Profiles & Operations Index > Profile: MedicationDispense
Profile: MedicationDispense
Simplifier project page: MedicationDispense
Derived from: MedicationDispense (R4)
Canonical_URL | Profile_Status | Profile_Version | FHIR_Version |
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http://ehealthontario.ca/fhir/StructureDefinition/ca-on-medications-profile-MedicationDispense | draft | 4.0.0 | 4.0.1 |
Formal Views of Profile Content
Description of Profiles, Differentials, Snapshots and how the different presentations work
Differential View
MedicationDispense | S I | MedicationDispense | There are no (further) constraints on this element Element IdMedicationDispense Dispensing a medication to a named patient DefinitionIndicates that a medication product is to be or has been dispensed for a named person/patient. This includes a description of the medication product (supply) provided and the instructions for administering the medication. The medication dispense is the result of a pharmacy system responding to a medication order.
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id | S Σ | 0..1 | System.String | There are no (further) constraints on this element Element IdMedicationDispense.id Logical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. System.String |
meta | S Σ | 0..1 | Meta | There are no (further) constraints on this element Element IdMedicationDispense.meta Metadata about the resource DefinitionThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
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versionId | S Σ | 0..1 | id | There are no (further) constraints on this element Element IdMedicationDispense.meta.versionId Version specific identifier DefinitionThe version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. 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.
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lastUpdated | S Σ | 0..1 | instant | There are no (further) constraints on this element Element IdMedicationDispense.meta.lastUpdated When the resource version last changed DefinitionWhen the resource last changed - e.g. when the version changed. 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.
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source | S Σ | 0..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.meta.source Identifies where the resource comes from DefinitionA 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. 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.
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profile | Σ | 0..* | canonical(StructureDefinition) | There are no (further) constraints on this element Element IdMedicationDispense.meta.profile Profiles this resource claims to conform to DefinitionA list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. 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. canonical(StructureDefinition) Constraints
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security | Σ | 0..* | CodingBinding | There are no (further) constraints on this element Element IdMedicationDispense.meta.security Security Labels applied to this resource DefinitionSecurity labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. 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. Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible)Constraints
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tag | Σ | 0..* | Coding | There are no (further) constraints on this element Element IdMedicationDispense.meta.tag Tags applied to this resource DefinitionTags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. 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. Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". CommonTags (example)Constraints
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contained | S | 1..* | Medication, MedicationRequest Prescription, Practitioner, Organization, PractitionerRole | Element IdMedicationDispense.contained Contained, inline Resources Alternate namesinline resources, anonymous resources, contained resources DefinitionThese resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. Medication, MedicationRequest Prescription, Practitioner, Organization, PractitionerRole Mappings
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id | S Σ | 0..1 | System.String | There are no (further) constraints on this element Element IdMedicationDispense.contained.id Logical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. System.String |
meta | S Σ | 0..1 | Meta | There are no (further) constraints on this element Element IdMedicationDispense.contained.meta Metadata about the resource DefinitionThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
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versionId | Σ | 0..1 | id | There are no (further) constraints on this element Element IdMedicationDispense.contained.meta.versionId Version specific identifier DefinitionThe version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. 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.
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lastUpdated | S Σ | 0..1 | instant | There are no (further) constraints on this element Element IdMedicationDispense.contained.meta.lastUpdated When the resource version last changed DefinitionWhen the resource last changed - e.g. when the version changed. 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.
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source | S Σ | 0..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.contained.meta.source Identifies where the resource comes from DefinitionA 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. 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.
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profile | Σ | 0..* | canonical(StructureDefinition) | There are no (further) constraints on this element Element IdMedicationDispense.contained.meta.profile Profiles this resource claims to conform to DefinitionA list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. 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. canonical(StructureDefinition) Constraints
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security | Σ | 0..* | CodingBinding | There are no (further) constraints on this element Element IdMedicationDispense.contained.meta.security Security Labels applied to this resource DefinitionSecurity labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. 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. Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible)Constraints
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tag | Σ | 0..* | Coding | There are no (further) constraints on this element Element IdMedicationDispense.contained.meta.tag Tags applied to this resource DefinitionTags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. 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. Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". CommonTags (example)Constraints
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extension | I | 0..* | Extension | Element IdMedicationDispense.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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DispenseRemainingRefills | S I | 0..1 | Extension(integer) | Element IdMedicationDispense.extension:DispenseRemainingRefills Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. DHDR: Refills Remaining. Number of authorized refills/repeats remaining after this dispense. 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. http://ehealthontario.ca/fhir/StructureDefinition/ca-on-medications-ext-refills-remaining Constraints
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DispenseRemainingQuantity | S I | 0..1 | Extension(Quantity) | Element IdMedicationDispense.extension:DispenseRemainingQuantity Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. DHDR: Quantity Remaining. Total quantity remaining on a prescription after this dispense. 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. http://ehealthontario.ca/fhir/StructureDefinition/ca-on-medications-ext-quantity-remaining Constraints
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DrugServiceCoverage | S I | 0..1 | Extension(Coding) | Element IdMedicationDispense.extension:DrugServiceCoverage Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://ehealthontario.ca/fhir/StructureDefinition/ca-on-medications-ext-drug-service-coverage Constraints
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identifier | S | 1..2 | Identifier | Element IdMedicationDispense.identifier External identifier DefinitionIdentifiers associated with this Medication Dispense that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server. This is a business identifier, not a resource identifier. Unordered, Open, by assigner.identifier.system(Value) Constraints
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currentRxNo | S | 1..1 | Identifier | There are no (further) constraints on this element Element IdMedicationDispense.identifier:currentRxNo External identifier DefinitionIdentifiers associated with this Medication Dispense that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server. This is a business identifier, not a resource identifier.
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.identifier:currentRxNo.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdMedicationDispense.identifier:currentRxNo.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | S Σ | 1..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.identifier:currentRxNo.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | S Σ | 1..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.identifier:currentRxNo.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdMedicationDispense.identifier:currentRxNo.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdMedicationDispense.identifier:currentRxNo.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
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originalRxNo | S | 0..1 | Identifier | There are no (further) constraints on this element Element IdMedicationDispense.identifier:originalRxNo External identifier DefinitionIdentifiers associated with this Medication Dispense that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server. This is a business identifier, not a resource identifier.
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.identifier:originalRxNo.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdMedicationDispense.identifier:originalRxNo.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | S Σ | 1..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.identifier:originalRxNo.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | S Σ | 1..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.identifier:originalRxNo.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdMedicationDispense.identifier:originalRxNo.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdMedicationDispense.identifier:originalRxNo.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
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partOf | I | 0..* | Reference(Procedure) | There are no (further) constraints on this element Element IdMedicationDispense.partOf Event that dispense is part of DefinitionThe procedure that trigger the dispense. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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status | S Σ ?! | 1..1 | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.status preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown DefinitionA code specifying the state of the set of dispense events. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. A coded concept specifying the state of the dispense event. MedicationDispense Status Codes (required)Constraints
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statusReason[x] | 0..1 | There are no (further) constraints on this element Element IdMedicationDispense.statusReason[x] Why a dispense was not performed DefinitionIndicates the reason why a dispense was not performed. A code describing why a dispense was not performed. MedicationDispense Status Reason Codes (example)Constraints
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statusReasonCodeableConcept | CodeableConcept | There are no (further) constraints on this element Data Type | ||
statusReasonReference | Reference(DetectedIssue) | There are no (further) constraints on this element Data Type | ||
category | S | 0..1 | CodeableConceptBinding | Element IdMedicationDispense.category Type of medication dispense DefinitionIndicates the type of medication dispense (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)). The category can be used to include where the medication is expected to be consumed or other types of dispenses. Invariants can be used to bind to different value sets when profiling to bind. Dispense type, e.g. drug, device or pharmacy service DispenseCategory (required)Constraints
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coding | S Σ | 1..1 | Coding | There are no (further) constraints on this element Element IdMedicationDispense.category.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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.
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system | S Σ | 1..1 | uriFixed Value | Element IdMedicationDispense.category.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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.
http://ehealthontario.ca/fhir/CodeSystem/medication-dispense-category
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.category.coding.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. 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.
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code | S Σ | 1..1 | code | There are no (further) constraints on this element Element IdMedicationDispense.category.coding.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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display | S Σ | 1..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.category.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdMedicationDispense.category.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.category.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. 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. Very often the text is the same as a displayName of one of the codings.
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medication[x] | S Σ | 1..1 | There are no (further) constraints on this element Element IdMedicationDispense.medication[x] What medication was supplied DefinitionIdentifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications. If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource.
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reference | S Σ I | 1..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.medication[x].reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdMedicationDispense.medication[x].type Type the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdMedicationDispense.medication[x].identifier Logical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.medication[x].display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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medicationReference | Reference(Medication) | Data Type | ||
subject | S Σ I | 1..1 | Reference(Patient) | Element IdMedicationDispense.subject Who the dispense is for DefinitionA link to a resource representing the person or the group to whom the medication will be given. SubstanceAdministration->subject->Patient.
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reference | S Σ I | 1..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.subject.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdMedicationDispense.subject.type Type the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdMedicationDispense.subject.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.subject.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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context | I | 0..1 | Reference(Encounter | EpisodeOfCare) | There are no (further) constraints on this element Element IdMedicationDispense.context Encounter / Episode associated with event DefinitionThe encounter or episode of care that establishes the context for this event. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Encounter | EpisodeOfCare) Constraints
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supportingInformation | I | 0..* | Reference(Resource) | There are no (further) constraints on this element Element IdMedicationDispense.supportingInformation Information that supports the dispensing of the medication DefinitionAdditional information that supports the medication being dispensed. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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performer | S | 0..1 | BackboneElement | There are no (further) constraints on this element Element IdMedicationDispense.performer Who performed event DefinitionIndicates who or what performed the event.
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function | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdMedicationDispense.performer.function Who performed the dispense and what they did DefinitionDistinguishes the type of performer in the dispense. For example, date enterer, packager, final checker. Allows disambiguation of the types of involvement of different performers. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. A code describing the role an individual played in dispensing a medication. MedicationDispense Performer Function Codes (example)Constraints
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actor | S I | 1..1 | Reference(PractitionerRole) | Element IdMedicationDispense.performer.actor Individual who was performing DefinitionThe device, practitioner, etc. who performed the action. It should be assumed that the actor is the dispenser of the medication. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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reference | S Σ I | 1..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.performer.actor.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdMedicationDispense.performer.actor.type Type the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdMedicationDispense.performer.actor.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.performer.actor.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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location | I | 0..1 | Reference(Location) | There are no (further) constraints on this element Element IdMedicationDispense.location Where the dispense occurred DefinitionThe principal physical location where the dispense was performed. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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authorizingPrescription | S I | 0..1 | Reference(MedicationRequest Prescription) | Element IdMedicationDispense.authorizingPrescription Medication order that authorizes the dispense DefinitionIndicates the medication order that is being dispensed against. Maps to basedOn in Event logical model. Reference(MedicationRequest Prescription) Constraints
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reference | S Σ I | 1..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.authorizingPrescription.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdMedicationDispense.authorizingPrescription.type Type the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdMedicationDispense.authorizingPrescription.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.authorizingPrescription.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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type | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdMedicationDispense.type Trial fill, partial fill, emergency fill, etc. DefinitionIndicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc. v3.ActPharmacySupplyType (example)Constraints
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quantity | S I | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element IdMedicationDispense.quantity Amount dispensed DefinitionThe amount of medication that has been dispensed. Includes unit of measure. The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
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value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element IdMedicationDispense.quantity.value Numerical value (with implicit precision) DefinitionThe value of the measured amount. The value includes an implicit precision in the presentation of the value. Precision is handled implicitly in almost all cases of measurement. 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).
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comparator | Σ ?! | 0..0 | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.quantity.comparator < | <= | >= | > - how to understand the value DefinitionNot allowed to be used in this context Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Note that FHIR strings SHALL NOT exceed 1MB in size If there is no comparator, then there is no modification of the value How the Quantity should be understood and represented. QuantityComparator (required)Constraints
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unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.quantity.unit Unit representation DefinitionA human-readable form of the unit. There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Note that FHIR strings SHALL NOT exceed 1MB in size
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system | S Σ I | 0..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.quantity.system System that defines coded unit form DefinitionThe identification of the system that provides the coded form of the unit. Need to know the system that defines the coded form of the unit. see http://en.wikipedia.org/wiki/Uniform_resource_identifier
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code | S Σ | 0..1 | codeBinding | Element IdMedicationDispense.quantity.code Coded form of the unit DefinitionA computer processable form of the unit in some unit representation system. 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. 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. https://tgateway.infoway-inforoute.ca/vs/prescribedquantityunit (extensible) Constraints
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daysSupply | S I | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element IdMedicationDispense.daysSupply Amount of medication expressed as a timing amount DefinitionThe amount of medication expressed as a timing amount. The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
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value | Σ | 1..1 | decimal | There are no (further) constraints on this element Element IdMedicationDispense.daysSupply.value Numerical value (with implicit precision) DefinitionThe value of the measured amount. The value includes an implicit precision in the presentation of the value. Precision is handled implicitly in almost all cases of measurement. 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).
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comparator | Σ ?! | 0..0 | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.daysSupply.comparator < | <= | >= | > - how to understand the value DefinitionNot allowed to be used in this context Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Note that FHIR strings SHALL NOT exceed 1MB in size If there is no comparator, then there is no modification of the value How the Quantity should be understood and represented. QuantityComparator (required)Constraints
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unit | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.daysSupply.unit Unit representation DefinitionA human-readable form of the unit. There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Note that FHIR strings SHALL NOT exceed 1MB in size
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system | Σ I | 0..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.daysSupply.system System that defines coded unit form DefinitionThe identification of the system that provides the coded form of the unit. Need to know the system that defines the coded form of the unit. see http://en.wikipedia.org/wiki/Uniform_resource_identifier
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code | Σ | 0..1 | code | There are no (further) constraints on this element Element IdMedicationDispense.daysSupply.code Coded form of the unit DefinitionA computer processable form of the unit in some unit representation system. 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. 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.
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whenPrepared | S Σ | 1..1 | dateTime | There are no (further) constraints on this element Element IdMedicationDispense.whenPrepared When product was packaged and reviewed DefinitionThe time when the dispensed product was packaged and reviewed.
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whenHandedOver | S | 0..1 | dateTime | There are no (further) constraints on this element Element IdMedicationDispense.whenHandedOver When product was given out DefinitionThe time the dispensed product was provided to the patient or their representative.
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destination | I | 0..1 | Reference(Location) | There are no (further) constraints on this element Element IdMedicationDispense.destination Where the medication was sent DefinitionIdentification of the facility/location where the medication was shipped to, as part of the dispense event. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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receiver | I | 0..* | Reference(Patient | Practitioner) | There are no (further) constraints on this element Element IdMedicationDispense.receiver Who collected the medication DefinitionIdentifies the person who picked up the medication. This will usually be a patient or their caregiver, but some cases exist where it can be a healthcare professional. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Patient | Practitioner) Constraints
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note | 0..* | Annotation | There are no (further) constraints on this element Element IdMedicationDispense.note Information about the dispense DefinitionExtra information about the dispense that could not be conveyed in the other attributes. For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).
