HL7 FHIR® CareConnect Baseline Profiles for STU3 (Draft Standard for Trial Use)

Important Announcement regarding CareConnect STU3

As of 19/09/2023, CareConnect has been deprecated and all development on the CareConnect FHIR assets has ceased.
Therefore, vendors looking to start new implementations or looking to update existing implementations should use UK Core R4 based solutions. Vendors continuing to implement CareConnect based solutions do so at their own risk and on the understanding that no maintenance or support will be available.

StructureDefinition-CareConnect-MedicationDispense

Indicates that a medication product is to be or has been dispensed for a named person/patient.

Snapshot View

CareConnect-MedicationDispense-1 (MedicationDispense)	I		MedicationDispense	There are no (further) constraints on this element Element id MedicationDispense Short description Dispensing a medication to a named patient Definition Indicates 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. Comments The WG will be updating the MedicationDispense resource to adjust each affected resource to align with the workflow pattern (see workflow.html). Data type MedicationDispense Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative `contained.text.empty()` dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource `contained.where(('#'+id in %resource.descendants().reference).not()).empty()` mdd-1: whenHandedOver cannot be before whenPrepared `whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared` Mappings rim: Entity. Role, or Act workflow: ..Event rim: Supply[moodCode=EVN] w5: clinical.medication
id	Σ	0..1	id	There are no (further) constraints on this element Element id MedicationDispense.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type id
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id MedicationDispense.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource. Data type Meta
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id MedicationDispense.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation. Data type uri
language		0..1	codeBinding	There are no (further) constraints on this element Element id MedicationDispense.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. Common Languages (extensible)
text	I	0..1	Narrative	There are no (further) constraints on this element Element id MedicationDispense.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later. Data type Narrative Mappings rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id MedicationDispense.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Data type Resource Mappings rim: N/A
extension		0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Mappings rim: N/A
modifierExtension	?!	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Mappings rim: N/A
identifier		0..*	Identifier	There are no (further) constraints on this element Element id MedicationDispense.identifier Short description External identifier Definition Identifier assigned by the dispensing facility - this is an identifier assigned outside FHIR. Data type Identifier Mappings workflow: …identifier rim: .id w5: id
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.identifier.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension		0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.identifier.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings rim: n/a
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id MedicationDispense.identifier.use Short description usual \| official \| temp \| secondary (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Mappings v2: N/A rim: Role.code or implied by context
type	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id MedicationDispense.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments 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. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) Mappings v2: CX.5 rim: Role.code or implied by context
system	Σ	1..1	uri	There are no (further) constraints on this element Element id MedicationDispense.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements 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. Data type uri Examples General http://www.acme.com/identifiers/patient Mappings v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType
value	Σ	1..1	string	There are no (further) constraints on this element Element id MedicationDispense.identifier.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments 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. Data type string Examples General 123456 Mappings v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value
period	Σ	0..1	Period	There are no (further) constraints on this element Element id MedicationDispense.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Data type Period Mappings v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
assigner	Σ	0..1	Reference(CareConnect-Organization-1)	Element id MedicationDispense.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments 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. Data type Reference(CareConnect-Organization-1) Mappings v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
partOf		0..*	Reference(CareConnect-Procedure-1)	Element id MedicationDispense.partOf Short description Event that dispense is part of Definition The procedure that the dispense is done because of. Data type Reference(CareConnect-Procedure-1) Mappings workflow: …part of rim: .outboundRelationship[typeCode=COMP]/target[classCode=PROC,moodCode=EVN]
status	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id MedicationDispense.status Short description preparation \| in-progress \| on-hold \| completed \| entered-in-error \| stopped Definition A code specifying the state of the set of dispense events. Comments This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. Data type code Binding A coded concept specifying the state of the dispense event. MedicationDispenseStatus (required) Mappings workflow: …status rim: .statusCode w5: status
