meta.security.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.meta.security.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.meta.security.system

Short Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Cardinality 0..1

Must Support True

Summary True

Requirements

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

Comments

Constraints

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

Mappings

v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

MedicationDispense.meta.security.version

Short Version of the system - if relevant

Definition

Cardinality 0..1

Must Support True

Summary True

Comments

Constraints

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

Mappings

v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

MedicationDispense.meta.security.code

Short 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).

Cardinality 0..1

Must Support True

Summary True

Requirements

Need to refer to a particular code in the system.

Constraints

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

Mappings

v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

MedicationDispense.meta.security.display

Short Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Cardinality 0..1

Summary True

Requirements

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

Constraints

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

Mappings

v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

MedicationDispense.meta.security.userSelected

Short 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).

Cardinality 0..1

Summary True

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

Constraints

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

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

MedicationDispense.meta.tag

Short Tags applied to this resource

Definition

Cardinality 0..*

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

CommonTags (example)

Summary True

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.

Constraints

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

MedicationDispense.implicitRules

Short A set of rules under which this content was created

Definition

Cardinality 0..1

Modifier True

Summary True

Comments

Constraints

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

MedicationDispense.language

Short Language of the resource content

Definition

The base language in which the resource is written.

Cardinality 0..1

A human language.

CommonLanguages (preferred)

Binding extensions

maxValueSet	AllLanguages

Comments

Constraints

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

MedicationDispense.text

Short Text summary of the resource, for human interpretation

Definition

Cardinality 0..1

Narrative

Alias narrative, html, xhtml, display

Comments

Constraints

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

Mappings

rim: Act.text?

MedicationDispense.contained

Short Contained, inline Resources

Definition

Cardinality 0..*

Resource

Alias inline resources, anonymous resources, contained resources

Comments

Mappings

rim: N/A

MedicationDispense.extension

Short Additional content defined by implementations

Definition

Cardinality 3..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

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

MedicationDispense.extension:nllNumberOfPackagesDispensed

Short Number of packages dispensed

Definition

The number of packages that were included in the dispense. Shall not be set for dose dispensed dispenses.

Cardinality 0..1

Type Extension(positiveInt)

Must Support True

Alias extensions, user content

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

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

MedicationDispense.extension:nllActorDispatchId

Short The identifier of the actor's dispatch in which the dispense was made

Definition

Optional Extension Element - found in all resources.

Cardinality 1..1

Type Extension(string)

Must Support True

Alias extensions, user content

Comments

Maximum string length: 12

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

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

MedicationDispense.extension:nllDispatchId

Short The identifier of the dispatch in which the dispense was made

Definition

Cardinality 0..1

Type Extension(string)

Must Support True

Alias extensions, user content

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

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

MedicationDispense.extension:nllBenefitChoiceCode

Short Benefit choice

Definition

Type of benefit for the dispense.

Cardinality 1..1

Type Extension(code)

benefit-choices (required)

Must Support True

Alias extensions, user content

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

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

MedicationDispense.extension:nllDispatchRowNo

Short Identier for MedicationDispense within dispatch

Definition

Used when communicationg an error or warning for a MedicationDispense within a dispatch. The DispatchRowNo (ExpeditionsRadNummer) uniquely identifies a MediationDispense within a dispatch.

Cardinality 1..1

Type Extension(decimal)

Must Support True

Alias extensions, user content

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

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

MedicationDispense.extension:nllDeductedQuantity

Short Deducted quantity

Definition

The quantity that is deducted form the prescription's remaining quantity. Only used if the deducted quantity should differ from the dispensed quantity.

Cardinality 0..1

Type Extension(decimal)

Must Support True

Alias extensions, user content

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

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

MedicationDispense.extension:nllCompletePrescriptionChoice

Short Prescription completion choice

Definition

Cardinality 0..1

Type Extension(code)

complete-prescription-choices (required)

Must Support True

Alias extensions, user content

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

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

MedicationDispense.extension:nllDispenseCrediting

Short Crediting details

Definition

Crediting details for a dispense

Cardinality 0..1

Type Extension(Complex)

Must Support True

Alias extensions, user content

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

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

MedicationDispense.extension:nllDispenseCrediting.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.extension:nllDispenseCrediting.extension

Short Additional content defined by implementations

Definition

Cardinality 2..*

Alias extensions, user content

Comments

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

MedicationDispense.extension:nllDispenseCrediting.extension:creditDate

Short Credit date and time

Definition

The date and time when the dispense was credited.

Cardinality 1..1

Must Support True

Alias extensions, user content

Comments

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
EHM: Krediteringstidpunkt

MedicationDispense.extension:nllDispenseCrediting.extension:creditDate.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.extension:nllDispenseCrediting.extension:creditDate.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.extension:nllDispenseCrediting.extension:creditDate.url

Short identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality 1..1

Comments

Auto Value

creditDate

Mappings

rim: N/A

MedicationDispense.extension:nllDispenseCrediting.extension:creditDate.value[x]

Short Value of extension

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Cardinality 1..1

Constraints

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

Mappings

rim: N/A

MedicationDispense.extension:nllDispenseCrediting.extension:creditDispatchId

Short Credit dispatch id

Definition

The id of the crediting dispatch.

Cardinality 1..1

Must Support True

Alias extensions, user content

Comments

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
EHM: Krediterande expeditions-id

MedicationDispense.extension:nllDispenseCrediting.extension:creditDispatchId.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.extension:nllDispenseCrediting.extension:creditDispatchId.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.extension:nllDispenseCrediting.extension:creditDispatchId.url

Short identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality 1..1

Comments

Auto Value

creditDispatchId

Mappings

rim: N/A

MedicationDispense.extension:nllDispenseCrediting.extension:creditDispatchId.value[x]

Short Value of extension

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Cardinality 1..1

Constraints

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

Mappings

rim: N/A

MedicationDispense.extension:nllDispenseCrediting.extension:creditDispatchRowNo

Short Credit dispatch row number

Definition

Cardinality 0..1

Must Support True

Alias extensions, user content

Comments

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
EHM: Aktörens krediterande expeditionsradnummer

MedicationDispense.extension:nllDispenseCrediting.extension:creditDispatchRowNo.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.extension:nllDispenseCrediting.extension:creditDispatchRowNo.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.extension:nllDispenseCrediting.extension:creditDispatchRowNo.url

Short identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality 1..1

Comments

Auto Value

creditDispatchRowNo

Mappings

rim: N/A

MedicationDispense.extension:nllDispenseCrediting.extension:creditDispatchRowNo.value[x]

Short Value of extension

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Cardinality 0..1

Type base64Binary, boolean, canonical(), code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference(), SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta

Constraints

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

Mappings

rim: N/A

MedicationDispense.extension:nllDispenseCrediting.url

Short identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality 1..1

Comments

Auto Value

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

Mappings

rim: N/A

MedicationDispense.extension:nllDispenseCrediting.value[x]

Short Value of extension

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Cardinality 0..0

Constraints

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

Mappings

rim: N/A

MedicationDispense.modifierExtension

Short Extensions that cannot be ignored

Definition

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Cardinality 0..*

Modifier True

Alias extensions, user content

Requirements

Comments

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

MedicationDispense.identifier

Short External identifier

Definition

Cardinality 0..*

Comments

This is a business identifier, not a resource identifier.

Constraints

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

Mappings

workflow: Event.identifier
w5: FiveWs.identifier
rim: .id
rx-dispense-rmim: CombinedMedicationDispense.id

MedicationDispense.partOf

Short Event that dispense is part of

Definition

The procedure that trigger the dispense.

Cardinality 0..*

Type Reference(Procedure)

Constraints

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

Mappings

workflow: Event.partOf
rim: .outboundRelationship[typeCode=COMP]/target[classCode=PROC,moodCode=EVN]

MedicationDispense.status

Short cancelled | completed

Definition

A code specifying the state of the set of dispense events.