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dosageInstruction | S | 0..* | Dosage | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction How the medication is to be used by the patient or administered by the caregiver DefinitionIndicates how the medication is to be used by the patient. When the dose or rate is intended to change over the entire administration period (e.g. Tapering dose prescriptions), multiple instances of dosage instructions will need to be supplied to convey the different doses/rates. The pharmacist reviews the medication order prior to dispense and updates the dosageInstruction based on the actual product being dispensed.
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sequence | S Σ | 0..1 | integer | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.sequence The order of the dosage instructions DefinitionIndicates the order in which the dosage instructions should be applied or interpreted. 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. 32 bit number; for values larger than this, use decimal
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text | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.text Free text dosage instructions e.g. SIG DefinitionFree text dosage instructions e.g. SIG. Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text. Note that FHIR strings SHALL NOT exceed 1MB in size
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additionalInstruction | S Σ | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.additionalInstruction Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" DefinitionSupplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps"). Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded. Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text. A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". SNOMEDCTAdditionalDosageInstructions (example)Constraints
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coding | S Σ | 0..* | Coding | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.additionalInstruction.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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.
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system | S Σ | 0..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.additionalInstruction.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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.
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.additionalInstruction.coding.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. 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.
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code | S Σ | 0..1 | code | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.additionalInstruction.coding.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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display | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.additionalInstruction.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.additionalInstruction.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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text | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.additionalInstruction.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. 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. Very often the text is the same as a displayName of one of the codings.
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patientInstruction | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.patientInstruction Patient or consumer oriented instructions DefinitionInstructions in terms that are understood by the patient or consumer. Note that FHIR strings SHALL NOT exceed 1MB in size
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timing | S Σ | 0..1 | Timing | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing When medication should be administered DefinitionWhen medication should be administered. 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. This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing.
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event | S Σ | 0..* | dateTime | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.event When the event occurs DefinitionIdentifies specific times when the event occurs. In a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification.
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repeat | S Σ I | 0..1 | Element | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat When the event is to occur DefinitionA set of rules that describe when the event is scheduled. Many timing schedules are determined by regular repetitions.
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bounds[x] | S Σ | 0..1 | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.bounds[x] Length/Range of lengths, or (Start and/or end) limits DefinitionEither a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.
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boundsDuration | Duration | There are no (further) constraints on this element Data Type | ||
boundsRange | Range | There are no (further) constraints on this element Data Type | ||
boundsPeriod | Period | There are no (further) constraints on this element Data Type | ||
count | S Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.count Number of times to repeat DefinitionA total count of the desired number of repetitions across the duration of the entire timing specification. If countMax is present, this element indicates the lower bound of the allowed range of count values. Repetitions may be limited by end time or total occurrences. If you have both bounds and count, then this should be understood as within the bounds period, until count times happens.
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countMax | S Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.countMax Maximum number of times to repeat DefinitionIf present, indicates that the count is a range - so to perform the action between [count] and [countMax] times. 32 bit number; for values larger than this, use decimal
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duration | S Σ | 0..1 | decimal | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.duration How long when it happens DefinitionHow long this thing happens for when it happens. If durationMax is present, this element indicates the lower bound of the allowed range of the duration. Some activities are not instantaneous and need to be maintained for a period of time. 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).
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durationMax | S Σ | 0..1 | decimal | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.durationMax How long when it happens (Max) DefinitionIf present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length. Some activities are not instantaneous and need to be maintained for a period of time. 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).
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durationUnit | S Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.durationUnit s | min | h | d | wk | mo | a - unit of time (UCUM) DefinitionThe units of time for the duration, in UCUM units. Note that FHIR strings SHALL NOT exceed 1MB in size A unit of time (units from UCUM). UnitsOfTime (required)Constraints
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frequency | S Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.frequency Event occurs frequency times per period DefinitionThe number of times to repeat the action within the specified period. If frequencyMax is present, this element indicates the lower bound of the allowed range of the frequency. 32 bit number; for values larger than this, use decimal If no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this
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frequencyMax | S Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.frequencyMax Event occurs up to frequencyMax times per period DefinitionIf present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range. 32 bit number; for values larger than this, use decimal
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period | S Σ | 0..1 | decimal | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.period Event occurs frequency times per period DefinitionIndicates the duration of time over which repetitions are to occur; e.g. to express "3 times per day", 3 would be the frequency and "1 day" would be the period. If periodMax is present, this element indicates the lower bound of the allowed range of the period length. Do not use an IEEE type floating point type, instead use something that works like a true decimal, with inbuilt precision (e.g. Java BigInteger)
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periodMax | S Σ | 0..1 | decimal | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.periodMax Upper limit of period (3-4 hours) DefinitionIf present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as "do this once every 3-5 days. Do not use an IEEE type floating point type, instead use something that works like a true decimal, with inbuilt precision (e.g. Java BigInteger)
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periodUnit | S Σ | 0..1 | codeBinding | Element IdMedicationDispense.dosageInstruction.timing.repeat.periodUnit s | min | h | d | wk | mo | a - unit of time (UCUM) DefinitionThe units of time for the period in UCUM units. Note that FHIR strings SHALL NOT exceed 1MB in size A unit of time (units from UCUM). UnitsOfTime (required)Constraints
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dayOfWeek | S Σ | 0..* | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.dayOfWeek mon | tue | wed | thu | fri | sat | sun DefinitionIf one or more days of week is provided, then the action happens only on the specified day(s). 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.
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timeOfDay | S Σ | 0..* | time | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.timeOfDay Time of day for action DefinitionSpecified time of day for action to take place. 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.
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when | S Σ | 0..* | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.when Code for time period of occurrence DefinitionAn approximate time period during the day, potentially linked to an event of daily living that indicates when the action should occur. Timings are frequently determined by occurrences such as waking, eating and sleep. When more than one event is listed, the event is tied to the union of the specified events. Real world event relating to the schedule. EventTiming (required)Constraints
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offset | S Σ | 0..1 | unsignedInt | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.offset Minutes from event (before or after) DefinitionThe number of minutes from the event. If the event code does not indicate whether the minutes is before or after the event, then the offset is assumed to be after the event. 32 bit number; for values larger than this, use decimal
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code | S Σ | 0..1 | CodeableConceptBinding | Element IdMedicationDispense.dosageInstruction.timing.code BID | TID | QID | AM | PM | QD | QOD | + DefinitionA code for the timing schedule (or just text in code.text). Some codes such as BID are ubiquitous, but many institutions define their own additional codes. If a code is provided, the code is understood to be a complete statement of whatever is specified in the structured timing data, and either the code or the data may be used to interpret the Timing, with the exception that .repeat.bounds still applies over the code (and is not contained in the code). 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). Code for a known / defined timing pattern. MedicationRepeatPattern (extensible)Constraints
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coding | S Σ | 0..* | Coding | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.code.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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.
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system | S Σ | 0..1 | uriFixed Value | Element IdMedicationDispense.dosageInstruction.timing.code.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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.
http://snomed.info/sct
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.code.coding.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. 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.
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code | S Σ | 0..1 | code | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.code.coding.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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display | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.code.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.code.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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text | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.code.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. 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. Very often the text is the same as a displayName of one of the codings.
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asNeeded[x] | S Σ | 0..1 | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.asNeeded[x] Take "as needed" (for x) DefinitionIndicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept). Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed".
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asNeededBoolean | boolean | Data Type | ||
site | S Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.site Body site to administer to DefinitionBody site to administer to. A coded specification of the anatomic site where the medication first enters the body. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both. A coded concept describing the site location the medicine enters into or onto the body. SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example)Constraints
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coding | S Σ | 0..* | Coding | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.site.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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.
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system | S Σ | 0..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.site.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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.
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.site.coding.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. 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.
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code | S Σ | 0..1 | code | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.site.coding.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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display | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.site.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.site.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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text | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.site.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. 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. Very often the text is the same as a displayName of one of the codings.
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route | S Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.route How drug should enter body DefinitionHow drug should enter body. A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. SNOMEDCTRouteCodes (example)Constraints
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coding | S Σ | 1..1 | CodingBinding | Element IdMedicationDispense.dosageInstruction.route.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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. RouteOfAdministration (required) Constraints
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system | S Σ | 1..1 | uriFixed Value | Element IdMedicationDispense.dosageInstruction.route.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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.
http://snomed.info/sct
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.route.coding.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. 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.
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code | S Σ | 1..1 | code | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.route.coding.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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display | S Σ | 1..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.route.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.route.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.route.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. 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. Very often the text is the same as a displayName of one of the codings.
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method | S Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.method Technique for administering medication DefinitionTechnique for administering medication. A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV. Terminologies used often pre-coordinate this term with the route and or form of administration. A coded concept describing the technique by which the medicine is administered. SNOMEDCTAdministrationMethodCodes (example)Constraints
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coding | S Σ | 0..* | Coding | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.method.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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.
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system | S Σ | 0..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.method.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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.
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.method.coding.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. 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.
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code | S Σ | 0..1 | code | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.method.coding.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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display | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.method.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.method.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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text | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.method.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. 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. Very often the text is the same as a displayName of one of the codings.
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doseAndRate | S Σ | 0..* | Element | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.doseAndRate Amount of medication administered DefinitionThe amount of medication administered.
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type | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.doseAndRate.type The kind of dose or rate specified DefinitionThe kind of dose or rate specified, for example, ordered or calculated. If the type is not populated, assume to be "ordered". Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The kind of dose or rate specified. DoseAndRateType (example)Constraints
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dose[x] | S Σ | 0..1 | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.doseAndRate.dose[x] Amount of medication per dose DefinitionAmount of medication per dose. The amount of therapeutic or other substance given at one administration event. 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.
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doseRange | Range | There are no (further) constraints on this element Data Type | ||
doseQuantity | SimpleQuantity | There are no (further) constraints on this element Data Type | ||
rate[x] | S Σ | 0..1 | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.doseAndRate.rate[x] Amount of medication per unit of time DefinitionAmount of medication per unit of time. Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. 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. It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate. It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.
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rateRatio | Ratio | There are no (further) constraints on this element Data Type | ||
rateRange | Range | There are no (further) constraints on this element Data Type | ||
rateQuantity | SimpleQuantity | There are no (further) constraints on this element Data Type | ||
maxDosePerPeriod | S Σ I | 0..1 | Ratio | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod Upper limit on medication per unit of time DefinitionUpper limit on medication per unit of time. 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. This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day".
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numerator | S Σ I | 0..1 | Quantity | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod.numerator Numerator value DefinitionThe value of the numerator. The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
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value | S Σ | 0..1 | decimal | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.value Numerical value (with implicit precision) DefinitionThe value of the measured amount. The value includes an implicit precision in the presentation of the value. Precision is handled implicitly in almost all cases of measurement. 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).
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comparator | S Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.comparator < | <= | >= | > - how to understand the value DefinitionHow the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value. Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Note that FHIR strings SHALL NOT exceed 1MB in size If there is no comparator, then there is no modification of the value How the Quantity should be understood and represented. QuantityComparator (required)Constraints
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unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.unit Unit representation DefinitionA human-readable form of the unit. There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Note that FHIR strings SHALL NOT exceed 1MB in size
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system | S Σ I | 0..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.system System that defines coded unit form DefinitionThe identification of the system that provides the coded form of the unit. Need to know the system that defines the coded form of the unit. see http://en.wikipedia.org/wiki/Uniform_resource_identifier
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code | S Σ | 0..1 | code | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.code Coded form of the unit DefinitionA computer processable form of the unit in some unit representation system. 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. 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.
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denominator | S Σ I | 0..1 | Quantity | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod.denominator Denominator value DefinitionThe value of the denominator. The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
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value | S Σ | 0..1 | decimal | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.value Numerical value (with implicit precision) DefinitionThe value of the measured amount. The value includes an implicit precision in the presentation of the value. Precision is handled implicitly in almost all cases of measurement. 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).
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comparator | S Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.comparator < | <= | >= | > - how to understand the value DefinitionHow the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value. Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Note that FHIR strings SHALL NOT exceed 1MB in size If there is no comparator, then there is no modification of the value How the Quantity should be understood and represented. QuantityComparator (required)Constraints
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unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.unit Unit representation DefinitionA human-readable form of the unit. There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Note that FHIR strings SHALL NOT exceed 1MB in size
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system | S Σ I | 0..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.system System that defines coded unit form DefinitionThe identification of the system that provides the coded form of the unit. Need to know the system that defines the coded form of the unit. see http://en.wikipedia.org/wiki/Uniform_resource_identifier
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code | S Σ | 0..1 | code | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.code Coded form of the unit DefinitionA computer processable form of the unit in some unit representation system. 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. 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.
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maxDosePerAdministration | S Σ I | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerAdministration Upper limit on medication per administration DefinitionUpper limit on medication per administration. The maximum total quantity of a therapeutic substance that may be administered to a subject per administration. 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.
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value | S Σ | 0..1 | decimal | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerAdministration.value Numerical value (with implicit precision) DefinitionThe value of the measured amount. The value includes an implicit precision in the presentation of the value. Precision is handled implicitly in almost all cases of measurement. 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).
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comparator | Σ ?! | 0..0 | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerAdministration.comparator < | <= | >= | > - how to understand the value DefinitionNot allowed to be used in this context Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Note that FHIR strings SHALL NOT exceed 1MB in size If there is no comparator, then there is no modification of the value How the Quantity should be understood and represented. QuantityComparator (required)Constraints
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unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerAdministration.unit Unit representation DefinitionA human-readable form of the unit. There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Note that FHIR strings SHALL NOT exceed 1MB in size
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system | S Σ I | 0..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerAdministration.system System that defines coded unit form DefinitionThe identification of the system that provides the coded form of the unit. Need to know the system that defines the coded form of the unit. see http://en.wikipedia.org/wiki/Uniform_resource_identifier
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code | S Σ | 0..1 | code | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerAdministration.code Coded form of the unit DefinitionA computer processable form of the unit in some unit representation system. 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. 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.
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maxDosePerLifetime | S Σ I | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerLifetime Upper limit on medication per lifetime of the patient DefinitionUpper limit on medication per lifetime of the patient. The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject. The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
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value | S Σ | 0..1 | decimal | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerLifetime.value Numerical value (with implicit precision) DefinitionThe value of the measured amount. The value includes an implicit precision in the presentation of the value. Precision is handled implicitly in almost all cases of measurement. 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).
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comparator | Σ ?! | 0..0 | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerLifetime.comparator < | <= | >= | > - how to understand the value DefinitionNot allowed to be used in this context Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Note that FHIR strings SHALL NOT exceed 1MB in size If there is no comparator, then there is no modification of the value How the Quantity should be understood and represented. QuantityComparator (required)Constraints
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unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerLifetime.unit Unit representation DefinitionA human-readable form of the unit. There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Note that FHIR strings SHALL NOT exceed 1MB in size
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system | S Σ I | 0..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerLifetime.system System that defines coded unit form DefinitionThe identification of the system that provides the coded form of the unit. Need to know the system that defines the coded form of the unit. see http://en.wikipedia.org/wiki/Uniform_resource_identifier
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code | S Σ | 0..1 | code | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerLifetime.code Coded form of the unit DefinitionA computer processable form of the unit in some unit representation system. 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. 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.
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substitution | 0..1 | BackboneElement | There are no (further) constraints on this element Element IdMedicationDispense.substitution Whether a substitution was performed on the dispense DefinitionIndicates whether or not substitution was made as part of the dispense. In some cases, substitution will be expected but does not happen, in other cases substitution is not expected but does happen. This block explains what substitution did or did not happen and why. If nothing is specified, substitution was not done.