category		0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id MedicationDispense.category Short description Type of medication dispense Definition Indicates type of medication dispense and where the medication is expected to be consumed or administered. Data type CodeableConcept Binding A code describing where the dispensed medication is expected to be consumed or administered MedicationDispenseCategory (preferred) Mappings rim: .inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication dispense"].value
medication[x]	Σ	1..1		Element id MedicationDispense.medication[x] Short description What medication was supplied Definition Identifies 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. Comments 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. . Binding A coded concept identifying which substance or product can be dispensed SNOMED CT Medication Codes (example) Mappings workflow: …code v2: RXD-2-Dispense/Give Code rim: .participation[typeCode=PRD].role w5: what
medicationCodeableConcept			CodeableConcept	Data type CodeableConcept
medicationReference			Reference(CareConnect-Medication-1)	Data type Reference(CareConnect-Medication-1)
subject	Σ	0..1	Reference(Group \| CareConnect-Patient-1)	Element id MedicationDispense.subject Short description Who the dispense is for Definition A link to a resource representing the person or the group to whom the medication will be given. Comments SubstanceAdministration->subject->Patient. Data type Reference(Group \| CareConnect-Patient-1) Mappings workflow: …subject v2: PID-3-Patient ID List rim: .participation[typeCode=SBJ].role[classCode=PAT] w5: who.focus
context		0..1	Reference(CareConnect-EpisodeOfCare-1 \| CareConnect-Encounter-1)	Element id MedicationDispense.context Short description Encounter / Episode associated with event Definition The encounter or episode of care that establishes the context for this event. Data type Reference(CareConnect-EpisodeOfCare-1 \| CareConnect-Encounter-1) Mappings workflow: …context rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]
supportingInformation		0..*	Reference(Resource)	There are no (further) constraints on this element Element id MedicationDispense.supportingInformation Short description Information that supports the dispensing of the medication Definition Additional information that supports the medication being dispensed. Data type Reference(Resource) Mappings rim: .outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)] w5: context
performer		0..*	BackboneElement	There are no (further) constraints on this element Element id MedicationDispense.performer Short description Who performed event Definition Indicates who or what performed the event. It should be assumed that the performer is the dispenser of the medication. Comments The performer will be reviewed as part of STU4. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings workflow: …performer rim: .participation[typeCode=PRF]
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.performer.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension		0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.performer.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Mappings rim: n/a
modifierExtension	Σ ?!	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.performer.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Mappings rim: N/A
actor		1..1	Reference(Device \| CareConnect-RelatedPerson-1 \| CareConnect-Organization-1 \| CareConnect-Patient-1 \| CareConnect-Practitioner-1)	Element id MedicationDispense.performer.actor Short description Individual who was performing Definition The device, practitioner, etc. who performed the action. It should be assumed that the actor is the dispenser of the medication. Data type Reference(Device \| CareConnect-RelatedPerson-1 \| CareConnect-Organization-1 \| CareConnect-Patient-1 \| CareConnect-Practitioner-1) Mappings workflow: ….actor rim: .role
onBehalfOf		0..1	Reference(CareConnect-Organization-1)	Element id MedicationDispense.performer.onBehalfOf Short description Organization organization was acting for Definition The organization the device or practitioner was acting on behalf of. Data type Reference(CareConnect-Organization-1) Mappings workflow: ….onBehalfOf rim: .role.scopingOrganization
authorizingPrescription		0..*	Reference(CareConnect-MedicationRequest-1)	Element id MedicationDispense.authorizingPrescription Short description Medication order that authorizes the dispense Definition Indicates the medication order that is being dispensed against. Comments Maps to basedOn in Event logical model. Data type Reference(CareConnect-MedicationRequest-1) Mappings workflow: …basedOn v2: ORC-2 Placer Order Number rim: .outboundRelationship[typeCode=FLFS].target[moodCode=RQO]
type		0..1	CodeableConceptBinding	Element id MedicationDispense.type Short description To identify the type of medication supply. Definition Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc. Data type CodeableConcept Binding A ValueSet to identify the type of medication supply. Care Connect Medication Supply Type (preferred) Mappings v2: RXD-33-Dispense Type rim: .code
quantity		0..1	SimpleQuantity	There are no (further) constraints on this element Element id MedicationDispense.quantity Short description Amount dispensed Definition The amount of medication that has been dispensed. Includes unit of measure. Data type SimpleQuantity Mappings v2: RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense Units.name of coding system rim: .quantity
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.quantity.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension		0..*	Extension	Element id MedicationDispense.quantity.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings rim: n/a
quantityText	I	0..1	Extension(string)	Element id MedicationDispense.quantity.extension:quantityText Short description Quantity representation Alternate names extensions, user content Definition Quantity representation. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(string) Extension URL https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationQuantityText-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