Cardinality 1..1

medication-dispense-status (required)

A coded concept specifying the state of the dispense event.

Must Support True

Modifier True

Summary True

Comments

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

Constraints

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

Mappings

workflow: Event.status
w5: FiveWs.status
rim: .statusCode
rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.statusCode
EHM: Uttagsstatus

MedicationDispense.statusReason[x]

Short Why a dispense was not performed

Definition

Indicates the reason why a dispense was not performed.

Cardinality 0..1

Type CodeableConcept, Reference(DetectedIssue)

MedicationDispense Status Reason Codes (example)

A code describing why a dispense was not performed.

Constraints

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

Mappings

workflow: Event.statusReason
rim: .outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code="not done reason"].value

MedicationDispense.category

Short 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)).

Cardinality 0..1

MedicationDispense Category Codes (preferred)

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

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.

Constraints

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

Mappings

rim: .inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication dispense"].value

MedicationDispense.medication[x]

Short Dispensed medication or reimbursed consumable

Definition

Cardinality 1..1

SNOMEDCTMedicationCodes (required)

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

Must Support True

Summary True

Comments

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

Constraints

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

Mappings

workflow: Event.code
w5: FiveWs.what[x]
v2: RXD-2-Dispense/Give Code
rim: .participation[typeCode=PRD].role
rx-dispense-rmim: CombinedMedicationRequest.component1.AdministrationRequest.consumable
EHM: Expedierad artikel

MedicationDispense.medication[x].id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.medication[x].extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.medication[x].coding

Short Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Cardinality 1..*

Must Support True

Summary True

Requirements

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

Comments

Unordered, Open, by system(Value)

Constraints

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

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

MedicationDispense.medication[x].coding:nplid

Short NPL-id

Definition

A unique identifier of a medical product according to "Nationellt produktregister för läkemedel" provided by the Swedish Medical Products Agency (sv Läkemedelsverket)

Cardinality 0..1

Must Support True

Summary True

Requirements

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

Comments

Constraints

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

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
EHM: NPL-id

MedicationDispense.medication[x].coding:nplid.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.medication[x].coding:nplid.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.medication[x].coding:nplid.system

Short Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Cardinality 1..1

Must Support True

Summary True

Requirements

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

Comments

Constraints

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

Auto Value

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

Mappings

v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

MedicationDispense.medication[x].coding:nplid.version

Short Version of the system - if relevant

Definition

Cardinality 0..1

Summary True

Comments

Constraints

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

Mappings

v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

MedicationDispense.medication[x].coding:nplid.code

Short 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).

Cardinality 1..1

Must Support True

Summary True

Requirements

Need to refer to a particular code in the system.

Comments

Maximum string length: 14

Constraints

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

Mappings

v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

MedicationDispense.medication[x].coding:nplid.display

Short Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Cardinality 0..1

Summary True

Requirements

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

Constraints

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

Mappings

v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

MedicationDispense.medication[x].coding:nplid.userSelected

Short 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).

Cardinality 0..1

Summary True

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

Constraints

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

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

MedicationDispense.medication[x].coding:nplpackid

Short NPL-pack-id

Definition

A unique identifier of a medical product package according to "Nationellt produktregister för läkemedel" provided by the Swedish Medical Products Agency (sv Läkemedelsverket).

Cardinality 0..1

Must Support True

Summary True

Requirements

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

Comments

Constraints

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

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
EHM: NPL-pack-id

MedicationDispense.medication[x].coding:nplpackid.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.medication[x].coding:nplpackid.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.medication[x].coding:nplpackid.system

Short Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Cardinality 1..1

Must Support True

Summary True

Requirements

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

Comments

Constraints

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

Auto Value

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

Mappings

v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

MedicationDispense.medication[x].coding:nplpackid.version

Short Version of the system - if relevant

Definition

Cardinality 0..1

Summary True

Comments

Constraints

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

Mappings

v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

MedicationDispense.medication[x].coding:nplpackid.code

Short 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).

Cardinality 1..1

Must Support True

Summary True

Requirements

Need to refer to a particular code in the system.

Comments

Maximum string length: 14

Constraints

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

Mappings

v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

MedicationDispense.medication[x].coding:nplpackid.display

Short Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Cardinality 0..1

Summary True

Requirements

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

Constraints

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

Mappings

v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

MedicationDispense.medication[x].coding:nplpackid.userSelected

Short 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).

Cardinality 0..1

Summary True

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

Constraints

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

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

MedicationDispense.medication[x].coding:varunr

Short Varunummer

Definition

Cardinality 0..1

Must Support True

Summary True

Requirements

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

Comments

Constraints

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

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
EHM: Varunummer

MedicationDispense.medication[x].coding:varunr.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.medication[x].coding:varunr.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.medication[x].coding:varunr.system

Short Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Cardinality 1..1

Must Support True

Summary True

Requirements

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

Comments

Constraints

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

Auto Value

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

Mappings

v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

MedicationDispense.medication[x].coding:varunr.version

Short Version of the system - if relevant

Definition

Cardinality 0..1

Summary True

Comments

Constraints

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

Mappings

v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

MedicationDispense.medication[x].coding:varunr.code

Short 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).

Cardinality 1..1

Must Support True

Summary True

Requirements

Need to refer to a particular code in the system.

Comments

Minimum string length: 6 Maximum string length: 6

Constraints

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

Mappings

v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

MedicationDispense.medication[x].coding:varunr.display

Short Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Cardinality 0..1

Summary True

Requirements

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

Constraints

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

Mappings

v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

MedicationDispense.medication[x].coding:varunr.userSelected

Short 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).

Cardinality 0..1

Summary True

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

Constraints

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

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

MedicationDispense.medication[x].text

Short 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.

Cardinality 0..1

Summary True

Requirements

Comments

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

Constraints

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

Mappings

v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

MedicationDispense.subject

Short Who the dispense is for

Definition

A link to a resource representing the person or the group to whom the medication will be given.

Cardinality 0..1

Type Reference(Patient | Group)

Summary True

Comments

SubstanceAdministration->subject->Patient.

Constraints

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

Mappings

workflow: Event.subject
w5: FiveWs.subject[x]
v2: PID-3-Patient ID List
rim: .participation[typeCode=SBJ].role[classCode=PAT]
w5: FiveWs.subject

MedicationDispense.context

Short Encounter / Episode associated with event

Definition

The encounter or episode of care that establishes the context for this event.

Cardinality 0..1

Type Reference(Encounter | EpisodeOfCare)

Constraints

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

Mappings

workflow: Event.context
rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]

MedicationDispense.supportingInformation

Short Information that supports the dispensing of the medication

Definition

Additional information that supports the medication being dispensed.

Cardinality 0..*

Type Reference(Resource)

Constraints

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

Mappings

w5: FiveWs.context
rim: .outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]

MedicationDispense.performer

Short Who performed event

Definition

Indicates who or what performed the event.

Cardinality 0..*

Constraints

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

Mappings

workflow: Event.performer
rim: .participation[typeCode=PRF]

MedicationDispense.performer.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.performer.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.performer.modifierExtension

Short Extensions that cannot be ignored even if unrecognized

Definition

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Cardinality 0..*

Modifier True

Summary True

Alias extensions, user content, modifiers

Requirements

Comments

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

MedicationDispense.performer.function

Short Who performed the dispense and what they did

Definition

Distinguishes the type of performer in the dispense. For example, date enterer, packager, final checker.

Cardinality 0..1

MedicationDispense Performer Function Codes (example)

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

Requirements

Allows disambiguation of the types of involvement of different performers.

Constraints

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

Mappings

rim: participation[typeCode=PRF].functionCode

MedicationDispense.performer.actor

Short 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.

Cardinality 1..1

Constraints

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

Mappings

workflow: Event.performer.actor
rim: .role

MedicationDispense.location

Short Where the dispense occurred

Definition

The principal physical location where the dispense was performed.