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wasSubstituted | 1..1 | boolean | There are no (further) constraints on this element Element IdMedicationDispense.substitution.wasSubstituted Whether a substitution was or was not performed on the dispense DefinitionTrue if the dispenser dispensed a different drug or product from what was prescribed.
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type | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdMedicationDispense.substitution.type Code signifying whether a different drug was dispensed from what was prescribed DefinitionA code signifying whether a different drug was dispensed from what was prescribed. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription. v3.ActSubstanceAdminSubstitutionCode (example)Constraints
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reason | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdMedicationDispense.substitution.reason Why was substitution made DefinitionIndicates the reason for the substitution (or lack of substitution) from what was prescribed. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed. v3.SubstanceAdminSubstitutionReason (example)Constraints
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responsibleParty | I | 0..* | Reference(Practitioner | PractitionerRole) | There are no (further) constraints on this element Element IdMedicationDispense.substitution.responsibleParty Who is responsible for the substitution DefinitionThe person or organization that has primary responsibility for the substitution. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Practitioner | PractitionerRole) Constraints
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detectedIssue | I | 0..* | Reference(DetectedIssue) | There are no (further) constraints on this element Element IdMedicationDispense.detectedIssue Clinical issue with action Alternate namesContraindication, Drug Utilization Review (DUR), Alert DefinitionIndicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. drug-drug interaction, duplicate therapy, dosage alert etc. This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue.
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eventHistory | I | 0..* | Reference(Provenance) | There are no (further) constraints on this element Element IdMedicationDispense.eventHistory A list of relevant lifecycle events DefinitionA summary of the events of interest that have occurred, such as when the dispense was verified. This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).
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Hybrid View
MedicationDispense | S I | MedicationDispense | There are no (further) constraints on this element Element IdMedicationDispense Dispensing a medication to a named patient DefinitionIndicates that a medication product is to be or has been dispensed for a named person/patient. This includes a description of the medication product (supply) provided and the instructions for administering the medication. The medication dispense is the result of a pharmacy system responding to a medication order.
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id | S Σ | 0..1 | System.String | There are no (further) constraints on this element Element IdMedicationDispense.id Logical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. System.String |
meta | S Σ | 0..1 | Meta | There are no (further) constraints on this element Element IdMedicationDispense.meta Metadata about the resource DefinitionThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
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versionId | S Σ | 0..1 | id | There are no (further) constraints on this element Element IdMedicationDispense.meta.versionId Version specific identifier DefinitionThe version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. 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.
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lastUpdated | S Σ | 0..1 | instant | There are no (further) constraints on this element Element IdMedicationDispense.meta.lastUpdated When the resource version last changed DefinitionWhen the resource last changed - e.g. when the version changed. 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.
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source | S Σ | 0..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.meta.source Identifies where the resource comes from DefinitionA 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. 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.
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profile | Σ | 0..* | canonical(StructureDefinition) | There are no (further) constraints on this element Element IdMedicationDispense.meta.profile Profiles this resource claims to conform to DefinitionA list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. 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. canonical(StructureDefinition) Constraints
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security | Σ | 0..* | CodingBinding | There are no (further) constraints on this element Element IdMedicationDispense.meta.security Security Labels applied to this resource DefinitionSecurity labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. 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. Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible)Constraints
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tag | Σ | 0..* | Coding | There are no (further) constraints on this element Element IdMedicationDispense.meta.tag Tags applied to this resource DefinitionTags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. 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. Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". CommonTags (example)Constraints
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contained | S | 1..* | Medication, MedicationRequest Prescription, Practitioner, Organization, PractitionerRole | Element IdMedicationDispense.contained Contained, inline Resources Alternate namesinline resources, anonymous resources, contained resources DefinitionThese resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. Medication, MedicationRequest Prescription, Practitioner, Organization, PractitionerRole Mappings
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id | S Σ | 0..1 | System.String | There are no (further) constraints on this element Element IdMedicationDispense.contained.id Logical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. System.String |
meta | S Σ | 0..1 | Meta | There are no (further) constraints on this element Element IdMedicationDispense.contained.meta Metadata about the resource DefinitionThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
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versionId | Σ | 0..1 | id | There are no (further) constraints on this element Element IdMedicationDispense.contained.meta.versionId Version specific identifier DefinitionThe version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. 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.
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lastUpdated | S Σ | 0..1 | instant | There are no (further) constraints on this element Element IdMedicationDispense.contained.meta.lastUpdated When the resource version last changed DefinitionWhen the resource last changed - e.g. when the version changed. 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.
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source | S Σ | 0..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.contained.meta.source Identifies where the resource comes from DefinitionA 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. 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.
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profile | Σ | 0..* | canonical(StructureDefinition) | There are no (further) constraints on this element Element IdMedicationDispense.contained.meta.profile Profiles this resource claims to conform to DefinitionA list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. 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. canonical(StructureDefinition) Constraints
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security | Σ | 0..* | CodingBinding | There are no (further) constraints on this element Element IdMedicationDispense.contained.meta.security Security Labels applied to this resource DefinitionSecurity labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. 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. Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible)Constraints
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tag | Σ | 0..* | Coding | There are no (further) constraints on this element Element IdMedicationDispense.contained.meta.tag Tags applied to this resource DefinitionTags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. 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. Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". CommonTags (example)Constraints
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extension | I | 0..* | Extension | Element IdMedicationDispense.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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DispenseRemainingRefills | S I | 0..1 | Extension(integer) | Element IdMedicationDispense.extension:DispenseRemainingRefills Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. DHDR: Refills Remaining. Number of authorized refills/repeats remaining after this dispense. 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. http://ehealthontario.ca/fhir/StructureDefinition/ca-on-medications-ext-refills-remaining Constraints
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DispenseRemainingQuantity | S I | 0..1 | Extension(Quantity) | Element IdMedicationDispense.extension:DispenseRemainingQuantity Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. DHDR: Quantity Remaining. Total quantity remaining on a prescription after this dispense. 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. http://ehealthontario.ca/fhir/StructureDefinition/ca-on-medications-ext-quantity-remaining Constraints
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DrugServiceCoverage | S I | 0..1 | Extension(Coding) | Element IdMedicationDispense.extension:DrugServiceCoverage Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://ehealthontario.ca/fhir/StructureDefinition/ca-on-medications-ext-drug-service-coverage Constraints
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identifier | S | 1..2 | Identifier | Element IdMedicationDispense.identifier External identifier DefinitionIdentifiers associated with this Medication Dispense that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server. This is a business identifier, not a resource identifier. Unordered, Open, by assigner.identifier.system(Value) Constraints
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currentRxNo | S | 1..1 | Identifier | There are no (further) constraints on this element Element IdMedicationDispense.identifier:currentRxNo External identifier DefinitionIdentifiers associated with this Medication Dispense that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server. This is a business identifier, not a resource identifier.
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.identifier:currentRxNo.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdMedicationDispense.identifier:currentRxNo.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | S Σ | 1..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.identifier:currentRxNo.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | S Σ | 1..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.identifier:currentRxNo.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdMedicationDispense.identifier:currentRxNo.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdMedicationDispense.identifier:currentRxNo.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
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originalRxNo | S | 0..1 | Identifier | There are no (further) constraints on this element Element IdMedicationDispense.identifier:originalRxNo External identifier DefinitionIdentifiers associated with this Medication Dispense that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server. This is a business identifier, not a resource identifier.
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.identifier:originalRxNo.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdMedicationDispense.identifier:originalRxNo.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | S Σ | 1..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.identifier:originalRxNo.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | S Σ | 1..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.identifier:originalRxNo.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdMedicationDispense.identifier:originalRxNo.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdMedicationDispense.identifier:originalRxNo.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
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partOf | I | 0..* | Reference(Procedure) | There are no (further) constraints on this element Element IdMedicationDispense.partOf Event that dispense is part of DefinitionThe procedure that trigger the dispense. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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status | S Σ ?! | 1..1 | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.status preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown DefinitionA code specifying the state of the set of dispense events. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. A coded concept specifying the state of the dispense event. MedicationDispense Status Codes (required)Constraints
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statusReason[x] | 0..1 | There are no (further) constraints on this element Element IdMedicationDispense.statusReason[x] Why a dispense was not performed DefinitionIndicates the reason why a dispense was not performed. A code describing why a dispense was not performed. MedicationDispense Status Reason Codes (example)Constraints
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statusReasonCodeableConcept | CodeableConcept | There are no (further) constraints on this element Data Type | ||
statusReasonReference | Reference(DetectedIssue) | There are no (further) constraints on this element Data Type | ||
category | S | 0..1 | CodeableConceptBinding | Element IdMedicationDispense.category Type of medication dispense DefinitionIndicates the type of medication dispense (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)). The category can be used to include where the medication is expected to be consumed or other types of dispenses. Invariants can be used to bind to different value sets when profiling to bind. Dispense type, e.g. drug, device or pharmacy service DispenseCategory (required)Constraints
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coding | S Σ | 1..1 | Coding | There are no (further) constraints on this element Element IdMedicationDispense.category.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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.
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system | S Σ | 1..1 | uriFixed Value | Element IdMedicationDispense.category.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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.
http://ehealthontario.ca/fhir/CodeSystem/medication-dispense-category
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.category.coding.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. 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.
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code | S Σ | 1..1 | code | There are no (further) constraints on this element Element IdMedicationDispense.category.coding.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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display | S Σ | 1..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.category.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdMedicationDispense.category.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.category.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. 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. Very often the text is the same as a displayName of one of the codings.
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medication[x] | S Σ | 1..1 | There are no (further) constraints on this element Element IdMedicationDispense.medication[x] What medication was supplied DefinitionIdentifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications. If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource.
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reference | S Σ I | 1..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.medication[x].reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdMedicationDispense.medication[x].type Type the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdMedicationDispense.medication[x].identifier Logical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.medication[x].display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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medicationReference | Reference(Medication) | Data Type | ||
subject | S Σ I | 1..1 | Reference(Patient) | Element IdMedicationDispense.subject Who the dispense is for DefinitionA link to a resource representing the person or the group to whom the medication will be given. SubstanceAdministration->subject->Patient.
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reference | S Σ I | 1..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.subject.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdMedicationDispense.subject.type Type the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdMedicationDispense.subject.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.subject.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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context | I | 0..1 | Reference(Encounter | EpisodeOfCare) | There are no (further) constraints on this element Element IdMedicationDispense.context Encounter / Episode associated with event DefinitionThe encounter or episode of care that establishes the context for this event. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Encounter | EpisodeOfCare) Constraints
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supportingInformation | I | 0..* | Reference(Resource) | There are no (further) constraints on this element Element IdMedicationDispense.supportingInformation Information that supports the dispensing of the medication DefinitionAdditional information that supports the medication being dispensed. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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performer | S | 0..1 | BackboneElement | There are no (further) constraints on this element Element IdMedicationDispense.performer Who performed event DefinitionIndicates who or what performed the event.
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function | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdMedicationDispense.performer.function Who performed the dispense and what they did DefinitionDistinguishes the type of performer in the dispense. For example, date enterer, packager, final checker. Allows disambiguation of the types of involvement of different performers. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. A code describing the role an individual played in dispensing a medication. MedicationDispense Performer Function Codes (example)Constraints
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actor | S I | 1..1 | Reference(PractitionerRole) | Element IdMedicationDispense.performer.actor Individual who was performing DefinitionThe device, practitioner, etc. who performed the action. It should be assumed that the actor is the dispenser of the medication. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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reference | S Σ I | 1..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.performer.actor.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdMedicationDispense.performer.actor.type Type the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdMedicationDispense.performer.actor.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.performer.actor.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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location | I | 0..1 | Reference(Location) | There are no (further) constraints on this element Element IdMedicationDispense.location Where the dispense occurred DefinitionThe principal physical location where the dispense was performed. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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authorizingPrescription | S I | 0..1 | Reference(MedicationRequest Prescription) | Element IdMedicationDispense.authorizingPrescription Medication order that authorizes the dispense DefinitionIndicates the medication order that is being dispensed against. Maps to basedOn in Event logical model. Reference(MedicationRequest Prescription) Constraints
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reference | S Σ I | 1..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.authorizingPrescription.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdMedicationDispense.authorizingPrescription.type Type the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdMedicationDispense.authorizingPrescription.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.authorizingPrescription.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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type | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdMedicationDispense.type Trial fill, partial fill, emergency fill, etc. DefinitionIndicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc. v3.ActPharmacySupplyType (example)Constraints
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quantity | S I | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element IdMedicationDispense.quantity Amount dispensed DefinitionThe amount of medication that has been dispensed. Includes unit of measure. The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
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value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element IdMedicationDispense.quantity.value Numerical value (with implicit precision) DefinitionThe value of the measured amount. The value includes an implicit precision in the presentation of the value. Precision is handled implicitly in almost all cases of measurement. 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).
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comparator | Σ ?! | 0..0 | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.quantity.comparator < | <= | >= | > - how to understand the value DefinitionNot allowed to be used in this context Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Note that FHIR strings SHALL NOT exceed 1MB in size If there is no comparator, then there is no modification of the value How the Quantity should be understood and represented. QuantityComparator (required)Constraints
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unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.quantity.unit Unit representation DefinitionA human-readable form of the unit. There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Note that FHIR strings SHALL NOT exceed 1MB in size
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system | S Σ I | 0..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.quantity.system System that defines coded unit form DefinitionThe identification of the system that provides the coded form of the unit. Need to know the system that defines the coded form of the unit. see http://en.wikipedia.org/wiki/Uniform_resource_identifier
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code | S Σ | 0..1 | codeBinding | Element IdMedicationDispense.quantity.code Coded form of the unit DefinitionA computer processable form of the unit in some unit representation system. 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. 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. https://tgateway.infoway-inforoute.ca/vs/prescribedquantityunit (extensible) Constraints
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daysSupply | S I | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element IdMedicationDispense.daysSupply Amount of medication expressed as a timing amount DefinitionThe amount of medication expressed as a timing amount. The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
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value | Σ | 1..1 | decimal | There are no (further) constraints on this element Element IdMedicationDispense.daysSupply.value Numerical value (with implicit precision) DefinitionThe value of the measured amount. The value includes an implicit precision in the presentation of the value. Precision is handled implicitly in almost all cases of measurement. 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).
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comparator | Σ ?! | 0..0 | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.daysSupply.comparator < | <= | >= | > - how to understand the value DefinitionNot allowed to be used in this context Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Note that FHIR strings SHALL NOT exceed 1MB in size If there is no comparator, then there is no modification of the value How the Quantity should be understood and represented. QuantityComparator (required)Constraints
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unit | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.daysSupply.unit Unit representation DefinitionA human-readable form of the unit. There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Note that FHIR strings SHALL NOT exceed 1MB in size
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system | Σ I | 0..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.daysSupply.system System that defines coded unit form DefinitionThe identification of the system that provides the coded form of the unit. Need to know the system that defines the coded form of the unit. see http://en.wikipedia.org/wiki/Uniform_resource_identifier
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code | Σ | 0..1 | code | There are no (further) constraints on this element Element IdMedicationDispense.daysSupply.code Coded form of the unit DefinitionA computer processable form of the unit in some unit representation system. 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. 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.
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whenPrepared | S Σ | 1..1 | dateTime | There are no (further) constraints on this element Element IdMedicationDispense.whenPrepared When product was packaged and reviewed DefinitionThe time when the dispensed product was packaged and reviewed.