value	Σ	0..1	decimal	There are no (further) constraints on this element Element id MedicationDispense.quantity.value Short description Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value. Requirements Precision is handled implicitly in almost all cases of measurement. Comments The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books). Data type decimal Mappings v2: SN.2 / CQ - N/A rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
comparator	Σ ?!	0..0	codeBinding	There are no (further) constraints on this element Element id MedicationDispense.quantity.comparator Short description < \| <= \| >= \| > - how to understand the value Definition Not allowed to be used in this context Requirements Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Comments This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value. Meaning when missing If there is no comparator, then there is no modification of the value Data type code Binding How the Quantity should be understood and represented. QuantityComparator (required) Mappings v2: SN.1 / CQ.1 rim: IVL properties
unit	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.quantity.unit Short description Unit representation Definition A human-readable form of the unit. Requirements There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Data type string Mappings v2: (see OBX.6 etc.) / CQ.2 rim: PQ.unit
system	Σ I	0..1	uri	There are no (further) constraints on this element Element id MedicationDispense.quantity.system Short description System that defines coded unit form Definition The identification of the system that provides the coded form of the unit. Requirements Need to know the system that defines the coded form of the unit. Data type uri Mappings v2: (see OBX.6 etc.) / CQ.2 rim: CO.codeSystem, PQ.translation.codeSystem
code	Σ	0..1	code	There are no (further) constraints on this element Element id MedicationDispense.quantity.code Short description Coded form of the unit Definition A computer processable form of the unit in some unit representation system. Requirements Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest. Comments The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system. Data type code Mappings v2: (see OBX.6 etc.) / CQ.2 rim: PQ.code, MO.currency, PQ.translation.code
daysSupply		0..1	SimpleQuantity	There are no (further) constraints on this element Element id MedicationDispense.daysSupply Short description Amount of medication expressed as a timing amount Definition The amount of medication expressed as a timing amount. Data type SimpleQuantity Mappings v2: TQ1.6 Timing/Quantity Segment Service Duration. Prior to v2.5, ORC.7.3 Common Order Segment / Quantity/Timing / Duration component. This is a formatted string, first character for the time unit (e.g., D=days), followed by the value. For example, “D14” represents “14 days supply” From v2.5 on, TQ1.6 Timing/Quantity Segment / Service Duration. This is a CQ data type (<Quantity (NM)> ^ <Units (CWE)>), thus for days supply, assuming the unit of measure is “days”, the numeric value is TQ1.6.1 (…\|14^ For backwards compatibility, ORC.7 was permitted through v2.6. Both forms (field and segment) may be present in v2.5, v2.5.1, and v2.6 rim: effectiveUseTime
whenPrepared	Σ	0..1	dateTime	There are no (further) constraints on this element Element id MedicationDispense.whenPrepared Short description When product was packaged and reviewed Definition The time when the dispensed product was packaged and reviewed. Data type dateTime Mappings v2: RXD-3-Date/Time Dispensed rim: .effectiveTime[xmi:type=IVL_TS].low
whenHandedOver		0..1	dateTime	There are no (further) constraints on this element Element id MedicationDispense.whenHandedOver Short description When product was given out Definition The time the dispensed product was provided to the patient or their representative. Data type dateTime Mappings workflow: …occurrenceDateTime v2: RXD-3-Date/Time Dispensed rim: .effectiveTime[xmi:type=IVL_TS].high
destination		0..1	Reference(CareConnect-Location-1)	Element id MedicationDispense.destination Short description Where the medication was sent Definition Identification of the facility/location where the medication was shipped to, as part of the dispense event. Data type Reference(CareConnect-Location-1) Mappings v2: RXD-13 Dispense-to Location; RXD-30 Dispense to Pharmacy; RXD-31 Dispense to Pharmacy Address rim: .participation[typeCode=DST].role
receiver		0..*	Reference(CareConnect-Patient-1 \| CareConnect-Practitioner-1)	Element id MedicationDispense.receiver Short description Who collected the medication Definition Identifies the person who picked up the medication. This will usually be a patient or their caregiver, but some cases exist where it can be a healthcare professional. Data type Reference(CareConnect-Patient-1 \| CareConnect-Practitioner-1) Mappings rim: .participation[typeCode=RCV].role
note		0..*	Annotation	There are no (further) constraints on this element Element id MedicationDispense.note Short description Information about the dispense Definition Extra information about the dispense that could not be conveyed in the other attributes. Data type Annotation Mappings workflow: …note v2: RXD-9 Dispense Notes rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=ACT,moodCode=EVN]
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.note.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension		0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.note.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings rim: n/a
author[x]	Σ	0..1		There are no (further) constraints on this element Element id MedicationDispense.note.author[x] Short description Individual responsible for the annotation Definition The individual responsible for making the annotation. Mappings v2: N/A rim: Act.participant[typeCode=AUT].role
authorString			string	Data type string
authorReference			Reference(CareConnect-RelatedPerson-1 \| CareConnect-Patient-1 \| CareConnect-Practitioner-1)	Data type Reference(CareConnect-RelatedPerson-1 \| CareConnect-Patient-1 \| CareConnect-Practitioner-1)
time	Σ	0..1	dateTime	There are no (further) constraints on this element Element id MedicationDispense.note.time Short description When the annotation was made Definition Indicates when this particular annotation was made. Data type dateTime Mappings v2: N/A rim: Act.effectiveTime