Cardinality 0..1

Type Reference(Location)

Constraints

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

Mappings

rim: .participation[typeCode=LOC].role

MedicationDispense.authorizingPrescription

Short MedicationRequest that authorizes the dispense

Definition

Reference to the MedicationRequest that was dispatched. Note that authorizingprescription must include the version of the medication request. That is done by using the /_history/ suffix.

Cardinality 1..1

Type Reference(NLLMedicationRequest)

Must Support True

Comments

Maps to basedOn in Event logical model.

Constraints

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

Mappings

workflow: Event.basedOn
v2: ORC-2 Placer Order Number
rim: .outboundRelationship[typeCode=FLFS].target[moodCode=RQO]
rx-dispense-rmim: CombinedMedicationDispense.inFulfillmentOf
EHM: Förskrivningsversion

MedicationDispense.type

Short Type of dispense

Definition

Cardinality 1..1

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

dispense-types (required)

Must Support True

Constraints

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

Mappings

v2: RXD-33-Dispense Type
rim: .code
rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.code
EHM: Uttagstyp

MedicationDispense.type.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.type.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.type.coding

Short Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Cardinality 1..1

Must Support True

Summary True

Requirements

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

Comments

Constraints

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

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

MedicationDispense.type.coding.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.type.coding.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.type.coding.system

Short Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Cardinality 0..1

Must Support True

Summary True

Requirements

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

Comments

Constraints

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

Mappings

v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

MedicationDispense.type.coding.version

Short Version of the system - if relevant

Definition

Cardinality 0..1

Must Support True

Summary True

Comments

Constraints

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

Mappings

v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

MedicationDispense.type.coding.code

Short 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).

Cardinality 1..1

Must Support True

Summary True

Requirements

Need to refer to a particular code in the system.

Constraints

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

Mappings

v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

MedicationDispense.type.coding.display

Short Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Cardinality 0..1

Summary True

Requirements

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

Constraints

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

Mappings

v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

MedicationDispense.type.coding.userSelected

Short 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).

Cardinality 0..1

Summary True

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

Constraints

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

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

MedicationDispense.type.text

Short 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.

Cardinality 0..1

Summary True

Requirements

Comments

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

Constraints

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

Mappings

v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

MedicationDispense.quantity

Short Amount dispensed

Definition

The amount of the article that has been dispensed.

Cardinality 0..1

Must Support True

Comments

Constraints

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

Mappings

v2: RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense Units.name of coding system
rim: .quantity
rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.quantity
EHM: Expedierad mängd

MedicationDispense.quantity.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.quantity.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.quantity.value

Short Numerical value (with implicit precision)

Definition

The value of the measured amount. The value includes an implicit precision in the presentation of the value.

Cardinality 1..1

Must Support True

Summary True

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).

Constraints

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

Mappings

v2: SN.2 / CQ - N/A
rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value

MedicationDispense.quantity.comparator

Short < | <= | >= | > - how to understand the value

Definition

Not allowed to be used in this context

Cardinality 0..0

How the Quantity should be understood and represented.

Modifier True

Summary True

Requirements

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

Meaning when missing

If there is no comparator, then there is no modification of the value

Constraints

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

Mappings

v2: SN.1 / CQ.1
rim: IVL properties

MedicationDispense.quantity.unit

Short Unit representation

Definition

A human-readable form of the unit.

Cardinality 0..1

Summary True

Requirements

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

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.unit

MedicationDispense.quantity.system

Short System that defines coded unit form

Definition

The identification of the system that provides the coded form of the unit.

Cardinality 0..1

Summary True

Requirements

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

Conditions The cardinality or value of this element may be affected by these constraints: qty-3

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: CO.codeSystem, PQ.translation.codeSystem

MedicationDispense.quantity.code

Short Coded form of the unit

Definition

A computer processable form of the unit in some unit representation system.

Cardinality 0..1

Summary True

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.

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.code, MO.currency, PQ.translation.code

MedicationDispense.daysSupply

Short Amount of medication expressed as a timing amount

Definition

The amount of medication expressed as a timing amount.

Cardinality 0..1

Constraints

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

Mappings

v2: TQ1.6 Timing/Quantity Segment Service Duration. Prior to v2.5, ORC.7.3 Common Order Segment / Quantity/Timing / Duration component. This is a formatted string, first character for the time unit (e.g., D=days), followed by the value. For example, “D14” represents “14 days supply” From v2.5 on, TQ1.6 Timing/Quantity Segment / Service Duration. This is a CQ data type (<Quantity (NM)> ^ <Units (CWE)>), thus for days supply, assuming the unit of measure is “days”, the numeric value is TQ1.6.1 (…|14^ For backwards compatibility, ORC.7 was permitted through v2.6. Both forms (field and segment) may be present in v2.5, v2.5.1, and v2.6
rim: effectiveUseTime

MedicationDispense.whenPrepared

Short When product was packaged and reviewed

Definition

The time when the dispensed product was packaged and reviewed.

Cardinality 0..1

Summary True

Constraints

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

Mappings

v2: RXD-3-Date/Time Dispensed
rim: .effectiveTime[xmi:type=IVL_TS].low
rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.effectiveTime

MedicationDispense.whenHandedOver

Short When product was given out

Definition

The time the dispensed product was provided to the patient or their representative.

Cardinality 0..1

Must Support True

Constraints

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

Mappings

workflow: Event.occurrence[x]
v2: RXD-3-Date/Time Dispensed
rim: .effectiveTime[xmi:type=IVL_TS].high
rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.effectiveTime
EHM: Expeditionstidpunkt

MedicationDispense.destination

Short Where the medication was sent

Definition

Identification of the facility/location where the medication was shipped to, as part of the dispense event.

Cardinality 0..1

Type Reference(Location)

Constraints

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

Mappings

v2: RXD-13 Dispense-to Location; RXD-30 Dispense to Pharmacy; RXD-31 Dispense to Pharmacy Address
rim: .participation[typeCode=DST].role
rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.destination

MedicationDispense.receiver

Short 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.

Cardinality 0..*

Type Reference(Patient | Practitioner)

Constraints

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

Mappings

rim: .participation[typeCode=RCV].role
rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.receiver

MedicationDispense.note

Short Pharmacists note

Definition

The pharmacists note about the dispense.

Cardinality 0..1

Must Support True

Comments

Maximum string length: 1016

Constraints

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

Mappings

workflow: Event.note
v2: RXD-9 Dispense Notes
rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=ACT,moodCode=EVN]
EHM: Uttagsnotering

MedicationDispense.note.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.note.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.note.author[x]

Short Individual responsible for the annotation

Definition

The individual responsible for making the annotation.

Cardinality 0..1

Type Reference(Practitioner | Patient | RelatedPerson | Organization), string

Summary True

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

v2: N/A
rim: Act.participant[typeCode=AUT].role

MedicationDispense.note.time

Short When the annotation was made

Definition

Indicates when this particular annotation was made.

Cardinality 0..1

Summary True

Constraints

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

Mappings

v2: N/A
rim: Act.effectiveTime

MedicationDispense.note.text

Short The annotation - text content (as markdown)

Definition

The text of the annotation in markdown format.

Cardinality 1..1

Must Support True

Summary True

Constraints

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

Mappings

v2: N/A
rim: Act.text

MedicationDispense.dosageInstruction

Short 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.

Cardinality 0..*

NLLDosage

Must Support True

Comments

Constraints

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

Mappings

rim: .outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]
rim: n/a

MedicationDispense.dosageInstruction.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.dosageInstruction.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.dosageInstruction.extension:nllObservandumDose

Short Dose exceeds recommended dose

Definition

Indicates that the prescriber has made a conscious choice where the dose exceeds what is recommended for the prescribed medication.