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whenHandedOver | S | 0..1 | dateTime | There are no (further) constraints on this element Element IdMedicationDispense.whenHandedOver When product was given out DefinitionThe time the dispensed product was provided to the patient or their representative.
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destination | I | 0..1 | Reference(Location) | There are no (further) constraints on this element Element IdMedicationDispense.destination Where the medication was sent DefinitionIdentification of the facility/location where the medication was shipped to, as part of the dispense event. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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receiver | I | 0..* | Reference(Patient | Practitioner) | There are no (further) constraints on this element Element IdMedicationDispense.receiver Who collected the medication DefinitionIdentifies the person who picked up the medication. This will usually be a patient or their caregiver, but some cases exist where it can be a healthcare professional. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Patient | Practitioner) Constraints
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note | 0..* | Annotation | There are no (further) constraints on this element Element IdMedicationDispense.note Information about the dispense DefinitionExtra information about the dispense that could not be conveyed in the other attributes. For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).
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dosageInstruction | S | 0..* | Dosage | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction How the medication is to be used by the patient or administered by the caregiver DefinitionIndicates how the medication is to be used by the patient. When the dose or rate is intended to change over the entire administration period (e.g. Tapering dose prescriptions), multiple instances of dosage instructions will need to be supplied to convey the different doses/rates. The pharmacist reviews the medication order prior to dispense and updates the dosageInstruction based on the actual product being dispensed.
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sequence | S Σ | 0..1 | integer | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.sequence The order of the dosage instructions DefinitionIndicates the order in which the dosage instructions should be applied or interpreted. 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. 32 bit number; for values larger than this, use decimal
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text | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.text Free text dosage instructions e.g. SIG DefinitionFree text dosage instructions e.g. SIG. Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text. Note that FHIR strings SHALL NOT exceed 1MB in size
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additionalInstruction | S Σ | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.additionalInstruction Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" DefinitionSupplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps"). Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded. Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text. A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". SNOMEDCTAdditionalDosageInstructions (example)Constraints
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coding | S Σ | 0..* | Coding | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.additionalInstruction.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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.
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system | S Σ | 0..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.additionalInstruction.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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.
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.additionalInstruction.coding.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. 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.
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code | S Σ | 0..1 | code | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.additionalInstruction.coding.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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display | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.additionalInstruction.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.additionalInstruction.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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text | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.additionalInstruction.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. 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. Very often the text is the same as a displayName of one of the codings.
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patientInstruction | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.patientInstruction Patient or consumer oriented instructions DefinitionInstructions in terms that are understood by the patient or consumer. Note that FHIR strings SHALL NOT exceed 1MB in size
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timing | S Σ | 0..1 | Timing | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing When medication should be administered DefinitionWhen medication should be administered. 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. This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing.
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event | S Σ | 0..* | dateTime | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.event When the event occurs DefinitionIdentifies specific times when the event occurs. In a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification.
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repeat | S Σ I | 0..1 | Element | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat When the event is to occur DefinitionA set of rules that describe when the event is scheduled. Many timing schedules are determined by regular repetitions.
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bounds[x] | S Σ | 0..1 | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.bounds[x] Length/Range of lengths, or (Start and/or end) limits DefinitionEither a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.
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boundsDuration | Duration | There are no (further) constraints on this element Data Type | ||
boundsRange | Range | There are no (further) constraints on this element Data Type | ||
boundsPeriod | Period | There are no (further) constraints on this element Data Type | ||
count | S Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.count Number of times to repeat DefinitionA total count of the desired number of repetitions across the duration of the entire timing specification. If countMax is present, this element indicates the lower bound of the allowed range of count values. Repetitions may be limited by end time or total occurrences. If you have both bounds and count, then this should be understood as within the bounds period, until count times happens.
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countMax | S Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.countMax Maximum number of times to repeat DefinitionIf present, indicates that the count is a range - so to perform the action between [count] and [countMax] times. 32 bit number; for values larger than this, use decimal
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duration | S Σ | 0..1 | decimal | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.duration How long when it happens DefinitionHow long this thing happens for when it happens. If durationMax is present, this element indicates the lower bound of the allowed range of the duration. Some activities are not instantaneous and need to be maintained for a period of time. 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).
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durationMax | S Σ | 0..1 | decimal | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.durationMax How long when it happens (Max) DefinitionIf present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length. Some activities are not instantaneous and need to be maintained for a period of time. 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).
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durationUnit | S Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.durationUnit s | min | h | d | wk | mo | a - unit of time (UCUM) DefinitionThe units of time for the duration, in UCUM units. Note that FHIR strings SHALL NOT exceed 1MB in size A unit of time (units from UCUM). UnitsOfTime (required)Constraints
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frequency | S Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.frequency Event occurs frequency times per period DefinitionThe number of times to repeat the action within the specified period. If frequencyMax is present, this element indicates the lower bound of the allowed range of the frequency. 32 bit number; for values larger than this, use decimal If no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this
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frequencyMax | S Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.frequencyMax Event occurs up to frequencyMax times per period DefinitionIf present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range. 32 bit number; for values larger than this, use decimal
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period | S Σ | 0..1 | decimal | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.period Event occurs frequency times per period DefinitionIndicates the duration of time over which repetitions are to occur; e.g. to express "3 times per day", 3 would be the frequency and "1 day" would be the period. If periodMax is present, this element indicates the lower bound of the allowed range of the period length. Do not use an IEEE type floating point type, instead use something that works like a true decimal, with inbuilt precision (e.g. Java BigInteger)
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periodMax | S Σ | 0..1 | decimal | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.periodMax Upper limit of period (3-4 hours) DefinitionIf present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as "do this once every 3-5 days. Do not use an IEEE type floating point type, instead use something that works like a true decimal, with inbuilt precision (e.g. Java BigInteger)
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periodUnit | S Σ | 0..1 | codeBinding | Element IdMedicationDispense.dosageInstruction.timing.repeat.periodUnit s | min | h | d | wk | mo | a - unit of time (UCUM) DefinitionThe units of time for the period in UCUM units. Note that FHIR strings SHALL NOT exceed 1MB in size A unit of time (units from UCUM). UnitsOfTime (required)Constraints
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dayOfWeek | S Σ | 0..* | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.dayOfWeek mon | tue | wed | thu | fri | sat | sun DefinitionIf one or more days of week is provided, then the action happens only on the specified day(s). 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.
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timeOfDay | S Σ | 0..* | time | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.timeOfDay Time of day for action DefinitionSpecified time of day for action to take place. 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.
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when | S Σ | 0..* | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.when Code for time period of occurrence DefinitionAn approximate time period during the day, potentially linked to an event of daily living that indicates when the action should occur. Timings are frequently determined by occurrences such as waking, eating and sleep. When more than one event is listed, the event is tied to the union of the specified events. Real world event relating to the schedule. EventTiming (required)Constraints
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offset | S Σ | 0..1 | unsignedInt | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.offset Minutes from event (before or after) DefinitionThe number of minutes from the event. If the event code does not indicate whether the minutes is before or after the event, then the offset is assumed to be after the event. 32 bit number; for values larger than this, use decimal
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code | S Σ | 0..1 | CodeableConceptBinding | Element IdMedicationDispense.dosageInstruction.timing.code BID | TID | QID | AM | PM | QD | QOD | + DefinitionA code for the timing schedule (or just text in code.text). Some codes such as BID are ubiquitous, but many institutions define their own additional codes. If a code is provided, the code is understood to be a complete statement of whatever is specified in the structured timing data, and either the code or the data may be used to interpret the Timing, with the exception that .repeat.bounds still applies over the code (and is not contained in the code). 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). Code for a known / defined timing pattern. MedicationRepeatPattern (extensible)Constraints
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coding | S Σ | 0..* | Coding | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.code.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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.
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system | S Σ | 0..1 | uriFixed Value | Element IdMedicationDispense.dosageInstruction.timing.code.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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.
http://snomed.info/sct
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.code.coding.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. 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.
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code | S Σ | 0..1 | code | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.code.coding.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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display | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.code.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.code.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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text | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.code.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. 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. Very often the text is the same as a displayName of one of the codings.
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asNeeded[x] | S Σ | 0..1 | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.asNeeded[x] Take "as needed" (for x) DefinitionIndicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept). Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed".
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asNeededBoolean | boolean | Data Type | ||
site | S Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.site Body site to administer to DefinitionBody site to administer to. A coded specification of the anatomic site where the medication first enters the body. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both. A coded concept describing the site location the medicine enters into or onto the body. SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example)Constraints
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coding | S Σ | 0..* | Coding | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.site.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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.
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system | S Σ | 0..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.site.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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.
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.site.coding.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. 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.
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code | S Σ | 0..1 | code | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.site.coding.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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display | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.site.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.site.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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text | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.site.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. 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. Very often the text is the same as a displayName of one of the codings.
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route | S Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.route How drug should enter body DefinitionHow drug should enter body. A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. SNOMEDCTRouteCodes (example)Constraints
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coding | S Σ | 1..1 | CodingBinding | Element IdMedicationDispense.dosageInstruction.route.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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. RouteOfAdministration (required) Constraints
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system | S Σ | 1..1 | uriFixed Value | Element IdMedicationDispense.dosageInstruction.route.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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.
http://snomed.info/sct
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.route.coding.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. 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.
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code | S Σ | 1..1 | code | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.route.coding.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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display | S Σ | 1..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.route.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.route.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.route.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. 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. Very often the text is the same as a displayName of one of the codings.
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method | S Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.method Technique for administering medication DefinitionTechnique for administering medication. A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV. Terminologies used often pre-coordinate this term with the route and or form of administration. A coded concept describing the technique by which the medicine is administered. SNOMEDCTAdministrationMethodCodes (example)Constraints
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coding | S Σ | 0..* | Coding | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.method.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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.
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system | S Σ | 0..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.method.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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.
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.method.coding.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. 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.
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code | S Σ | 0..1 | code | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.method.coding.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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display | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.method.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.method.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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text | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.method.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. 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. Very often the text is the same as a displayName of one of the codings.
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doseAndRate | S Σ | 0..* | Element | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.doseAndRate Amount of medication administered DefinitionThe amount of medication administered.
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type | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.doseAndRate.type The kind of dose or rate specified DefinitionThe kind of dose or rate specified, for example, ordered or calculated. If the type is not populated, assume to be "ordered". Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The kind of dose or rate specified. DoseAndRateType (example)Constraints
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dose[x] | S Σ | 0..1 | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.doseAndRate.dose[x] Amount of medication per dose DefinitionAmount of medication per dose. The amount of therapeutic or other substance given at one administration event. 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.
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doseRange | Range | There are no (further) constraints on this element Data Type | ||
doseQuantity | SimpleQuantity | There are no (further) constraints on this element Data Type | ||
rate[x] | S Σ | 0..1 | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.doseAndRate.rate[x] Amount of medication per unit of time DefinitionAmount of medication per unit of time. Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. 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. It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate. It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.
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rateRatio | Ratio | There are no (further) constraints on this element Data Type | ||
rateRange | Range | There are no (further) constraints on this element Data Type | ||
rateQuantity | SimpleQuantity | There are no (further) constraints on this element Data Type | ||
maxDosePerPeriod | S Σ I | 0..1 | Ratio | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod Upper limit on medication per unit of time DefinitionUpper limit on medication per unit of time. 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. This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day".
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numerator | S Σ I | 0..1 | Quantity | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod.numerator Numerator value DefinitionThe value of the numerator. The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
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value | S Σ | 0..1 | decimal | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.value Numerical value (with implicit precision) DefinitionThe value of the measured amount. The value includes an implicit precision in the presentation of the value. Precision is handled implicitly in almost all cases of measurement. 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).
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comparator | S Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.comparator < | <= | >= | > - how to understand the value DefinitionHow the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value. Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Note that FHIR strings SHALL NOT exceed 1MB in size If there is no comparator, then there is no modification of the value How the Quantity should be understood and represented. QuantityComparator (required)Constraints
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unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.unit Unit representation DefinitionA human-readable form of the unit. There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Note that FHIR strings SHALL NOT exceed 1MB in size
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system | S Σ I | 0..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.system System that defines coded unit form DefinitionThe identification of the system that provides the coded form of the unit. Need to know the system that defines the coded form of the unit. see http://en.wikipedia.org/wiki/Uniform_resource_identifier
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code | S Σ | 0..1 | code | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.code Coded form of the unit DefinitionA computer processable form of the unit in some unit representation system. 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. 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.
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denominator | S Σ I | 0..1 | Quantity | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod.denominator Denominator value DefinitionThe value of the denominator. The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
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value | S Σ | 0..1 | decimal | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.value Numerical value (with implicit precision) DefinitionThe value of the measured amount. The value includes an implicit precision in the presentation of the value. Precision is handled implicitly in almost all cases of measurement. 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).
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comparator | S Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.comparator < | <= | >= | > - how to understand the value DefinitionHow the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value. Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Note that FHIR strings SHALL NOT exceed 1MB in size If there is no comparator, then there is no modification of the value How the Quantity should be understood and represented. QuantityComparator (required)Constraints
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unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.unit Unit representation DefinitionA human-readable form of the unit. There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Note that FHIR strings SHALL NOT exceed 1MB in size
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system | S Σ I | 0..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.system System that defines coded unit form DefinitionThe identification of the system that provides the coded form of the unit. Need to know the system that defines the coded form of the unit. see http://en.wikipedia.org/wiki/Uniform_resource_identifier
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code | S Σ | 0..1 | code | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.code Coded form of the unit DefinitionA computer processable form of the unit in some unit representation system. 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. 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.
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maxDosePerAdministration | S Σ I | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerAdministration Upper limit on medication per administration DefinitionUpper limit on medication per administration. The maximum total quantity of a therapeutic substance that may be administered to a subject per administration. 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.
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value | S Σ | 0..1 | decimal | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerAdministration.value Numerical value (with implicit precision) DefinitionThe value of the measured amount. The value includes an implicit precision in the presentation of the value. Precision is handled implicitly in almost all cases of measurement. 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).
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comparator | Σ ?! | 0..0 | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerAdministration.comparator < | <= | >= | > - how to understand the value DefinitionNot allowed to be used in this context Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Note that FHIR strings SHALL NOT exceed 1MB in size If there is no comparator, then there is no modification of the value How the Quantity should be understood and represented. QuantityComparator (required)Constraints
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unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerAdministration.unit Unit representation DefinitionA human-readable form of the unit. There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Note that FHIR strings SHALL NOT exceed 1MB in size
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system | S Σ I | 0..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerAdministration.system System that defines coded unit form DefinitionThe identification of the system that provides the coded form of the unit. Need to know the system that defines the coded form of the unit. see http://en.wikipedia.org/wiki/Uniform_resource_identifier
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code | S Σ | 0..1 | code | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerAdministration.code Coded form of the unit DefinitionA computer processable form of the unit in some unit representation system. 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. 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.
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maxDosePerLifetime | S Σ I | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerLifetime Upper limit on medication per lifetime of the patient DefinitionUpper limit on medication per lifetime of the patient. The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject. The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
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value | S Σ | 0..1 | decimal | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerLifetime.value Numerical value (with implicit precision) DefinitionThe value of the measured amount. The value includes an implicit precision in the presentation of the value. Precision is handled implicitly in almost all cases of measurement. 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).