text		1..1	string	There are no (further) constraints on this element Element id MedicationDispense.note.text Short description The annotation - text content Definition The text of the annotation. Data type string Mappings v2: N/A rim: Act.text
dosageInstruction		0..*	Dosage	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction Short description How the medication is to be used by the patient or administered by the caregiver Definition Indicates how the medication is to be used by the patient. Comments 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. Data type Dosage Mappings rim: .outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]
substitution		0..1	BackboneElement	There are no (further) constraints on this element Element id MedicationDispense.substitution Short description Whether a substitution was performed on the dispense Definition Indicates whether or not substitution was made as part of the dispense. In some cases substitution will be expected but does not happen, in other cases substitution is not expected but does happen. This block explains what substitution did or did not happen and why. If nothing is specified, substitution was not done. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=COMP].target[classCode=SUBST, moodCode=EVN]
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.substitution.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension		0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.substitution.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Mappings rim: n/a
modifierExtension	Σ ?!	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.substitution.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Mappings rim: N/A
wasSubstituted		1..1	boolean	There are no (further) constraints on this element Element id MedicationDispense.substitution.wasSubstituted Short description Whether a substitution was or was not performed on the dispense Definition True if the dispenser dispensed a different drug or product from what was prescribed. Data type boolean Mappings rim: .actionNegationInd
type		0..1	CodeableConcept	There are no (further) constraints on this element Element id MedicationDispense.substitution.type Short description Code signifying whether a different drug was dispensed from what was prescribed Definition A code signifying whether a different drug was dispensed from what was prescribed. Data type CodeableConcept Binding A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription ActSubstanceAdminSubstitutionCode (example) Mappings v2: RXO-9-Allow Substitutions / RXE-9-Substitution Status rim: .code
reason		0..*	CodeableConcept	There are no (further) constraints on this element Element id MedicationDispense.substitution.reason Short description Why was substitution made Definition Indicates the reason for the substitution of (or lack of substitution) from what was prescribed. Data type CodeableConcept Binding A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed SubstanceAdminSubstitutionReason (example) Mappings rim: .reasonCode
responsibleParty		0..*	Reference(CareConnect-Practitioner-1)	Element id MedicationDispense.substitution.responsibleParty Short description Who is responsible for the substitution Definition The person or organization that has primary responsibility for the substitution. Data type Reference(CareConnect-Practitioner-1) Mappings rim: .participation[typeCode=PFM].role[classCode=ASSIGN]
detectedIssue		0..*	Reference(DetectedIssue)	There are no (further) constraints on this element Element id MedicationDispense.detectedIssue Short description Clinical issue with action Alternate names Contraindication, Drug Utilization Review (DUR), Alert Definition Indicates 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. Data type Reference(DetectedIssue) Mappings rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value
notDone		0..1	boolean	There are no (further) constraints on this element Element id MedicationDispense.notDone Short description Whether the dispense was or was not performed Definition True if the dispense was not performed for some reason. Data type boolean Mappings workflow: …notDone rim: .actionNegationInd
notDoneReason[x]		0..1		There are no (further) constraints on this element Element id MedicationDispense.notDoneReason[x] Short description Why a dispense was not performed Definition Indicates the reason why a dispense was not performed. Mappings workflow: …notDoneReason rim: .outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code="not done reason"].value
notDoneReasonCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data type CodeableConcept
notDoneReasonReference			Reference(DetectedIssue)	There are no (further) constraints on this element Data type Reference(DetectedIssue)
eventHistory		0..*	Reference(Provenance)	There are no (further) constraints on this element Element id MedicationDispense.eventHistory Short description A list of releveant lifecycle events Definition A summary of the events of interest that have occurred, such as when the dispense was verified. Comments This may not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.). Data type Reference(Provenance) Mappings rim: .inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]

Differential View

CareConnect-MedicationDispense-1 (MedicationDispense)	I		MedicationDispense	There are no (further) constraints on this element Element id MedicationDispense Short description Dispensing a medication to a named patient Definition Indicates 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. Comments The WG will be updating the MedicationDispense resource to adjust each affected resource to align with the workflow pattern (see workflow.html). Data type MedicationDispense Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative `contained.text.empty()` dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource `contained.where(('#'+id in %resource.descendants().reference).not()).empty()` mdd-1: whenHandedOver cannot be before whenPrepared `whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared` Mappings rim: Entity. Role, or Act workflow: ..Event rim: Supply[moodCode=EVN] w5: clinical.medication