Cardinality 0..1

Type Extension(boolean)

Must Support True

Alias extensions, user content

Comments

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

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

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

MedicationDispense.dosageInstruction.extension:nllAdministeringInstruction

Short Patient oriented administration instructions

Definition

Administration instructions put in terms that are comprehensible to the patient. This shall be generated from the structured administration information attributes.

Cardinality 0..1

Type Extension(string)

Must Support True

Alias extensions, user content

Comments

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

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

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

MedicationDispense.dosageInstruction.extension:nllMedicalDevice

Short Medical device to use for administration.

Definition

Medical device to use for administration.

Cardinality 0..1

Type Extension(CodeableConcept)

Must Support True

Alias extensions, user content

Requirements

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

Comments

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

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

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

MedicationDispense.dosageInstruction.extension:nllMedicalDevice.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.dosageInstruction.extension:nllMedicalDevice.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.dosageInstruction.extension:nllMedicalDevice.url

Short identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality 1..1

Comments

Auto Value

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

Mappings

rim: N/A

MedicationDispense.dosageInstruction.extension:nllMedicalDevice.value[x]

Short Value of extension

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Cardinality 1..1

Must Support True

Constraints

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

Mappings

rim: N/A

MedicationDispense.dosageInstruction.extension:nllMedicalDevice.value[x].id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.dosageInstruction.extension:nllMedicalDevice.value[x].extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.dosageInstruction.extension:nllMedicalDevice.value[x].coding

Short Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Cardinality 0..1

http://electronichealth.se/fhir/ValueSet/nll-snomed-medical-device (required)

Must Support True

Summary True

Requirements

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

Comments

Constraints

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

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

MedicationDispense.dosageInstruction.extension:nllMedicalDevice.value[x].coding.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.dosageInstruction.extension:nllMedicalDevice.value[x].coding.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.dosageInstruction.extension:nllMedicalDevice.value[x].coding.system

Short Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Cardinality 0..1

Must Support True

Summary True

Requirements

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

Comments

Constraints

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

Mappings

v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

MedicationDispense.dosageInstruction.extension:nllMedicalDevice.value[x].coding.version

Short Version of the system - if relevant

Definition

Cardinality 0..1

Must Support True

Summary True

Comments

Constraints

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

Mappings

v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

MedicationDispense.dosageInstruction.extension:nllMedicalDevice.value[x].coding.code

Short 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).

Cardinality 1..1

Must Support True

Summary True

Requirements

Need to refer to a particular code in the system.

Constraints

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

Mappings

v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

MedicationDispense.dosageInstruction.extension:nllMedicalDevice.value[x].coding.display

Short Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Cardinality 0..1

Summary True

Requirements

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

Constraints

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

Mappings

v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

MedicationDispense.dosageInstruction.extension:nllMedicalDevice.value[x].coding.userSelected

Short 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).

Cardinality 0..1

Summary True

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

Constraints

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

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

MedicationDispense.dosageInstruction.extension:nllMedicalDevice.value[x].text

Short 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.

Cardinality 0..1

Must Support True

Summary True

Requirements

Comments

Maximum string length: 256

Constraints

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

Maximum string length 256

Mappings

v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
EHM: Beskrivning annan medicinteknisk produkt

MedicationDispense.dosageInstruction.extension:nllSubSequence

Short Subsequence

Definition

Indicates the order of subqeuences within a sequence.

Cardinality 0..1

Type Extension(integer)

Must Support True

Alias extensions, user content

Requirements

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

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

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

MedicationDispense.dosageInstruction.extension:nllDosageType

Short Dosage type

Definition

Calculated by the Swedish eHealth Agency. The dosage type that matches the provided set of dosage data.

Cardinality 0..1

Type Extension(code)

Must Support True

Alias extensions, user content

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

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

MedicationDispense.dosageInstruction.extension:nllSiteQualifier

Short More precise administration site

Definition

Qualified adminsitration site is used when more exact information about the site is needed.

Cardinality 0..1

Type Extension(CodeableConcept)

Must Support True

Alias extensions, user content

Requirements

Comments

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

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

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

MedicationDispense.dosageInstruction.extension:nllSiteQualifier.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.dosageInstruction.extension:nllSiteQualifier.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.dosageInstruction.extension:nllSiteQualifier.url

Short identifies the meaning of the extension

Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality 1..1

Comments

Auto Value

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

Mappings

rim: N/A

MedicationDispense.dosageInstruction.extension:nllSiteQualifier.value[x]

Short Value of extension

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Cardinality 1..1

Must Support True

Constraints

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

Mappings

rim: N/A

MedicationDispense.dosageInstruction.extension:nllSiteQualifier.value[x].id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.dosageInstruction.extension:nllSiteQualifier.value[x].extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.dosageInstruction.extension:nllSiteQualifier.value[x].coding

Short Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Cardinality 1..1

http://electronichealth.se/fhir/ValueSet/nll-snomed-qualifier (required)

Must Support True

Summary True

Requirements

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

Comments

Constraints

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

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

MedicationDispense.dosageInstruction.extension:nllSiteQualifier.value[x].coding.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.dosageInstruction.extension:nllSiteQualifier.value[x].coding.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.dosageInstruction.extension:nllSiteQualifier.value[x].coding.system

Short Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Cardinality 0..1

Must Support True

Summary True

Requirements

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

Comments

Constraints

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

Mappings

v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

MedicationDispense.dosageInstruction.extension:nllSiteQualifier.value[x].coding.version

Short Version of the system - if relevant

Definition

Cardinality 0..1

Must Support True

Summary True

Comments

Constraints

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

Mappings

v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

MedicationDispense.dosageInstruction.extension:nllSiteQualifier.value[x].coding.code

Short 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).

Cardinality 1..1

Must Support True

Summary True

Requirements

Need to refer to a particular code in the system.

Constraints

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

Mappings

v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
EHM: Precisering av administreringsställe

MedicationDispense.dosageInstruction.extension:nllSiteQualifier.value[x].coding.display

Short Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Cardinality 0..1

Summary True

Requirements

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

Constraints

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

Mappings

v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

MedicationDispense.dosageInstruction.extension:nllSiteQualifier.value[x].coding.userSelected

Short 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).

Cardinality 0..1

Summary True

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

Constraints

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

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

MedicationDispense.dosageInstruction.extension:nllSiteQualifier.value[x].text

Short 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.

Cardinality 0..1

Must Support True

Summary True

Requirements

Comments

Maximum string length: 256

Constraints

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

Maximum string length 256

Mappings

v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
EHM: Beskrivning annan precisering av administreringsställe

MedicationDispense.dosageInstruction.modifierExtension

Short Extensions that cannot be ignored even if unrecognized

Definition

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Cardinality 0..*

Modifier True

Summary True

Alias extensions, user content, modifiers

Requirements

Comments

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

MedicationDispense.dosageInstruction.sequence

Short The order of the dosage instructions

Definition

Indicates the order in which the dosage instructions should be applied or interpreted .

Cardinality 1..1

Must Support True

Summary True

Requirements

Comments

Constraints

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

Mappings

v2: TQ1-1
rim: .text
EHM: Sekvens

MedicationDispense.dosageInstruction.text

Short Free text dosage

Definition

Free text dosage

Cardinality 0..1

Must Support True

Summary True

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

Constraints

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

Maximum string length 512

Mappings

v2: RXO-6; RXE-21
rim: .text
EHM: Fritextdosering

MedicationDispense.dosageInstruction.additionalInstruction

Short Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"

Definition

Cardinality 0..1

SNOMEDCTAdditionalDosageInstructions (example)

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

Must Support True

Summary True

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.

Constraints

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

Mappings

v2: RXO-7
rim: .text

MedicationDispense.dosageInstruction.additionalInstruction.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.dosageInstruction.additionalInstruction.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.dosageInstruction.additionalInstruction.coding

Short Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Cardinality 0..*

Summary True

Requirements

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

Comments

Constraints

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

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

MedicationDispense.dosageInstruction.additionalInstruction.text

Short 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.