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comparator | Σ ?! | 0..0 | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerLifetime.comparator < | <= | >= | > - how to understand the value DefinitionNot allowed to be used in this context Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Note that FHIR strings SHALL NOT exceed 1MB in size If there is no comparator, then there is no modification of the value How the Quantity should be understood and represented. QuantityComparator (required)Constraints
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unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerLifetime.unit Unit representation DefinitionA human-readable form of the unit. There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Note that FHIR strings SHALL NOT exceed 1MB in size
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system | S Σ I | 0..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerLifetime.system System that defines coded unit form DefinitionThe identification of the system that provides the coded form of the unit. Need to know the system that defines the coded form of the unit. see http://en.wikipedia.org/wiki/Uniform_resource_identifier
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code | S Σ | 0..1 | code | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerLifetime.code Coded form of the unit DefinitionA computer processable form of the unit in some unit representation system. 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. 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.
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substitution | 0..1 | BackboneElement | There are no (further) constraints on this element Element IdMedicationDispense.substitution Whether a substitution was performed on the dispense DefinitionIndicates whether or not substitution was made as part of the dispense. In some cases, substitution will be expected but does not happen, in other cases substitution is not expected but does happen. This block explains what substitution did or did not happen and why. If nothing is specified, substitution was not done.
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wasSubstituted | 1..1 | boolean | There are no (further) constraints on this element Element IdMedicationDispense.substitution.wasSubstituted Whether a substitution was or was not performed on the dispense DefinitionTrue if the dispenser dispensed a different drug or product from what was prescribed.
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type | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdMedicationDispense.substitution.type Code signifying whether a different drug was dispensed from what was prescribed DefinitionA code signifying whether a different drug was dispensed from what was prescribed. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription. v3.ActSubstanceAdminSubstitutionCode (example)Constraints
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reason | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdMedicationDispense.substitution.reason Why was substitution made DefinitionIndicates the reason for the substitution (or lack of substitution) from what was prescribed. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed. v3.SubstanceAdminSubstitutionReason (example)Constraints
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responsibleParty | I | 0..* | Reference(Practitioner | PractitionerRole) | There are no (further) constraints on this element Element IdMedicationDispense.substitution.responsibleParty Who is responsible for the substitution DefinitionThe person or organization that has primary responsibility for the substitution. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Practitioner | PractitionerRole) Constraints
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detectedIssue | I | 0..* | Reference(DetectedIssue) | There are no (further) constraints on this element Element IdMedicationDispense.detectedIssue Clinical issue with action Alternate namesContraindication, Drug Utilization Review (DUR), Alert DefinitionIndicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. drug-drug interaction, duplicate therapy, dosage alert etc. This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue.
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eventHistory | I | 0..* | Reference(Provenance) | There are no (further) constraints on this element Element IdMedicationDispense.eventHistory A list of relevant lifecycle events DefinitionA summary of the events of interest that have occurred, such as when the dispense was verified. This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).
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Snapshot View
MedicationDispense | S I | MedicationDispense | There are no (further) constraints on this element Element IdMedicationDispense Dispensing a medication to a named patient DefinitionIndicates that a medication product is to be or has been dispensed for a named person/patient. This includes a description of the medication product (supply) provided and the instructions for administering the medication. The medication dispense is the result of a pharmacy system responding to a medication order.
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id | S Σ | 0..1 | System.String | There are no (further) constraints on this element Element IdMedicationDispense.id Logical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. System.String |
meta | S Σ | 0..1 | Meta | There are no (further) constraints on this element Element IdMedicationDispense.meta Metadata about the resource DefinitionThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
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versionId | S Σ | 0..1 | id | There are no (further) constraints on this element Element IdMedicationDispense.meta.versionId Version specific identifier DefinitionThe version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. 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.
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lastUpdated | S Σ | 0..1 | instant | There are no (further) constraints on this element Element IdMedicationDispense.meta.lastUpdated When the resource version last changed DefinitionWhen the resource last changed - e.g. when the version changed. 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.
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source | S Σ | 0..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.meta.source Identifies where the resource comes from DefinitionA 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. 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.
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profile | Σ | 0..* | canonical(StructureDefinition) | There are no (further) constraints on this element Element IdMedicationDispense.meta.profile Profiles this resource claims to conform to DefinitionA list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. 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. canonical(StructureDefinition) Constraints
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security | Σ | 0..* | CodingBinding | There are no (further) constraints on this element Element IdMedicationDispense.meta.security Security Labels applied to this resource DefinitionSecurity labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. 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. Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible)Constraints
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tag | Σ | 0..* | Coding | There are no (further) constraints on this element Element IdMedicationDispense.meta.tag Tags applied to this resource DefinitionTags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. 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. Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". CommonTags (example)Constraints
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contained | S | 1..* | Medication, MedicationRequest Prescription, Practitioner, Organization, PractitionerRole | Element IdMedicationDispense.contained Contained, inline Resources Alternate namesinline resources, anonymous resources, contained resources DefinitionThese resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. Medication, MedicationRequest Prescription, Practitioner, Organization, PractitionerRole Mappings
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id | S Σ | 0..1 | System.String | There are no (further) constraints on this element Element IdMedicationDispense.contained.id Logical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. System.String |
meta | S Σ | 0..1 | Meta | There are no (further) constraints on this element Element IdMedicationDispense.contained.meta Metadata about the resource DefinitionThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
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versionId | Σ | 0..1 | id | There are no (further) constraints on this element Element IdMedicationDispense.contained.meta.versionId Version specific identifier DefinitionThe version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. 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.
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lastUpdated | S Σ | 0..1 | instant | There are no (further) constraints on this element Element IdMedicationDispense.contained.meta.lastUpdated When the resource version last changed DefinitionWhen the resource last changed - e.g. when the version changed. 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.
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source | S Σ | 0..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.contained.meta.source Identifies where the resource comes from DefinitionA 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. 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.
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profile | Σ | 0..* | canonical(StructureDefinition) | There are no (further) constraints on this element Element IdMedicationDispense.contained.meta.profile Profiles this resource claims to conform to DefinitionA list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. 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. canonical(StructureDefinition) Constraints
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security | Σ | 0..* | CodingBinding | There are no (further) constraints on this element Element IdMedicationDispense.contained.meta.security Security Labels applied to this resource DefinitionSecurity labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. 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. Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible)Constraints
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tag | Σ | 0..* | Coding | There are no (further) constraints on this element Element IdMedicationDispense.contained.meta.tag Tags applied to this resource DefinitionTags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. 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. Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". CommonTags (example)Constraints
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extension | I | 0..* | Extension | Element IdMedicationDispense.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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DispenseRemainingRefills | S I | 0..1 | Extension(integer) | Element IdMedicationDispense.extension:DispenseRemainingRefills Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. DHDR: Refills Remaining. Number of authorized refills/repeats remaining after this dispense. 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. http://ehealthontario.ca/fhir/StructureDefinition/ca-on-medications-ext-refills-remaining Constraints
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DispenseRemainingQuantity | S I | 0..1 | Extension(Quantity) | Element IdMedicationDispense.extension:DispenseRemainingQuantity Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. DHDR: Quantity Remaining. Total quantity remaining on a prescription after this dispense. 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. http://ehealthontario.ca/fhir/StructureDefinition/ca-on-medications-ext-quantity-remaining Constraints
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DrugServiceCoverage | S I | 0..1 | Extension(Coding) | Element IdMedicationDispense.extension:DrugServiceCoverage Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://ehealthontario.ca/fhir/StructureDefinition/ca-on-medications-ext-drug-service-coverage Constraints
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identifier | S | 1..2 | Identifier | Element IdMedicationDispense.identifier External identifier DefinitionIdentifiers associated with this Medication Dispense that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server. This is a business identifier, not a resource identifier. Unordered, Open, by assigner.identifier.system(Value) Constraints
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currentRxNo | S | 1..1 | Identifier | There are no (further) constraints on this element Element IdMedicationDispense.identifier:currentRxNo External identifier DefinitionIdentifiers associated with this Medication Dispense that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server. This is a business identifier, not a resource identifier.
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.identifier:currentRxNo.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdMedicationDispense.identifier:currentRxNo.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | S Σ | 1..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.identifier:currentRxNo.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | S Σ | 1..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.identifier:currentRxNo.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdMedicationDispense.identifier:currentRxNo.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdMedicationDispense.identifier:currentRxNo.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
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originalRxNo | S | 0..1 | Identifier | There are no (further) constraints on this element Element IdMedicationDispense.identifier:originalRxNo External identifier DefinitionIdentifiers associated with this Medication Dispense that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server. This is a business identifier, not a resource identifier.
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.identifier:originalRxNo.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdMedicationDispense.identifier:originalRxNo.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints
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system | S Σ | 1..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.identifier:originalRxNo.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | S Σ | 1..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.identifier:originalRxNo.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdMedicationDispense.identifier:originalRxNo.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration.
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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdMedicationDispense.identifier:originalRxNo.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
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partOf | I | 0..* | Reference(Procedure) | There are no (further) constraints on this element Element IdMedicationDispense.partOf Event that dispense is part of DefinitionThe procedure that trigger the dispense. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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status | S Σ ?! | 1..1 | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.status preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown DefinitionA code specifying the state of the set of dispense events. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. A coded concept specifying the state of the dispense event. MedicationDispense Status Codes (required)Constraints
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statusReason[x] | 0..1 | There are no (further) constraints on this element Element IdMedicationDispense.statusReason[x] Why a dispense was not performed DefinitionIndicates the reason why a dispense was not performed. A code describing why a dispense was not performed. MedicationDispense Status Reason Codes (example)Constraints
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statusReasonCodeableConcept | CodeableConcept | There are no (further) constraints on this element Data Type | ||
statusReasonReference | Reference(DetectedIssue) | There are no (further) constraints on this element Data Type | ||
category | S | 0..1 | CodeableConceptBinding | Element IdMedicationDispense.category Type of medication dispense DefinitionIndicates the type of medication dispense (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)). The category can be used to include where the medication is expected to be consumed or other types of dispenses. Invariants can be used to bind to different value sets when profiling to bind. Dispense type, e.g. drug, device or pharmacy service DispenseCategory (required)Constraints
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coding | S Σ | 1..1 | Coding | There are no (further) constraints on this element Element IdMedicationDispense.category.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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.
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system | S Σ | 1..1 | uriFixed Value | Element IdMedicationDispense.category.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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.
http://ehealthontario.ca/fhir/CodeSystem/medication-dispense-category
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.category.coding.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. 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.
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code | S Σ | 1..1 | code | There are no (further) constraints on this element Element IdMedicationDispense.category.coding.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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display | S Σ | 1..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.category.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdMedicationDispense.category.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.category.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. 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. Very often the text is the same as a displayName of one of the codings.
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medication[x] | S Σ | 1..1 | There are no (further) constraints on this element Element IdMedicationDispense.medication[x] What medication was supplied DefinitionIdentifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications. If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource.
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reference | S Σ I | 1..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.medication[x].reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdMedicationDispense.medication[x].type Type the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdMedicationDispense.medication[x].identifier Logical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.medication[x].display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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medicationReference | Reference(Medication) | Data Type | ||
subject | S Σ I | 1..1 | Reference(Patient) | Element IdMedicationDispense.subject Who the dispense is for DefinitionA link to a resource representing the person or the group to whom the medication will be given. SubstanceAdministration->subject->Patient.
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reference | S Σ I | 1..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.subject.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdMedicationDispense.subject.type Type the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdMedicationDispense.subject.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.subject.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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context | I | 0..1 | Reference(Encounter | EpisodeOfCare) | There are no (further) constraints on this element Element IdMedicationDispense.context Encounter / Episode associated with event DefinitionThe encounter or episode of care that establishes the context for this event. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Encounter | EpisodeOfCare) Constraints
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supportingInformation | I | 0..* | Reference(Resource) | There are no (further) constraints on this element Element IdMedicationDispense.supportingInformation Information that supports the dispensing of the medication DefinitionAdditional information that supports the medication being dispensed. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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performer | S | 0..1 | BackboneElement | There are no (further) constraints on this element Element IdMedicationDispense.performer Who performed event DefinitionIndicates who or what performed the event.
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function | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdMedicationDispense.performer.function Who performed the dispense and what they did DefinitionDistinguishes the type of performer in the dispense. For example, date enterer, packager, final checker. Allows disambiguation of the types of involvement of different performers. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. A code describing the role an individual played in dispensing a medication. MedicationDispense Performer Function Codes (example)Constraints
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actor | S I | 1..1 | Reference(PractitionerRole) | Element IdMedicationDispense.performer.actor Individual who was performing DefinitionThe device, practitioner, etc. who performed the action. It should be assumed that the actor is the dispenser of the medication. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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reference | S Σ I | 1..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.performer.actor.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdMedicationDispense.performer.actor.type Type the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdMedicationDispense.performer.actor.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.performer.actor.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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location | I | 0..1 | Reference(Location) | There are no (further) constraints on this element Element IdMedicationDispense.location Where the dispense occurred DefinitionThe principal physical location where the dispense was performed. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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authorizingPrescription | S I | 0..1 | Reference(MedicationRequest Prescription) | Element IdMedicationDispense.authorizingPrescription Medication order that authorizes the dispense DefinitionIndicates the medication order that is being dispensed against. Maps to basedOn in Event logical model. Reference(MedicationRequest Prescription) Constraints
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reference | S Σ I | 1..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.authorizingPrescription.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdMedicationDispense.authorizingPrescription.type Type the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdMedicationDispense.authorizingPrescription.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.authorizingPrescription.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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type | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdMedicationDispense.type Trial fill, partial fill, emergency fill, etc. DefinitionIndicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc. v3.ActPharmacySupplyType (example)Constraints
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quantity | S I | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element IdMedicationDispense.quantity Amount dispensed DefinitionThe amount of medication that has been dispensed. Includes unit of measure. The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
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value | S Σ | 1..1 | decimal | There are no (further) constraints on this element Element IdMedicationDispense.quantity.value Numerical value (with implicit precision) DefinitionThe value of the measured amount. The value includes an implicit precision in the presentation of the value. Precision is handled implicitly in almost all cases of measurement. 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).
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comparator | Σ ?! | 0..0 | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.quantity.comparator < | <= | >= | > - how to understand the value DefinitionNot allowed to be used in this context Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Note that FHIR strings SHALL NOT exceed 1MB in size If there is no comparator, then there is no modification of the value How the Quantity should be understood and represented. QuantityComparator (required)Constraints
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unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.quantity.unit Unit representation DefinitionA human-readable form of the unit. There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Note that FHIR strings SHALL NOT exceed 1MB in size
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system | S Σ I | 0..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.quantity.system System that defines coded unit form DefinitionThe identification of the system that provides the coded form of the unit. Need to know the system that defines the coded form of the unit. see http://en.wikipedia.org/wiki/Uniform_resource_identifier
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code | S Σ | 0..1 | codeBinding | Element IdMedicationDispense.quantity.code Coded form of the unit DefinitionA computer processable form of the unit in some unit representation system. 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. 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. https://tgateway.infoway-inforoute.ca/vs/prescribedquantityunit (extensible) Constraints
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daysSupply | S I | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element IdMedicationDispense.daysSupply Amount of medication expressed as a timing amount DefinitionThe amount of medication expressed as a timing amount. The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
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value | Σ | 1..1 | decimal | There are no (further) constraints on this element Element IdMedicationDispense.daysSupply.value Numerical value (with implicit precision) DefinitionThe value of the measured amount. The value includes an implicit precision in the presentation of the value. Precision is handled implicitly in almost all cases of measurement. 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).