Cardinality 0..1

Must Support True

Summary True

Requirements

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

Comments

Maximum string length: 512

Constraints

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

Maximum string length 512

Mappings

v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
EHM: Annan instruktion

MedicationDispense.dosageInstruction.patientInstruction

Short 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.

Cardinality 1..1

Must Support True

Summary True

Comments

Maximum string length: 512 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())

Maximum string length 512

Mappings

v2: RXO-7
rim: .text
EHM: Doseringsinstruktion

MedicationDispense.dosageInstruction.timing

Short When medication should be administered

Definition

When medication should be administered.

Cardinality 0..1

Must Support True

Summary True

Requirements

Comments

Constraints

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

Mappings

rim: .effectiveTime

MedicationDispense.dosageInstruction.timing.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.dosageInstruction.timing.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.dosageInstruction.timing.modifierExtension

Short Extensions that cannot be ignored even if unrecognized

Definition

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Cardinality 0..*

Modifier True

Summary True

Alias extensions, user content, modifiers

Requirements

Comments

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

MedicationDispense.dosageInstruction.timing.event

Short When the event occurs

Definition

Identifies specific times when the event occurs.

Cardinality 0..*

Summary True

Requirements

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

Constraints

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

Mappings

rim: QLIST<TS>

MedicationDispense.dosageInstruction.timing.repeat

Short When the event is to occur

Definition

A set of rules that describe when the event is scheduled.

Cardinality 0..1

Must Support True

Summary True

Requirements

Many timing schedules are determined by regular repetitions.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
tim-1: if there's a duration, there needs to be duration units
duration.empty() or durationUnit.exists()
tim-2: if there's a period, there needs to be period units
period.empty() or periodUnit.exists()
tim-4: duration SHALL be a non-negative value
duration.exists() implies duration >= 0
tim-5: period SHALL be a non-negative value
period.exists() implies period >= 0
tim-6: If there's a periodMax, there must be a period
periodMax.empty() or period.exists()
tim-7: If there's a durationMax, there must be a duration
durationMax.empty() or duration.exists()
tim-8: If there's a countMax, there must be a count
countMax.empty() or count.exists()
tim-9: If there's an offset, there must be a when (and not C, CM, CD, CV)
offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not()))
tim-10: If there's a timeOfDay, there cannot be a when, or vice versa
timeOfDay.empty() or when.empty()

Mappings

rim: Implies PIVL or EIVL

MedicationDispense.dosageInstruction.timing.repeat.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.dosageInstruction.timing.repeat.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.dosageInstruction.timing.repeat.extension:nllSubSequenceDuration

Short SubSequence duration

Definition

Cardinality 0..1

Type Extension(Quantity)

Must Support True

Alias extensions, user content

Requirements

Used for the dosage type "tillfällesdosering".

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

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

MedicationDispense.dosageInstruction.timing.repeat.bounds[x]

Short 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.

Cardinality 0..1

Type Duration, Range

Must Support True

Summary True

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: IVL(TS) used in a QSI

MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsDuration

Short Sequence length

Definition

A duration for the length of the timing schedule.

Cardinality 0..1

Must Support True

Summary True

Constraints

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

Mappings

rim: IVL(TS) used in a QSI
EHM: Längd doseringssteg

MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.value

Short Numerical value (with implicit precision)

Definition

The value of the measured amount. The value includes an implicit precision in the presentation of the value.

Cardinality 1..1

Must Support True

Summary True

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).

Constraints

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

Mappings

v2: SN.2 / CQ - N/A
rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
EHM: Längd doseringssteg

MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.comparator

Short < | <= | >= | > - how to understand the value

Definition

Cardinality 0..1

How the Quantity should be understood and represented.

Modifier True

Summary True

Requirements

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

Meaning when missing

If there is no comparator, then there is no modification of the value

Constraints

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

Mappings

v2: SN.1 / CQ.1
rim: IVL properties

MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.unit

Short Unit representation

Definition

A human-readable form of the unit.

Cardinality 0..1

Summary True

Requirements

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

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.unit

MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.system

Short System that defines coded unit form

Definition

The identification of the system that provides the coded form of the unit.

Cardinality 0..1

Must Support True

Summary True

Requirements

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

Conditions The cardinality or value of this element may be affected by these constraints: qty-3

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: CO.codeSystem, PQ.translation.codeSystem

MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsDuration.code

Short Coded form of the unit

Definition

A computer processable form of the unit in some unit representation system.

Cardinality 1..1

Must Support True

Summary True

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.

Constraints

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

Auto Value

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.code, MO.currency, PQ.translation.code
EHM: Enhet längd doseringssteg

MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange

Short Range of lengths

Definition

A range of possible length.

Cardinality 0..1

Must Support True

Summary True

Constraints

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

Mappings

rim: IVL(TS) used in a QSI
EHM: Längd doseringssteg min/max

MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low

Short Low limit

Definition

The low limit. The boundary is inclusive.

Cardinality 1..1

Must Support True

Summary True

Comments

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

Constraints

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

Mappings

v2: NR.1
rim: ./low
EHM: Min längd doseringssteg

MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.value

Short Numerical value (with implicit precision)

Definition

The value of the measured amount. The value includes an implicit precision in the presentation of the value.

Cardinality 1..1

Must Support True

Summary True

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).

Constraints

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

Mappings

v2: SN.2 / CQ - N/A
rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
EHM: Min längd doseringssteg

MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.comparator

Short < | <= | >= | > - how to understand the value

Definition

Not allowed to be used in this context

Cardinality 0..0

How the Quantity should be understood and represented.

Modifier True

Summary True

Requirements

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

Meaning when missing

If there is no comparator, then there is no modification of the value

Constraints

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

Mappings

v2: SN.1 / CQ.1
rim: IVL properties

MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.unit

Short Unit representation

Definition

A human-readable form of the unit.

Cardinality 0..1

Summary True

Requirements

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

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.unit

MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.system

Short System that defines coded unit form

Definition

The identification of the system that provides the coded form of the unit.

Cardinality 0..1

Must Support True

Summary True

Requirements

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

Conditions The cardinality or value of this element may be affected by these constraints: qty-3

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: CO.codeSystem, PQ.translation.codeSystem

MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.low.code

Short Coded form of the unit

Definition

A computer processable form of the unit in some unit representation system.

Cardinality 1..1

Must Support True

Summary True

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.

Constraints

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

Auto Value

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.code, MO.currency, PQ.translation.code
EHM: Enhet min längd doseringssteg

MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high

Short High limit

Definition

The high limit. The boundary is inclusive.

Cardinality 1..1

Must Support True

Summary True

Comments

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

Constraints

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

Mappings

v2: NR.2
rim: ./high
EHM: Max längd doseringssteg

MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.value

Short Numerical value (with implicit precision)

Definition

The value of the measured amount. The value includes an implicit precision in the presentation of the value.

Cardinality 1..1

Must Support True

Summary True

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).

Constraints

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

Mappings

v2: SN.2 / CQ - N/A
rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
EHM: Max längd doseringssteg

MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.comparator

Short < | <= | >= | > - how to understand the value

Definition

Not allowed to be used in this context

Cardinality 0..0

How the Quantity should be understood and represented.

Modifier True

Summary True

Requirements

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

Meaning when missing

If there is no comparator, then there is no modification of the value

Constraints

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

Mappings

v2: SN.1 / CQ.1
rim: IVL properties

MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.unit

Short Unit representation

Definition

A human-readable form of the unit.

Cardinality 0..1

Summary True

Requirements

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

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.unit

MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.system

Short System that defines coded unit form

Definition

The identification of the system that provides the coded form of the unit.

Cardinality 0..1

Must Support True

Summary True

Requirements

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

Conditions The cardinality or value of this element may be affected by these constraints: qty-3

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: CO.codeSystem, PQ.translation.codeSystem

MedicationDispense.dosageInstruction.timing.repeat.bounds[x]:boundsRange.high.code

Short Coded form of the unit

Definition

A computer processable form of the unit in some unit representation system.