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comparator | Σ ?! | 0..0 | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.daysSupply.comparator < | <= | >= | > - how to understand the value DefinitionNot allowed to be used in this context Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Note that FHIR strings SHALL NOT exceed 1MB in size If there is no comparator, then there is no modification of the value How the Quantity should be understood and represented. QuantityComparator (required)Constraints
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unit | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.daysSupply.unit Unit representation DefinitionA human-readable form of the unit. There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Note that FHIR strings SHALL NOT exceed 1MB in size
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system | Σ I | 0..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.daysSupply.system System that defines coded unit form DefinitionThe identification of the system that provides the coded form of the unit. Need to know the system that defines the coded form of the unit. see http://en.wikipedia.org/wiki/Uniform_resource_identifier
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code | Σ | 0..1 | code | There are no (further) constraints on this element Element IdMedicationDispense.daysSupply.code Coded form of the unit DefinitionA computer processable form of the unit in some unit representation system. 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. 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.
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whenPrepared | S Σ | 1..1 | dateTime | There are no (further) constraints on this element Element IdMedicationDispense.whenPrepared When product was packaged and reviewed DefinitionThe time when the dispensed product was packaged and reviewed.
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whenHandedOver | S | 0..1 | dateTime | There are no (further) constraints on this element Element IdMedicationDispense.whenHandedOver When product was given out DefinitionThe time the dispensed product was provided to the patient or their representative.
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destination | I | 0..1 | Reference(Location) | There are no (further) constraints on this element Element IdMedicationDispense.destination Where the medication was sent DefinitionIdentification of the facility/location where the medication was shipped to, as part of the dispense event. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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receiver | I | 0..* | Reference(Patient | Practitioner) | There are no (further) constraints on this element Element IdMedicationDispense.receiver Who collected the medication DefinitionIdentifies the person who picked up the medication. This will usually be a patient or their caregiver, but some cases exist where it can be a healthcare professional. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Patient | Practitioner) Constraints
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note | 0..* | Annotation | There are no (further) constraints on this element Element IdMedicationDispense.note Information about the dispense DefinitionExtra information about the dispense that could not be conveyed in the other attributes. For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).
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dosageInstruction | S | 0..* | Dosage | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction How the medication is to be used by the patient or administered by the caregiver DefinitionIndicates how the medication is to be used by the patient. When the dose or rate is intended to change over the entire administration period (e.g. Tapering dose prescriptions), multiple instances of dosage instructions will need to be supplied to convey the different doses/rates. The pharmacist reviews the medication order prior to dispense and updates the dosageInstruction based on the actual product being dispensed.
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sequence | S Σ | 0..1 | integer | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.sequence The order of the dosage instructions DefinitionIndicates the order in which the dosage instructions should be applied or interpreted. 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. 32 bit number; for values larger than this, use decimal
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text | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.text Free text dosage instructions e.g. SIG DefinitionFree text dosage instructions e.g. SIG. Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text. Note that FHIR strings SHALL NOT exceed 1MB in size
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additionalInstruction | S Σ | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.additionalInstruction Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" DefinitionSupplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps"). Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded. Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text. A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". SNOMEDCTAdditionalDosageInstructions (example)Constraints
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coding | S Σ | 0..* | Coding | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.additionalInstruction.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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.
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system | S Σ | 0..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.additionalInstruction.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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.
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.additionalInstruction.coding.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. 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.
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code | S Σ | 0..1 | code | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.additionalInstruction.coding.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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display | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.additionalInstruction.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.additionalInstruction.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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text | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.additionalInstruction.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. 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. Very often the text is the same as a displayName of one of the codings.
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patientInstruction | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.patientInstruction Patient or consumer oriented instructions DefinitionInstructions in terms that are understood by the patient or consumer. Note that FHIR strings SHALL NOT exceed 1MB in size
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timing | S Σ | 0..1 | Timing | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing When medication should be administered DefinitionWhen medication should be administered. 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. This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing.
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event | S Σ | 0..* | dateTime | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.event When the event occurs DefinitionIdentifies specific times when the event occurs. In a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification.
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repeat | S Σ I | 0..1 | Element | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat When the event is to occur DefinitionA set of rules that describe when the event is scheduled. Many timing schedules are determined by regular repetitions.
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bounds[x] | S Σ | 0..1 | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.bounds[x] Length/Range of lengths, or (Start and/or end) limits DefinitionEither a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.
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boundsDuration | Duration | There are no (further) constraints on this element Data Type | ||
boundsRange | Range | There are no (further) constraints on this element Data Type | ||
boundsPeriod | Period | There are no (further) constraints on this element Data Type | ||
count | S Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.count Number of times to repeat DefinitionA total count of the desired number of repetitions across the duration of the entire timing specification. If countMax is present, this element indicates the lower bound of the allowed range of count values. Repetitions may be limited by end time or total occurrences. If you have both bounds and count, then this should be understood as within the bounds period, until count times happens.
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countMax | S Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.countMax Maximum number of times to repeat DefinitionIf present, indicates that the count is a range - so to perform the action between [count] and [countMax] times. 32 bit number; for values larger than this, use decimal
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duration | S Σ | 0..1 | decimal | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.duration How long when it happens DefinitionHow long this thing happens for when it happens. If durationMax is present, this element indicates the lower bound of the allowed range of the duration. Some activities are not instantaneous and need to be maintained for a period of time. 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).
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durationMax | S Σ | 0..1 | decimal | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.durationMax How long when it happens (Max) DefinitionIf present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length. Some activities are not instantaneous and need to be maintained for a period of time. 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).
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durationUnit | S Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.durationUnit s | min | h | d | wk | mo | a - unit of time (UCUM) DefinitionThe units of time for the duration, in UCUM units. Note that FHIR strings SHALL NOT exceed 1MB in size A unit of time (units from UCUM). UnitsOfTime (required)Constraints
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frequency | S Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.frequency Event occurs frequency times per period DefinitionThe number of times to repeat the action within the specified period. If frequencyMax is present, this element indicates the lower bound of the allowed range of the frequency. 32 bit number; for values larger than this, use decimal If no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this
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frequencyMax | S Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.frequencyMax Event occurs up to frequencyMax times per period DefinitionIf present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range. 32 bit number; for values larger than this, use decimal
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period | S Σ | 0..1 | decimal | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.period Event occurs frequency times per period DefinitionIndicates the duration of time over which repetitions are to occur; e.g. to express "3 times per day", 3 would be the frequency and "1 day" would be the period. If periodMax is present, this element indicates the lower bound of the allowed range of the period length. Do not use an IEEE type floating point type, instead use something that works like a true decimal, with inbuilt precision (e.g. Java BigInteger)
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periodMax | S Σ | 0..1 | decimal | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.periodMax Upper limit of period (3-4 hours) DefinitionIf present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as "do this once every 3-5 days. Do not use an IEEE type floating point type, instead use something that works like a true decimal, with inbuilt precision (e.g. Java BigInteger)
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periodUnit | S Σ | 0..1 | codeBinding | Element IdMedicationDispense.dosageInstruction.timing.repeat.periodUnit s | min | h | d | wk | mo | a - unit of time (UCUM) DefinitionThe units of time for the period in UCUM units. Note that FHIR strings SHALL NOT exceed 1MB in size A unit of time (units from UCUM). UnitsOfTime (required)Constraints
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dayOfWeek | S Σ | 0..* | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.dayOfWeek mon | tue | wed | thu | fri | sat | sun DefinitionIf one or more days of week is provided, then the action happens only on the specified day(s). 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.
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timeOfDay | S Σ | 0..* | time | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.timeOfDay Time of day for action DefinitionSpecified time of day for action to take place. 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.
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when | S Σ | 0..* | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.when Code for time period of occurrence DefinitionAn approximate time period during the day, potentially linked to an event of daily living that indicates when the action should occur. Timings are frequently determined by occurrences such as waking, eating and sleep. When more than one event is listed, the event is tied to the union of the specified events. Real world event relating to the schedule. EventTiming (required)Constraints
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offset | S Σ | 0..1 | unsignedInt | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.repeat.offset Minutes from event (before or after) DefinitionThe number of minutes from the event. If the event code does not indicate whether the minutes is before or after the event, then the offset is assumed to be after the event. 32 bit number; for values larger than this, use decimal
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code | S Σ | 0..1 | CodeableConceptBinding | Element IdMedicationDispense.dosageInstruction.timing.code BID | TID | QID | AM | PM | QD | QOD | + DefinitionA code for the timing schedule (or just text in code.text). Some codes such as BID are ubiquitous, but many institutions define their own additional codes. If a code is provided, the code is understood to be a complete statement of whatever is specified in the structured timing data, and either the code or the data may be used to interpret the Timing, with the exception that .repeat.bounds still applies over the code (and is not contained in the code). 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). Code for a known / defined timing pattern. MedicationRepeatPattern (extensible)Constraints
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coding | S Σ | 0..* | Coding | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.code.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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.
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system | S Σ | 0..1 | uriFixed Value | Element IdMedicationDispense.dosageInstruction.timing.code.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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.
http://snomed.info/sct
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.code.coding.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. 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.
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code | S Σ | 0..1 | code | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.code.coding.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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display | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.code.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.code.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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text | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.timing.code.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. 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. Very often the text is the same as a displayName of one of the codings.
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asNeeded[x] | S Σ | 0..1 | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.asNeeded[x] Take "as needed" (for x) DefinitionIndicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept). Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed".
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asNeededBoolean | boolean | Data Type | ||
site | S Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.site Body site to administer to DefinitionBody site to administer to. A coded specification of the anatomic site where the medication first enters the body. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both. A coded concept describing the site location the medicine enters into or onto the body. SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example)Constraints
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coding | S Σ | 0..* | Coding | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.site.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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.
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system | S Σ | 0..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.site.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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.
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.site.coding.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. 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.
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code | S Σ | 0..1 | code | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.site.coding.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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display | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.site.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.site.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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text | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.site.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. 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. Very often the text is the same as a displayName of one of the codings.
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route | S Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.route How drug should enter body DefinitionHow drug should enter body. A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. SNOMEDCTRouteCodes (example)Constraints
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coding | S Σ | 1..1 | CodingBinding | Element IdMedicationDispense.dosageInstruction.route.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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. RouteOfAdministration (required) Constraints
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system | S Σ | 1..1 | uriFixed Value | Element IdMedicationDispense.dosageInstruction.route.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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.
http://snomed.info/sct
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.route.coding.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. 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.
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code | S Σ | 1..1 | code | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.route.coding.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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display | S Σ | 1..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.route.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.route.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.route.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. 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. Very often the text is the same as a displayName of one of the codings.
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method | S Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.method Technique for administering medication DefinitionTechnique for administering medication. A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV. Terminologies used often pre-coordinate this term with the route and or form of administration. A coded concept describing the technique by which the medicine is administered. SNOMEDCTAdministrationMethodCodes (example)Constraints
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coding | S Σ | 0..* | Coding | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.method.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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.
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system | S Σ | 0..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.method.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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.
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.method.coding.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. 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.
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code | S Σ | 0..1 | code | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.method.coding.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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display | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.method.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.method.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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text | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.method.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. 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. Very often the text is the same as a displayName of one of the codings.
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doseAndRate | S Σ | 0..* | Element | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.doseAndRate Amount of medication administered DefinitionThe amount of medication administered.
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type | Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.doseAndRate.type The kind of dose or rate specified DefinitionThe kind of dose or rate specified, for example, ordered or calculated. If the type is not populated, assume to be "ordered". Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The kind of dose or rate specified. DoseAndRateType (example)Constraints
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dose[x] | S Σ | 0..1 | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.doseAndRate.dose[x] Amount of medication per dose DefinitionAmount of medication per dose. The amount of therapeutic or other substance given at one administration event. 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.
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doseRange | Range | There are no (further) constraints on this element Data Type | ||
doseQuantity | SimpleQuantity | There are no (further) constraints on this element Data Type | ||
rate[x] | S Σ | 0..1 | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.doseAndRate.rate[x] Amount of medication per unit of time DefinitionAmount of medication per unit of time. Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. 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. It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate. It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.
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rateRatio | Ratio | There are no (further) constraints on this element Data Type | ||
rateRange | Range | There are no (further) constraints on this element Data Type | ||
rateQuantity | SimpleQuantity | There are no (further) constraints on this element Data Type | ||
maxDosePerPeriod | S Σ I | 0..1 | Ratio | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod Upper limit on medication per unit of time DefinitionUpper limit on medication per unit of time. 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. This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day".
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numerator | S Σ I | 0..1 | Quantity | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod.numerator Numerator value DefinitionThe value of the numerator. The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
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value | S Σ | 0..1 | decimal | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.value Numerical value (with implicit precision) DefinitionThe value of the measured amount. The value includes an implicit precision in the presentation of the value. Precision is handled implicitly in almost all cases of measurement. 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).
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comparator | S Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.comparator < | <= | >= | > - how to understand the value DefinitionHow the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value. Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Note that FHIR strings SHALL NOT exceed 1MB in size If there is no comparator, then there is no modification of the value How the Quantity should be understood and represented. QuantityComparator (required)Constraints
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unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.unit Unit representation DefinitionA human-readable form of the unit. There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Note that FHIR strings SHALL NOT exceed 1MB in size
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system | S Σ I | 0..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.system System that defines coded unit form DefinitionThe identification of the system that provides the coded form of the unit. Need to know the system that defines the coded form of the unit. see http://en.wikipedia.org/wiki/Uniform_resource_identifier
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code | S Σ | 0..1 | code | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.code Coded form of the unit DefinitionA computer processable form of the unit in some unit representation system. 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. 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.
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denominator | S Σ I | 0..1 | Quantity | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod.denominator Denominator value DefinitionThe value of the denominator. The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
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value | S Σ | 0..1 | decimal | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.value Numerical value (with implicit precision) DefinitionThe value of the measured amount. The value includes an implicit precision in the presentation of the value. Precision is handled implicitly in almost all cases of measurement. 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).
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comparator | S Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.comparator < | <= | >= | > - how to understand the value DefinitionHow the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value. Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Note that FHIR strings SHALL NOT exceed 1MB in size If there is no comparator, then there is no modification of the value How the Quantity should be understood and represented. QuantityComparator (required)Constraints
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unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.unit Unit representation DefinitionA human-readable form of the unit. There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Note that FHIR strings SHALL NOT exceed 1MB in size
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system | S Σ I | 0..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.system System that defines coded unit form DefinitionThe identification of the system that provides the coded form of the unit. Need to know the system that defines the coded form of the unit. see http://en.wikipedia.org/wiki/Uniform_resource_identifier
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code | S Σ | 0..1 | code | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.code Coded form of the unit DefinitionA computer processable form of the unit in some unit representation system. 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. 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.
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maxDosePerAdministration | S Σ I | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerAdministration Upper limit on medication per administration DefinitionUpper limit on medication per administration. The maximum total quantity of a therapeutic substance that may be administered to a subject per administration. 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.
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value | S Σ | 0..1 | decimal | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerAdministration.value Numerical value (with implicit precision) DefinitionThe value of the measured amount. The value includes an implicit precision in the presentation of the value. Precision is handled implicitly in almost all cases of measurement. 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).