Cardinality 1..1

Must Support True

Summary True

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.

Constraints

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

Auto Value

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.code, MO.currency, PQ.translation.code
EHM: Enhet max längd doseringssteg

MedicationDispense.dosageInstruction.timing.repeat.count

Short Single dose

Definition

A total count of the desired number of repetitions across the duration of the entire timing specification.

Cardinality 0..1

Must Support True

Summary True

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.

Constraints

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

Mappings

rim: PIVL.count
EHM: Antal upprepningar

MedicationDispense.dosageInstruction.timing.repeat.countMax

Short 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.

Cardinality 0..1

Summary True

Constraints

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

Mappings

rim: PIVL.count

MedicationDispense.dosageInstruction.timing.repeat.duration

Short Duration of the administration

Definition

Duration of the administration of the medication

Cardinality 0..1

Must Support True

Summary True

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])

Constraints

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

Mappings

rim: PIVL.phase
EHM: Administreringstillfällets varaktighet

MedicationDispense.dosageInstruction.timing.repeat.durationMax

Short 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.

Cardinality 0..1

Summary True

Requirements

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

Comments

Constraints

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

Mappings

rim: PIVL.phase

MedicationDispense.dosageInstruction.timing.repeat.durationUnit

Short min | h - unit of time (UCUM)

Definition

The units of time for the duration, in UCUM units.

Cardinality 0..1

dose-duration-units (required)

A unit of time (units from UCUM).

Must Support True

Summary True

Constraints

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

Mappings

rim: PIVL.phase.unit
EHM: Enhet för administreringstillfällets varaktighet

MedicationDispense.dosageInstruction.timing.repeat.frequency

Short 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.

Cardinality 0..1

Must Support True

Summary True

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

Constraints

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

Mappings

rim: PIVL.phase
EHM: Antal administreringar

MedicationDispense.dosageInstruction.timing.repeat.frequencyMax

Short 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.

Cardinality 0..1

Must Support True

Summary True

Constraints

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

Mappings

rim: PIVL.phase
EHM: Antal administreringar max

MedicationDispense.dosageInstruction.timing.repeat.period

Short Event occurs frequency times per period

Definition

Cardinality 0..1

Must Support True

Summary True

Constraints

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

Mappings

rim: PIVL.phase
EHM: Period

MedicationDispense.dosageInstruction.timing.repeat.periodMax

Short 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.

Cardinality 0..1

Must Support True

Summary True

Constraints

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

Mappings

rim: PIVL.phase
EHM: Period max

MedicationDispense.dosageInstruction.timing.repeat.periodUnit

Short h | d - unit of time (UCUM)

Definition

The units of time for the period in UCUM units.

Cardinality 0..1

A unit of time (units from UCUM).

dose-period-units (required)

Must Support True

Summary True

Constraints

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

Mappings

rim: PIVL.phase.unit
EHM: Periodenhet

MedicationDispense.dosageInstruction.timing.repeat.dayOfWeek

Short 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).

Cardinality 0..*

DaysOfWeek (required)

Must Support True

Summary True

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.

Constraints

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

Mappings

rim: n/a
EHM: Veckodag

MedicationDispense.dosageInstruction.timing.repeat.timeOfDay

Short Time of day for action

Definition

Cardinality 0..*

Must Support True

Summary True

Requirements

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

Comments

Constraints

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

Mappings

rim: n/a
EHM: Klockslag

MedicationDispense.dosageInstruction.timing.repeat.when

Short 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.

Cardinality 0..*

Real world event relating to the schedule.

nll-event-timing (required)

Must Support True

Summary True

Requirements

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

Comments

Constraints

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

Mappings

rim: EIVL.event
EHM: Period på dygnet

MedicationDispense.dosageInstruction.timing.repeat.offset

Short 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.

Cardinality 0..1

Summary True

Constraints

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

Mappings

rim: EIVL.offset

MedicationDispense.dosageInstruction.timing.code

Short BID | TID | QID | AM | PM | QD | QOD | +

Definition

Cardinality 0..1

TimingAbbreviation (preferred)

Code for a known / defined timing pattern.

Summary True

Comments

Constraints

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

Mappings

rim: QSC.code

MedicationDispense.dosageInstruction.asNeeded[x]

Short Take "as needed"

Definition

Indicates that the medication only should be taken when needed.

Cardinality 0..1

Must Support True

Summary True

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

v2: TQ1-9
rim: .outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept
EHM: Vid behov

MedicationDispense.dosageInstruction.site

Short Site of administration

Definition

Site of administration.

Cardinality 0..1

SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example)

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

Must Support True

Summary True

Requirements

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

v2: RXR-2
rim: .approachSiteCode
EHM: Administreringsställe

MedicationDispense.dosageInstruction.site.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.dosageInstruction.site.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.dosageInstruction.site.coding

Short Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Cardinality 1..1

http://electronichealth.se/fhir/ValueSet/nll-snomed-site (required)

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

Must Support True

Summary True

Requirements

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

Comments

Constraints

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

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

MedicationDispense.dosageInstruction.site.coding.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.dosageInstruction.site.coding.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.dosageInstruction.site.coding.system

Short Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Cardinality 0..1

Must Support True

Summary True

Requirements

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

Comments

Constraints

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

Mappings

v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

MedicationDispense.dosageInstruction.site.coding.version

Short Version of the system - if relevant

Definition

Cardinality 0..1

Must Support True

Summary True

Comments

Constraints

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

Mappings

v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

MedicationDispense.dosageInstruction.site.coding.code

Short 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).

Cardinality 1..1

Must Support True

Summary True

Requirements

Need to refer to a particular code in the system.

Constraints

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

Mappings

v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

MedicationDispense.dosageInstruction.site.coding.display

Short Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Cardinality 0..1

Summary True

Requirements

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

Constraints

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

Mappings

v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

MedicationDispense.dosageInstruction.site.coding.userSelected

Short 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).

Cardinality 0..1

Summary True

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

Constraints

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

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

MedicationDispense.dosageInstruction.site.text

Short 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.

Cardinality 0..1

Must Support True

Summary True

Requirements

Comments

Maximum string length: 256

Constraints

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

Mappings

v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
EHM: Beskrivning annat administreringsställe

MedicationDispense.dosageInstruction.route

Short How the medication should enter the body

Definition

How the medication should enter the body.

Cardinality 0..1

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

SNOMEDCTRouteCodes (example)

Must Support True

Summary True

Requirements

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

v2: RXR-1
rim: .routeCode
EHM: Administreringsväg

MedicationDispense.dosageInstruction.route.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.dosageInstruction.route.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.dosageInstruction.route.coding

Short Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Cardinality 1..1

http://electronichealth.se/fhir/ValueSet/nll-snomed-route (required)

Snomed CT codes for administration route, as stipulated by NLL

Must Support True

Summary True

Requirements

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

Comments

Constraints

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

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

MedicationDispense.dosageInstruction.route.coding.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.dosageInstruction.route.coding.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.dosageInstruction.route.coding.system

Short Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Cardinality 0..1

Must Support True

Summary True

Requirements

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

Comments

Constraints

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

Mappings

v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

MedicationDispense.dosageInstruction.route.coding.version

Short Version of the system - if relevant

Definition

Cardinality 0..1

Must Support True

Summary True

Comments

Constraints

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

Mappings

v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

MedicationDispense.dosageInstruction.route.coding.code

Short 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).

Cardinality 1..1

Must Support True

Summary True

Requirements

Need to refer to a particular code in the system.

Constraints

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

Mappings

v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

MedicationDispense.dosageInstruction.route.coding.display

Short Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Cardinality 0..1

Summary True

Requirements

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

Constraints

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

Mappings

v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

MedicationDispense.dosageInstruction.route.coding.userSelected

Short 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).