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comparator | Σ ?! | 0..0 | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerAdministration.comparator < | <= | >= | > - how to understand the value DefinitionNot allowed to be used in this context Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Note that FHIR strings SHALL NOT exceed 1MB in size If there is no comparator, then there is no modification of the value How the Quantity should be understood and represented. QuantityComparator (required)Constraints
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unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerAdministration.unit Unit representation DefinitionA human-readable form of the unit. There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Note that FHIR strings SHALL NOT exceed 1MB in size
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system | S Σ I | 0..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerAdministration.system System that defines coded unit form DefinitionThe identification of the system that provides the coded form of the unit. Need to know the system that defines the coded form of the unit. see http://en.wikipedia.org/wiki/Uniform_resource_identifier
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code | S Σ | 0..1 | code | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerAdministration.code Coded form of the unit DefinitionA computer processable form of the unit in some unit representation system. 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. 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.
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maxDosePerLifetime | S Σ I | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerLifetime Upper limit on medication per lifetime of the patient DefinitionUpper limit on medication per lifetime of the patient. The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject. The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
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value | S Σ | 0..1 | decimal | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerLifetime.value Numerical value (with implicit precision) DefinitionThe value of the measured amount. The value includes an implicit precision in the presentation of the value. Precision is handled implicitly in almost all cases of measurement. 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).
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comparator | Σ ?! | 0..0 | codeBinding | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerLifetime.comparator < | <= | >= | > - how to understand the value DefinitionNot allowed to be used in this context Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Note that FHIR strings SHALL NOT exceed 1MB in size If there is no comparator, then there is no modification of the value How the Quantity should be understood and represented. QuantityComparator (required)Constraints
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unit | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerLifetime.unit Unit representation DefinitionA human-readable form of the unit. There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Note that FHIR strings SHALL NOT exceed 1MB in size
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system | S Σ I | 0..1 | uri | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerLifetime.system System that defines coded unit form DefinitionThe identification of the system that provides the coded form of the unit. Need to know the system that defines the coded form of the unit. see http://en.wikipedia.org/wiki/Uniform_resource_identifier
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code | S Σ | 0..1 | code | There are no (further) constraints on this element Element IdMedicationDispense.dosageInstruction.maxDosePerLifetime.code Coded form of the unit DefinitionA computer processable form of the unit in some unit representation system. 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. 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.
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substitution | 0..1 | BackboneElement | There are no (further) constraints on this element Element IdMedicationDispense.substitution Whether a substitution was performed on the dispense DefinitionIndicates whether or not substitution was made as part of the dispense. In some cases, substitution will be expected but does not happen, in other cases substitution is not expected but does happen. This block explains what substitution did or did not happen and why. If nothing is specified, substitution was not done.
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wasSubstituted | 1..1 | boolean | There are no (further) constraints on this element Element IdMedicationDispense.substitution.wasSubstituted Whether a substitution was or was not performed on the dispense DefinitionTrue if the dispenser dispensed a different drug or product from what was prescribed.
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type | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdMedicationDispense.substitution.type Code signifying whether a different drug was dispensed from what was prescribed DefinitionA code signifying whether a different drug was dispensed from what was prescribed. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription. v3.ActSubstanceAdminSubstitutionCode (example)Constraints
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reason | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdMedicationDispense.substitution.reason Why was substitution made DefinitionIndicates the reason for the substitution (or lack of substitution) from what was prescribed. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed. v3.SubstanceAdminSubstitutionReason (example)Constraints
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responsibleParty | I | 0..* | Reference(Practitioner | PractitionerRole) | There are no (further) constraints on this element Element IdMedicationDispense.substitution.responsibleParty Who is responsible for the substitution DefinitionThe person or organization that has primary responsibility for the substitution. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Practitioner | PractitionerRole) Constraints
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detectedIssue | I | 0..* | Reference(DetectedIssue) | There are no (further) constraints on this element Element IdMedicationDispense.detectedIssue Clinical issue with action Alternate namesContraindication, Drug Utilization Review (DUR), Alert DefinitionIndicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. drug-drug interaction, duplicate therapy, dosage alert etc. This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue.
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eventHistory | I | 0..* | Reference(Provenance) | There are no (further) constraints on this element Element IdMedicationDispense.eventHistory A list of relevant lifecycle events DefinitionA summary of the events of interest that have occurred, such as when the dispense was verified. This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).
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Table View
MedicationDispense | .. | |
MedicationDispense.id | .. | |
MedicationDispense.meta | .. | |
MedicationDispense.meta.versionId | .. | |
MedicationDispense.meta.lastUpdated | .. | |
MedicationDispense.meta.source | .. | |
MedicationDispense.contained | Medication, MedicationRequest Prescription, Practitioner, Organization, PractitionerRole | 1.. |
MedicationDispense.contained.id | .. | |
MedicationDispense.contained.meta | .. | |
MedicationDispense.contained.meta.lastUpdated | .. | |
MedicationDispense.contained.meta.source | .. | |
MedicationDispense.extension | 0.. | |
MedicationDispense.extension | Extension | 0..1 |
MedicationDispense.extension | Extension | 0..1 |
MedicationDispense.extension | Extension | 0..1 |
MedicationDispense.identifier | 1..2 | |
MedicationDispense.identifier | 1..1 | |
MedicationDispense.identifier.system | 1.. | |
MedicationDispense.identifier.value | 1.. | |
MedicationDispense.identifier | ..1 | |
MedicationDispense.identifier.system | 1.. | |
MedicationDispense.identifier.value | 1.. | |
MedicationDispense.status | .. | |
MedicationDispense.category | .. | |
MedicationDispense.category.coding | 1..1 | |
MedicationDispense.category.coding.system | 1.. | |
MedicationDispense.category.coding.code | 1.. | |
MedicationDispense.category.coding.display | 1.. | |
MedicationDispense.medication[x] | Reference() | .. |
MedicationDispense.medication[x].reference | 1.. | |
MedicationDispense.subject | Reference(Patient) | 1.. |
MedicationDispense.subject.reference | 1.. | |
MedicationDispense.performer | ..1 | |
MedicationDispense.performer.actor | Reference(PractitionerRole) | .. |
MedicationDispense.performer.actor.reference | 1.. | |
MedicationDispense.authorizingPrescription | Reference(MedicationRequest Prescription) | ..1 |
MedicationDispense.authorizingPrescription.reference | 1.. | |
MedicationDispense.quantity | .. | |
MedicationDispense.quantity.value | 1.. | |
MedicationDispense.quantity.unit | .. | |
MedicationDispense.quantity.system | .. | |
MedicationDispense.quantity.code | .. | |
MedicationDispense.daysSupply | .. | |
MedicationDispense.daysSupply.value | 1.. | |
MedicationDispense.whenPrepared | 1.. | |
MedicationDispense.whenHandedOver | .. | |
MedicationDispense.dosageInstruction | .. | |
MedicationDispense.dosageInstruction.sequence | .. | |
MedicationDispense.dosageInstruction.text | .. | |
MedicationDispense.dosageInstruction.additionalInstruction | .. | |
MedicationDispense.dosageInstruction.additionalInstruction.coding | .. | |
MedicationDispense.dosageInstruction.additionalInstruction.coding.system | .. | |
MedicationDispense.dosageInstruction.additionalInstruction.coding.code | .. | |
MedicationDispense.dosageInstruction.additionalInstruction.coding.display | .. | |
MedicationDispense.dosageInstruction.additionalInstruction.text | .. | |
MedicationDispense.dosageInstruction.patientInstruction | .. | |
MedicationDispense.dosageInstruction.timing | .. | |
MedicationDispense.dosageInstruction.timing.event | .. | |
MedicationDispense.dosageInstruction.timing.repeat | .. | |
MedicationDispense.dosageInstruction.timing.repeat.bounds[x] | .. | |
MedicationDispense.dosageInstruction.timing.repeat.count | .. | |
MedicationDispense.dosageInstruction.timing.repeat.countMax | .. | |
MedicationDispense.dosageInstruction.timing.repeat.duration | .. | |
MedicationDispense.dosageInstruction.timing.repeat.durationMax | .. | |
MedicationDispense.dosageInstruction.timing.repeat.durationUnit | .. | |
MedicationDispense.dosageInstruction.timing.repeat.frequency | .. | |
MedicationDispense.dosageInstruction.timing.repeat.frequencyMax | .. | |
MedicationDispense.dosageInstruction.timing.repeat.period | .. | |
MedicationDispense.dosageInstruction.timing.repeat.periodMax | .. | |
MedicationDispense.dosageInstruction.timing.repeat.periodUnit | .. | |
MedicationDispense.dosageInstruction.timing.repeat.dayOfWeek | .. | |
MedicationDispense.dosageInstruction.timing.repeat.timeOfDay | .. | |
MedicationDispense.dosageInstruction.timing.repeat.when | .. | |
MedicationDispense.dosageInstruction.timing.repeat.offset | .. | |
MedicationDispense.dosageInstruction.timing.code | .. | |
MedicationDispense.dosageInstruction.timing.code.coding | .. | |
MedicationDispense.dosageInstruction.timing.code.coding.system | .. | |
MedicationDispense.dosageInstruction.timing.code.coding.code | .. | |
MedicationDispense.dosageInstruction.timing.code.coding.display | .. | |
MedicationDispense.dosageInstruction.timing.code.text | .. | |
MedicationDispense.dosageInstruction.asNeeded[x] | boolean | .. |
MedicationDispense.dosageInstruction.site | .. | |
MedicationDispense.dosageInstruction.site.coding | .. | |
MedicationDispense.dosageInstruction.site.coding.system | .. | |
MedicationDispense.dosageInstruction.site.coding.code | .. | |
MedicationDispense.dosageInstruction.site.coding.display | .. | |
MedicationDispense.dosageInstruction.site.text | .. | |
MedicationDispense.dosageInstruction.route | .. | |
MedicationDispense.dosageInstruction.route.coding | 1..1 | |
MedicationDispense.dosageInstruction.route.coding.system | 1.. | |
MedicationDispense.dosageInstruction.route.coding.code | 1.. | |
MedicationDispense.dosageInstruction.route.coding.display | 1.. | |
MedicationDispense.dosageInstruction.method | .. | |
MedicationDispense.dosageInstruction.method.coding | .. | |
MedicationDispense.dosageInstruction.method.coding.system | .. | |
MedicationDispense.dosageInstruction.method.coding.code | .. | |
MedicationDispense.dosageInstruction.method.coding.display | .. | |
MedicationDispense.dosageInstruction.method.text | .. | |
MedicationDispense.dosageInstruction.doseAndRate | .. | |
MedicationDispense.dosageInstruction.doseAndRate.dose[x] | .. | |
MedicationDispense.dosageInstruction.doseAndRate.rate[x] | .. | |
MedicationDispense.dosageInstruction.maxDosePerPeriod | .. | |
MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator | .. | |
MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.value | .. | |
MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.comparator | .. | |
MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.unit | .. | |
MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.system | .. | |
MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.code | .. | |
MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator | .. | |
MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.value | .. | |
MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.comparator | .. | |
MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.unit | .. | |
MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.system | .. | |
MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.code | .. | |
MedicationDispense.dosageInstruction.maxDosePerAdministration | .. | |
MedicationDispense.dosageInstruction.maxDosePerAdministration.value | .. | |
MedicationDispense.dosageInstruction.maxDosePerAdministration.unit | .. | |
MedicationDispense.dosageInstruction.maxDosePerAdministration.system | .. | |
MedicationDispense.dosageInstruction.maxDosePerAdministration.code | .. | |
MedicationDispense.dosageInstruction.maxDosePerLifetime | .. | |
MedicationDispense.dosageInstruction.maxDosePerLifetime.value | .. | |
MedicationDispense.dosageInstruction.maxDosePerLifetime.unit | .. | |
MedicationDispense.dosageInstruction.maxDosePerLifetime.system | .. | |
MedicationDispense.dosageInstruction.maxDosePerLifetime.code | .. |
JSON View
{ "resourceType": "StructureDefinition", "id": "d5d38102-c557-41af-a34b-38bfa77a5ea0", "meta": { "lastUpdated": "2023-07-07T15:43:44.0821131+00:00" }, "url": "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-medications-profile-MedicationDispense", "version": "4.0.0", "name": "MedicationDispense", "title": "MedicationDispense", "status": "draft", "date": "2022-02-14T19:05:36.9336556+00:00", "description": "Indicates that a medication is to be or has been dispensed for a named patient", "fhirVersion": "4.0.1", "kind": "resource", "abstract": false, "type": "MedicationDispense", "baseDefinition": "http://hl7.org/fhir/StructureDefinition/MedicationDispense", "derivation": "constraint", "differential": { "element": [ { "id": "MedicationDispense", "path": "MedicationDispense", "mustSupport": true }, { "id": "MedicationDispense.id", "path": "MedicationDispense.id", "mustSupport": true }, { "id": "MedicationDispense.meta", "path": "MedicationDispense.meta", "mustSupport": true }, { "id": "MedicationDispense.meta.versionId", "path": "MedicationDispense.meta.versionId", "mustSupport": true }, { "id": "MedicationDispense.meta.lastUpdated", "path": "MedicationDispense.meta.lastUpdated", "mustSupport": true }, { "id": "MedicationDispense.meta.source", "path": "MedicationDispense.meta.source", "mustSupport": true }, { "id": "MedicationDispense.contained", "path": "MedicationDispense.contained", "min": 1, "type": [ { "code": "Resource", "profile": [ "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-medications-profile-Medication", "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-medications-profile-MedicationRequest", "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-medications-profile-Practitioner", "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-medications-profile-Organization", "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-medications-profile-PractitionerRole" ] } ], "mustSupport": true }, { "id": "MedicationDispense.contained.id", "path": "MedicationDispense.contained.id", "mustSupport": true }, { "id": "MedicationDispense.contained.meta", "path": "MedicationDispense.contained.meta", "mustSupport": true }, { "id": "MedicationDispense.contained.meta.lastUpdated", "path": "MedicationDispense.contained.meta.lastUpdated", "mustSupport": true }, { "id": "MedicationDispense.contained.meta.source", "path": "MedicationDispense.contained.meta.source", "mustSupport": true }, { "id": "MedicationDispense.extension", "path": "MedicationDispense.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "rules": "open" }, "min": 0 }, { "id": "MedicationDispense.extension:DispenseRemainingRefills", "path": "MedicationDispense.extension", "sliceName": "DispenseRemainingRefills", "min": 0, "max": "1", "type": [ { "code": "Extension", "profile": [ "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-medications-ext-refills-remaining" ] } ], "isModifier": false }, { "id": "MedicationDispense.extension:DispenseRemainingQuantity", "path": "MedicationDispense.extension", "sliceName": "DispenseRemainingQuantity", "min": 0, "max": "1", "type": [ { "code": "Extension", "profile": [ "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-medications-ext-quantity-remaining" ] } ], "isModifier": false }, { "id": "MedicationDispense.extension:DrugServiceCoverage", "path": "MedicationDispense.extension", "sliceName": "DrugServiceCoverage", "min": 0, "max": "1", "type": [ { "code": "Extension", "profile": [ "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-medications-ext-drug-service-coverage" ] } ], "isModifier": false }, { "id": "MedicationDispense.identifier", "path": "MedicationDispense.identifier", "slicing": { "discriminator": [ { "type": "value", "path": "assigner.identifier.system" } ], "rules": "open" }, "min": 1, "max": "2", "mustSupport": true }, { "id": "MedicationDispense.identifier:currentRxNo", "path": "MedicationDispense.identifier", "sliceName": "currentRxNo", "min": 1, "max": "1", "mustSupport": true }, { "id": "MedicationDispense.identifier:currentRxNo.system", "path": "MedicationDispense.identifier.system", "min": 1, "mustSupport": true }, { "id": "MedicationDispense.identifier:currentRxNo.value", "path": "MedicationDispense.identifier.value", "min": 1, "mustSupport": true }, { "id": "MedicationDispense.identifier:originalRxNo", "path": "MedicationDispense.identifier", "sliceName": "originalRxNo", "max": "1", "mustSupport": true }, { "id": "MedicationDispense.identifier:originalRxNo.system", "path": "MedicationDispense.identifier.system", "min": 1, "mustSupport": true }, { "id": "MedicationDispense.identifier:originalRxNo.value", "path": "MedicationDispense.identifier.value", "min": 1, "mustSupport": true }, { "id": "MedicationDispense.status", "path": "MedicationDispense.status", "mustSupport": true }, { "id": "MedicationDispense.category", "path": "MedicationDispense.category", "mustSupport": true, "binding": { "strength": "required", "description": "Dispense type, e.g. drug, device or pharmacy service", "valueSet": "http://ehealthontario.ca/fhir/ValueSet/dhdr-dispense-category" } }, { "id": "MedicationDispense.category.coding", "path": "MedicationDispense.category.coding", "min": 1, "max": "1", "mustSupport": true }, { "id": "MedicationDispense.category.coding.system", "path": "MedicationDispense.category.coding.system", "min": 1, "fixedUri": "http://ehealthontario.ca/fhir/CodeSystem/medication-dispense-category", "mustSupport": true }, { "id": "MedicationDispense.category.coding.code", "path": "MedicationDispense.category.coding.code", "min": 1, "mustSupport": true }, { "id": "MedicationDispense.category.coding.display", "path": "MedicationDispense.category.coding.display", "min": 1, "mustSupport": true }, { "id": "MedicationDispense.medication[x]", "path": "MedicationDispense.medication[x]", "type": [ { "code": "Reference" } ], "mustSupport": true }, { "id": "MedicationDispense.medication[x].reference", "path": "MedicationDispense.medication[x].reference", "min": 1, "mustSupport": true }, { "id": "MedicationDispense.subject", "path": "MedicationDispense.subject", "min": 1, "type": [ { "code": "Reference", "targetProfile": [ "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-medications-profile-Patient" ] } ], "mustSupport": true }, { "id": "MedicationDispense.subject.reference", "path": "MedicationDispense.subject.reference", "min": 1, "mustSupport": true }, { "id": "MedicationDispense.performer", "path": "MedicationDispense.performer", "max": "1", "mustSupport": true }, { "id": "MedicationDispense.performer.actor", "path": "MedicationDispense.performer.actor", "type": [ { "code": "Reference", "targetProfile": [ "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-medications-profile-PractitionerRole" ] } ], "mustSupport": true }, { "id": "MedicationDispense.performer.actor.reference", "path": "MedicationDispense.performer.actor.reference", "min": 1, "mustSupport": true }, { "id": "MedicationDispense.authorizingPrescription", "path": "MedicationDispense.authorizingPrescription", "max": "1", "type": [ { "code": "Reference", "targetProfile": [ "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-medications-profile-MedicationRequest" ] } ], "mustSupport": true }, { "id": "MedicationDispense.authorizingPrescription.reference", "path": "MedicationDispense.authorizingPrescription.reference", "min": 1, "mustSupport": true }, { "id": "MedicationDispense.quantity", "path": "MedicationDispense.quantity", "mustSupport": true }, { "id": "MedicationDispense.quantity.value", "path": "MedicationDispense.quantity.value", "min": 1, "mustSupport": true }, { "id": "MedicationDispense.quantity.unit", "path": "MedicationDispense.quantity.unit", "mustSupport": true }, { "id": "MedicationDispense.quantity.system", "path": "MedicationDispense.quantity.system", "mustSupport": true }, { "id": "MedicationDispense.quantity.code", "path": "MedicationDispense.quantity.code", "mustSupport": true, "binding": { "strength": "extensible", "valueSet": "https://tgateway.infoway-inforoute.ca/vs/prescribedquantityunit" } }, { "id": "MedicationDispense.daysSupply", "path": "MedicationDispense.daysSupply", "mustSupport": true }, { "id": "MedicationDispense.daysSupply.value", "path": "MedicationDispense.daysSupply.value", "min": 1 }, { "id": "MedicationDispense.whenPrepared", "path": "MedicationDispense.whenPrepared", "min": 1, "mustSupport": true }, { "id": "MedicationDispense.whenHandedOver", "path": "MedicationDispense.whenHandedOver", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction", "path": "MedicationDispense.dosageInstruction", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.sequence", "path": "MedicationDispense.dosageInstruction.sequence", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.text", "path": "MedicationDispense.dosageInstruction.text", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.additionalInstruction", "path": "MedicationDispense.dosageInstruction.additionalInstruction", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.additionalInstruction.coding", "path": "MedicationDispense.dosageInstruction.additionalInstruction.coding", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.additionalInstruction.coding.system", "path": "MedicationDispense.dosageInstruction.additionalInstruction.coding.system", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.additionalInstruction.coding.code", "path": "MedicationDispense.dosageInstruction.additionalInstruction.coding.code", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.additionalInstruction.coding.display", "path": "MedicationDispense.dosageInstruction.additionalInstruction.coding.display", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.additionalInstruction.text", "path": "MedicationDispense.dosageInstruction.additionalInstruction.text", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.patientInstruction", "path": "MedicationDispense.dosageInstruction.patientInstruction", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.timing", "path": "MedicationDispense.dosageInstruction.timing", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.timing.event", "path": "MedicationDispense.dosageInstruction.timing.event", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.timing.repeat", "path": "MedicationDispense.dosageInstruction.timing.repeat", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.timing.repeat.bounds[x]", "path": "MedicationDispense.dosageInstruction.timing.repeat.bounds[x]", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.timing.repeat.count", "path": "MedicationDispense.dosageInstruction.timing.repeat.count", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.timing.repeat.countMax", "path": "MedicationDispense.dosageInstruction.timing.repeat.countMax", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.timing.repeat.duration", "path": "MedicationDispense.dosageInstruction.timing.repeat.duration", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.timing.repeat.durationMax", "path": "MedicationDispense.dosageInstruction.timing.repeat.durationMax", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.timing.repeat.durationUnit", "path": "MedicationDispense.dosageInstruction.timing.repeat.durationUnit", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.timing.repeat.frequency", "path": "MedicationDispense.dosageInstruction.timing.repeat.frequency", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.timing.repeat.frequencyMax", "path": "MedicationDispense.dosageInstruction.timing.repeat.frequencyMax", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.timing.repeat.period", "path": "MedicationDispense.dosageInstruction.timing.repeat.period", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.timing.repeat.periodMax", "path": "MedicationDispense.dosageInstruction.timing.repeat.periodMax", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.timing.repeat.periodUnit", "path": "MedicationDispense.dosageInstruction.timing.repeat.periodUnit", "mustSupport": true, "binding": { "strength": "required", "valueSet": "http://hl7.org/fhir/ValueSet/units-of-time|4.0.0" } }, { "id": "MedicationDispense.dosageInstruction.timing.repeat.dayOfWeek", "path": "MedicationDispense.dosageInstruction.timing.repeat.dayOfWeek", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.timing.repeat.timeOfDay", "path": "MedicationDispense.dosageInstruction.timing.repeat.timeOfDay", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.timing.repeat.when", "path": "MedicationDispense.dosageInstruction.timing.repeat.when", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.timing.repeat.offset", "path": "MedicationDispense.dosageInstruction.timing.repeat.offset", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.timing.code", "path": "MedicationDispense.dosageInstruction.timing.code", "mustSupport": true, "binding": { "strength": "extensible", "valueSet": "http://ehealthontario.ca/fhir/ValueSet/dhdr-medication-repeat-pattern" } }, { "id": "MedicationDispense.dosageInstruction.timing.code.coding", "path": "MedicationDispense.dosageInstruction.timing.code.coding", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.timing.code.coding.system", "path": "MedicationDispense.dosageInstruction.timing.code.coding.system", "fixedUri": "http://snomed.info/sct", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.timing.code.coding.code", "path": "MedicationDispense.dosageInstruction.timing.code.coding.code", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.timing.code.coding.display", "path": "MedicationDispense.dosageInstruction.timing.code.coding.display", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.timing.code.text", "path": "MedicationDispense.dosageInstruction.timing.code.text", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.asNeeded[x]", "path": "MedicationDispense.dosageInstruction.asNeeded[x]", "type": [ { "code": "boolean" } ], "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.site", "path": "MedicationDispense.dosageInstruction.site", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.site.coding", "path": "MedicationDispense.dosageInstruction.site.coding", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.site.coding.system", "path": "MedicationDispense.dosageInstruction.site.coding.system", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.site.coding.code", "path": "MedicationDispense.dosageInstruction.site.coding.code", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.site.coding.display", "path": "MedicationDispense.dosageInstruction.site.coding.display", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.site.text", "path": "MedicationDispense.dosageInstruction.site.text", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.route", "path": "MedicationDispense.dosageInstruction.route", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.route.coding", "path": "MedicationDispense.dosageInstruction.route.coding", "min": 1, "max": "1", "mustSupport": true, "binding": { "strength": "required", "valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/routeofadministration" } }, { "id": "MedicationDispense.dosageInstruction.route.coding.system", "path": "MedicationDispense.dosageInstruction.route.coding.system", "min": 1, "fixedUri": "http://snomed.info/sct", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.route.coding.code", "path": "MedicationDispense.dosageInstruction.route.coding.code", "min": 1, "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.route.coding.display", "path": "MedicationDispense.dosageInstruction.route.coding.display", "min": 1, "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.method", "path": "MedicationDispense.dosageInstruction.method", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.method.coding", "path": "MedicationDispense.dosageInstruction.method.coding", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.method.coding.system", "path": "MedicationDispense.dosageInstruction.method.coding.system", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.method.coding.code", "path": "MedicationDispense.dosageInstruction.method.coding.code", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.method.coding.display", "path": "MedicationDispense.dosageInstruction.method.coding.display", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.method.text", "path": "MedicationDispense.dosageInstruction.method.text", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.doseAndRate", "path": "MedicationDispense.dosageInstruction.doseAndRate", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.doseAndRate.dose[x]", "path": "MedicationDispense.dosageInstruction.doseAndRate.dose[x]", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.doseAndRate.rate[x]", "path": "MedicationDispense.dosageInstruction.doseAndRate.rate[x]", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.maxDosePerPeriod", "path": "MedicationDispense.dosageInstruction.maxDosePerPeriod", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator", "path": "MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.value", "path": "MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.value", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.comparator", "path": "MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.comparator", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.unit", "path": "MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.unit", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.system", "path": "MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.system", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.code", "path": "MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.code", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator", "path": "MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.value", "path": "MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.value", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.comparator", "path": "MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.comparator", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.unit", "path": "MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.unit", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.system", "path": "MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.system", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.code", "path": "MedicationDispense.dosageInstruction.maxDosePerPeriod.denominator.code", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.maxDosePerAdministration", "path": "MedicationDispense.dosageInstruction.maxDosePerAdministration", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.maxDosePerAdministration.value", "path": "MedicationDispense.dosageInstruction.maxDosePerAdministration.value", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.maxDosePerAdministration.unit", "path": "MedicationDispense.dosageInstruction.maxDosePerAdministration.unit", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.maxDosePerAdministration.system", "path": "MedicationDispense.dosageInstruction.maxDosePerAdministration.system", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.maxDosePerAdministration.code", "path": "MedicationDispense.dosageInstruction.maxDosePerAdministration.code", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.maxDosePerLifetime", "path": "MedicationDispense.dosageInstruction.maxDosePerLifetime", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.maxDosePerLifetime.value", "path": "MedicationDispense.dosageInstruction.maxDosePerLifetime.value", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.maxDosePerLifetime.unit", "path": "MedicationDispense.dosageInstruction.maxDosePerLifetime.unit", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.maxDosePerLifetime.system", "path": "MedicationDispense.dosageInstruction.maxDosePerLifetime.system", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.maxDosePerLifetime.code", "path": "MedicationDispense.dosageInstruction.maxDosePerLifetime.code", "mustSupport": true } ] } }
Usage
The MedicationDispense Resource represents a medication report from DHDR. MedicationDispense shall contain references to other resources such as patient, practitioner, organization, medication, and medicationRequest resources.
Notes
.meta
source
can be
HNS:http://ehealthontario.ca/hns
NMS:http://ehealthontario.ca/nms
Pharmacy:http://ehealthontario.ca/pharmacy
COVAX:http://ehealthontario.ca/covaxon
.identifier
- sliced identifier element
- business identifier for the medication report
- the field contains current Rx Number assigned by the dispensing pharmacy and/or original RX number
identifier:currentRxNo.system
the namespace for the identifier value.
e.g.[id-system-local-base]/ca-on-pharmacy-[Pharmacy ID]-rx-number
identifier:currentRxNo.value
the unique identifier of the data source record (RX number for pharmacy feeds, Immunization ID for COVaxON records)identifier:originalRxNo.system
each pharmacy to be assigned a unique URI (Pharmacy ID is a CPhA National Pharmacy ID Code or eHealth Ontario UPI (Unique Provider Identifier)).
e.g.[id-system-local-base]/ca-on-pharmacy-[Pharmacy ID]-original-rx-number
identifier:originalRxNo.value
should be original Rx Number assigned by the pharmacy system on the first fill. This might be unknown for some dispenses that get loaded to DHDR from non-pharmacy feeds, e.g. ODB or NMS.
.status
- a code specifying the state of the dispense event. For dispense that occurred:
completed
. For reversed dispense:entered-in-error
.category
- type of medication dispense to distinguish between drugs, devices and professional services.
.performer
- this field identifies the actor that is the dispenser of the medication (despensing pharmacy or dispensing pharmacist). It should contain a reference to an organization or ptactitioner instance in the bundle.
.authorizingPrescription
- this field indicates the medication dispensed or pharmacy service rendered
- SHALL be mandatory if category is
drug
.quantity
- this field indicates the quantity of medication/devices dispensed (dosage units or metric weights)
- this field is mandatory for meidcations and devices. Optional for services
.daysSupply
- estimated number of days of treatment based on the directions for use on the prescription and the pharmacists judgment on usage
- SHALL be mandatory if category is
drug
.whenPrepared
- this field indicates dispense date (when product was packaged and reviewed) - when pharmacy service was rendered
.whenHandedOver
- this field indicates when product was given out (picked up by a patient or their representative)
.dosageInstruction
dosageInstruction.text
the dosage specification. Free text dosage instructions.dosageInstruction.patientInstruction
this field indicates patient dosage instruction. The instructions to the patient on how to take the medication (e.g. with food)dosageInstruction.timing
this field indicates frequency, a timing schedule that specifies an event that may occur multiple timesdosageInstruction.timing.repeat.periodMax
this field indicates the upper limit of the period when the dosage is a range, for example, every 4-6 hours.dosageInstruction.asNeeded[x]
PRN indicator. Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).