Cardinality 0..1

Summary True

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

Constraints

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

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

MedicationDispense.dosageInstruction.route.text

Short 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.

Cardinality 0..1

Must Support True

Summary True

Requirements

Comments

Maximum string length: 256

Constraints

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

Maximum string length 256

Mappings

v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
EHM: Beskrivning annan administreringsväg

MedicationDispense.dosageInstruction.method

Short Method used for administering the medication

Definition

Method used for administering the medication.

Cardinality 0..1

SNOMEDCTAdministrationMethodCodes (example)

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

Must Support True

Summary True

Requirements

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

v2: RXR-4
rim: .doseQuantity
EHM: Administreringsmetod

MedicationDispense.dosageInstruction.method.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.dosageInstruction.method.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.dosageInstruction.method.coding

Short Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Cardinality 1..1

http://electronichealth.se/fhir/ValueSet/nll-snomed-method (required)

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

Must Support True

Summary True

Requirements

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

Comments

Constraints

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

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

MedicationDispense.dosageInstruction.method.coding.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.dosageInstruction.method.coding.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.dosageInstruction.method.coding.system

Short Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Cardinality 0..1

Must Support True

Summary True

Requirements

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

Comments

Constraints

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

Mappings

v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

MedicationDispense.dosageInstruction.method.coding.version

Short Version of the system - if relevant

Definition

Cardinality 0..1

Must Support True

Summary True

Comments

Constraints

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

Mappings

v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

MedicationDispense.dosageInstruction.method.coding.code

Short 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).

Cardinality 1..1

Must Support True

Summary True

Requirements

Need to refer to a particular code in the system.

Constraints

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

Mappings

v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

MedicationDispense.dosageInstruction.method.coding.display

Short Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Cardinality 0..1

Summary True

Requirements

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

Constraints

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

Mappings

v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

MedicationDispense.dosageInstruction.method.coding.userSelected

Short 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).

Cardinality 0..1

Summary True

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

Constraints

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

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

MedicationDispense.dosageInstruction.method.text

Short 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.

Cardinality 0..1

Must Support True

Summary True

Requirements

Comments

Maximum string length: 256

Constraints

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

Maximum string length 256

Mappings

v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
EHM: Beskrivning annan administreringsmetod

MedicationDispense.dosageInstruction.doseAndRate

Short Amount of medication administered

Definition

The amount of medication administered.

Cardinality 0..1

Must Support True

Summary True

Constraints

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

Mappings

v2: TQ1-2

MedicationDispense.dosageInstruction.doseAndRate.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.dosageInstruction.doseAndRate.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.dosageInstruction.doseAndRate.type

Short The kind of dose or rate specified

Definition

The kind of dose or rate specified, for example, ordered or calculated.

Cardinality 0..1

The kind of dose or rate specified.

DoseAndRateType (example)

Summary True

Requirements

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

Constraints

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

Mappings

v2: RXO-21; RXE-23

MedicationDispense.dosageInstruction.doseAndRate.dose[x]

Short Amount of medication per dose

Definition

Amount of medication per dose.

Cardinality 0..1

Type Range, SimpleQuantity

Must Support True

Summary True

Requirements

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

Comments

Unordered, Open, by $this(Type)

Constraints

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

Mappings

v2: RXO-2, RXE-3
rim: .doseQuantity

MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange

Short Amount of medication per dose

Definition

Amount of medication per dose.

Cardinality 0..1

Must Support True

Summary True

Requirements

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

Comments

Constraints

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

Mappings

v2: RXO-2, RXE-3
rim: .doseQuantity

MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.low

Short Low limit

Definition

The low limit. The boundary is inclusive.

Cardinality 1..1

Must Support True

Summary True

Comments

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

Constraints

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

Mappings

v2: NR.1
rim: ./low
EHM: Dos min

MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.low.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.low.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.low.value

Short Dose range low value

Definition

Dose range low value

Cardinality 1..1

Must Support True

Summary True

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])

Constraints

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

Mappings

v2: SN.2 / CQ - N/A
rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
EHM: Dos min

MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.low.comparator

Short < | <= | >= | > - how to understand the value

Definition

Not allowed to be used in this context

Cardinality 0..0

How the Quantity should be understood and represented.

Modifier True

Summary True

Requirements

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

Meaning when missing

If there is no comparator, then there is no modification of the value

Constraints

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

Mappings

v2: SN.1 / CQ.1
rim: IVL properties

MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.low.unit

Short Unit representation

Definition

A human-readable form of the unit.

Cardinality 0..1

Summary True

Requirements

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

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.unit

MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.low.system

Short System that defines coded unit form

Definition

The identification of the system that provides the coded form of the unit.

Cardinality 0..1

Must Support True

Summary True

Requirements

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

Conditions The cardinality or value of this element may be affected by these constraints: qty-3

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: CO.codeSystem, PQ.translation.codeSystem

MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.low.code

Short Coded form of the unit

Definition

A computer processable form of the unit in some unit representation system.

Cardinality 1..1

Must Support True

Summary True

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.

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.code, MO.currency, PQ.translation.code
EHM: Dosenhet min

MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.high

Short High limit

Definition

The high limit. The boundary is inclusive.

Cardinality 1..1

Must Support True

Summary True

Comments

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

Constraints

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

Mappings

v2: NR.2
rim: ./high
EHM: Dos max

MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.high.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.high.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.high.value

Short Dose range high value

Definition

Dose range high value

Cardinality 1..1

Must Support True

Summary True

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])

Constraints

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

Mappings

v2: SN.2 / CQ - N/A
rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
EHM: Dos max

MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.high.comparator

Short < | <= | >= | > - how to understand the value

Definition

Not allowed to be used in this context

Cardinality 0..0

How the Quantity should be understood and represented.

Modifier True

Summary True

Requirements

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

Meaning when missing

If there is no comparator, then there is no modification of the value

Constraints

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

Mappings

v2: SN.1 / CQ.1
rim: IVL properties

MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.high.unit

Short Unit representation

Definition

A human-readable form of the unit.

Cardinality 0..1

Summary True

Requirements

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

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.unit

MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.high.system

Short System that defines coded unit form

Definition

The identification of the system that provides the coded form of the unit.

Cardinality 0..1

Must Support True

Summary True

Requirements

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

Conditions The cardinality or value of this element may be affected by these constraints: qty-3

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: CO.codeSystem, PQ.translation.codeSystem

MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseRange.high.code

Short Coded form of the unit

Definition

A computer processable form of the unit in some unit representation system.

Cardinality 1..1

Must Support True

Summary True

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.

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.code, MO.currency, PQ.translation.code
EHM: Dosenhet max

MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity

Short Amount of medication per dose

Definition

Amount of medication per dose.

Cardinality 0..1

Must Support True

Summary True

Requirements

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

Comments

Constraints

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

Mappings

v2: RXO-2, RXE-3
rim: .doseQuantity

MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.value

Short Dose quantity value

Definition

Dose quantity value.

Cardinality 0..1

Must Support True

Summary True

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])

Constraints

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

Mappings

v2: SN.2 / CQ - N/A
rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
EHM: Dos

MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.comparator

Short < | <= | >= | > - how to understand the value

Definition

Not allowed to be used in this context

Cardinality 0..0

How the Quantity should be understood and represented.

Modifier True

Summary True

Requirements

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

Meaning when missing

If there is no comparator, then there is no modification of the value

Constraints

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

Mappings

v2: SN.1 / CQ.1
rim: IVL properties

MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.unit

Short Unit representation

Definition

A human-readable form of the unit.

Cardinality 0..1

Summary True

Requirements

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

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.unit

MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.system

Short System that defines coded unit form

Definition

The identification of the system that provides the coded form of the unit.

Cardinality 0..1

Must Support True

Summary True

Requirements

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

Conditions The cardinality or value of this element may be affected by these constraints: qty-3

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: CO.codeSystem, PQ.translation.codeSystem

MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.code

Short Coded form of the unit

Definition

A computer processable form of the unit in some unit representation system.

Cardinality 0..1

Must Support True

Summary True

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.

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.code, MO.currency, PQ.translation.code
EHM: Dosenhet

MedicationDispense.dosageInstruction.doseAndRate.rate[x]

Short Amount of medication per unit of time

Definition

Amount of medication per unit of time.

Cardinality 0..1

nll-ucum-rate-unit (required)

Must Support True

Summary True

Requirements

Comments

Constraints

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

Mappings

v2: RXE22, RXE23, RXE-24
rim: .rateQuantity
EHM: Doseringshastighet

MedicationDispense.dosageInstruction.doseAndRate.rate[x].id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.dosageInstruction.doseAndRate.rate[x].extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.dosageInstruction.doseAndRate.rate[x].value

Short Rate value

Definition

Rate value

Cardinality 0..1

Must Support True

Summary True

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])

Constraints

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

Mappings

v2: SN.2 / CQ - N/A
rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
EHM: Doseringshastighet

MedicationDispense.dosageInstruction.doseAndRate.rate[x].comparator

Short < | <= | >= | > - how to understand the value

Definition

Not allowed to be used in this context

Cardinality 0..0

How the Quantity should be understood and represented.

Modifier True

Summary True

Requirements

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

Meaning when missing

If there is no comparator, then there is no modification of the value

Constraints

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

Mappings

v2: SN.1 / CQ.1
rim: IVL properties

MedicationDispense.dosageInstruction.doseAndRate.rate[x].unit

Short Unit representation

Definition

A human-readable form of the unit.

Cardinality 0..1

Summary True

Requirements

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

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.unit

MedicationDispense.dosageInstruction.doseAndRate.rate[x].system

Short System that defines coded unit form

Definition

The identification of the system that provides the coded form of the unit.

Cardinality 0..1

Must Support True

Summary True

Requirements

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

Conditions The cardinality or value of this element may be affected by these constraints: qty-3

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: CO.codeSystem, PQ.translation.codeSystem

MedicationDispense.dosageInstruction.doseAndRate.rate[x].code

Short Coded form of the unit

Definition

A computer processable form of the unit in some unit representation system.

Cardinality 1..1

Must Support True

Summary True

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.

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.code, MO.currency, PQ.translation.code
EHM: Doseringshastighetsenhet

MedicationDispense.dosageInstruction.maxDosePerPeriod

Short Upper limit on medication per day

Definition

Upper limit on medication per day.

Cardinality 0..1

Must Support True

Summary True

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.

Constraints

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

Mappings

v2: RXO-23, RXE-19
rim: .maxDoseQuantity
EHM: Maxdos

MedicationDispense.dosageInstruction.maxDosePerPeriod.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.dosageInstruction.maxDosePerPeriod.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator

Short Numerator value

Definition

The value of the numerator.

Cardinality 0..1

Must Support True

Summary True

Constraints

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

Mappings

rim: .numerator
EHM: Maxdos

MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.value

Short Max dose therapeutic substance value

Definition

Max dose therapeutic substance value

Cardinality 0..1

Must Support True

Summary True

Requirements

Comments

Constraints

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

Mappings

v2: SN.2 / CQ - N/A
rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
EHM: Maxdos

MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.comparator

Short < | <= | >= | > - how to understand the value

Definition

Cardinality 0..1

How the Quantity should be understood and represented.

Modifier True

Summary True

Requirements

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

Meaning when missing

If there is no comparator, then there is no modification of the value

Constraints

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

Mappings

v2: SN.1 / CQ.1
rim: IVL properties

MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.unit

Short Unit representation

Definition

A human-readable form of the unit.

Cardinality 0..1

Summary True

Requirements

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

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.unit

MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.system

Short System that defines coded unit form

Definition

The identification of the system that provides the coded form of the unit.

Cardinality 0..1

Must Support True

Summary True

Requirements

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

Conditions The cardinality or value of this element may be affected by these constraints: qty-3

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: CO.codeSystem, PQ.translation.codeSystem

MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.code

Short Coded form of the unit

Definition

A computer processable form of the unit in some unit representation system.

Cardinality 1..1

Must Support True

Summary True

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.

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.code, MO.currency, PQ.translation.code
EHM: Maxdosenhet

MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator

Short Denominator value

Definition

The value of the denominator.

Cardinality 0..1

Must Support True

Summary True

Constraints

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

Auto Value

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

Mappings

rim: .denominator
EHM: Maxdosperiod

MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.value

Short Numerical value (with implicit precision)

Definition

The value of the measured amount. The value includes an implicit precision in the presentation of the value.

Cardinality 0..1

Must Support True

Summary True

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).

Constraints

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

Auto Value

Mappings

v2: SN.2 / CQ - N/A
rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
EHM: Maxdosperiod

MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.comparator

Short < | <= | >= | > - how to understand the value

Definition

Cardinality 0..1

How the Quantity should be understood and represented.

Modifier True

Summary True

Requirements

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

Meaning when missing

If there is no comparator, then there is no modification of the value

Constraints

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

Mappings

v2: SN.1 / CQ.1
rim: IVL properties

MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.unit

Short Unit representation

Definition

A human-readable form of the unit.

Cardinality 0..1

Summary True

Requirements

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

Constraints

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

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.unit

MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.system

Short System that defines coded unit form

Definition

The identification of the system that provides the coded form of the unit.

Cardinality 0..1

Must Support True

Summary True

Requirements

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

Conditions The cardinality or value of this element may be affected by these constraints: qty-3

Constraints

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

Auto Value

http://unitsofmeasure.org

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: CO.codeSystem, PQ.translation.codeSystem

MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.code

Short Coded form of the unit

Definition

A computer processable form of the unit in some unit representation system.

Cardinality 0..1

Must Support True

Summary True

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.

Constraints

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

Auto Value

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.code, MO.currency, PQ.translation.code
EHM: Maxdosperiodenhet

MedicationDispense.dosageInstruction.maxDosePerAdministration

Short Upper limit on medication per administration

Definition

Upper limit on medication per administration.

Cardinality 0..1

Summary True

Requirements

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

Comments

Constraints

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

Mappings

rim: not supported

MedicationDispense.dosageInstruction.maxDosePerLifetime

Short Upper limit on medication per lifetime of the patient

Definition

Upper limit on medication per lifetime of the patient.

Cardinality 0..1

Summary True

Requirements

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

Constraints

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

Mappings

rim: not supported

MedicationDispense.substitution

Short Whether a substitution was performed on the dispense

Definition

Cardinality 0..1

Must Support True

Constraints

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

Mappings

rim: .outboundRelationship[typeCode=COMP].target[classCode=SUBST, moodCode=EVN]
rx-dispense-rmim: CombinedMedicationDispense.substitutionMade
EHM: Generikautbyte utfört

MedicationDispense.substitution.id

Short 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.

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.substitution.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

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

MedicationDispense.substitution.modifierExtension

Short Extensions that cannot be ignored even if unrecognized

Definition

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Cardinality 0..*

Modifier True

Summary True

Alias extensions, user content, modifiers

Requirements

Comments

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

MedicationDispense.substitution.wasSubstituted

Short 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.

Cardinality 1..1

Must Support True

Constraints

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

Mappings

rim: .actionNegationInd
EHM: Generikautbyte utfört

MedicationDispense.substitution.type

Short 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.

Cardinality 0..1

v3.ActSubstanceAdminSubstitutionCode (example)

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

Constraints

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

Mappings

v2: RXO-9-Allow Substitutions / RXE-9-Substitution Status
rim: .code
rx-dispense-rmim: CombinedMedicationDispense.substitutionMade.code

MedicationDispense.substitution.reason

Short Why was substitution made

Definition

Indicates the reason for the substitution (or lack of substitution) from what was prescribed.

Cardinality 0..*