id	Σ	0..1	id	There are no (further) constraints on this element Element id MedicationDispense.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type id
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id MedicationDispense.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource. Data type Meta
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id MedicationDispense.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation. Data type uri
language		0..1	codeBinding	There are no (further) constraints on this element Element id MedicationDispense.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. Common Languages (extensible)
text	I	0..1	Narrative	There are no (further) constraints on this element Element id MedicationDispense.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later. Data type Narrative Mappings rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id MedicationDispense.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Data type Resource Mappings rim: N/A
extension		0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Mappings rim: N/A
modifierExtension	?!	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Mappings rim: N/A
identifier		0..*	Identifier	There are no (further) constraints on this element Element id MedicationDispense.identifier Short description External identifier Definition Identifier assigned by the dispensing facility - this is an identifier assigned outside FHIR. Data type Identifier Mappings workflow: …identifier rim: .id w5: id
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.identifier.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension		0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.identifier.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings rim: n/a
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id MedicationDispense.identifier.use Short description usual \| official \| temp \| secondary (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Mappings v2: N/A rim: Role.code or implied by context
type	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id MedicationDispense.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments 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. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) Mappings v2: CX.5 rim: Role.code or implied by context
system	Σ	1..1	uri	There are no (further) constraints on this element Element id MedicationDispense.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements 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. Data type uri Examples General http://www.acme.com/identifiers/patient Mappings v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType
value	Σ	1..1	string	There are no (further) constraints on this element Element id MedicationDispense.identifier.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments 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. Data type string Examples General 123456 Mappings v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value
period	Σ	0..1	Period	There are no (further) constraints on this element Element id MedicationDispense.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Data type Period Mappings v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
assigner	Σ	0..1	Reference(CareConnect-Organization-1)	Element id MedicationDispense.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments 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. Data type Reference(CareConnect-Organization-1) Mappings v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
partOf		0..*	Reference(CareConnect-Procedure-1)	Element id MedicationDispense.partOf Short description Event that dispense is part of Definition The procedure that the dispense is done because of. Data type Reference(CareConnect-Procedure-1) Mappings workflow: …part of rim: .outboundRelationship[typeCode=COMP]/target[classCode=PROC,moodCode=EVN]
status	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id MedicationDispense.status Short description preparation \| in-progress \| on-hold \| completed \| entered-in-error \| stopped Definition A code specifying the state of the set of dispense events. Comments This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. Data type code Binding A coded concept specifying the state of the dispense event. MedicationDispenseStatus (required) Mappings workflow: …status rim: .statusCode w5: status
category		0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id MedicationDispense.category Short description Type of medication dispense Definition Indicates type of medication dispense and where the medication is expected to be consumed or administered. Data type CodeableConcept Binding A code describing where the dispensed medication is expected to be consumed or administered MedicationDispenseCategory (preferred) Mappings rim: .inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication dispense"].value
medication[x]	Σ	1..1		Element id MedicationDispense.medication[x] Short description What medication was supplied Definition Identifies 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. Comments 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. . Binding A coded concept identifying which substance or product can be dispensed SNOMED CT Medication Codes (example) Mappings workflow: …code v2: RXD-2-Dispense/Give Code rim: .participation[typeCode=PRD].role w5: what
medicationCodeableConcept			CodeableConcept	Data type CodeableConcept
medicationReference			Reference(CareConnect-Medication-1)	Data type Reference(CareConnect-Medication-1)
subject	Σ	0..1	Reference(Group \| CareConnect-Patient-1)	Element id MedicationDispense.subject Short description Who the dispense is for Definition A link to a resource representing the person or the group to whom the medication will be given. Comments SubstanceAdministration->subject->Patient. Data type Reference(Group \| CareConnect-Patient-1) Mappings workflow: …subject v2: PID-3-Patient ID List rim: .participation[typeCode=SBJ].role[classCode=PAT] w5: who.focus
context		0..1	Reference(CareConnect-EpisodeOfCare-1 \| CareConnect-Encounter-1)	Element id MedicationDispense.context Short description Encounter / Episode associated with event Definition The encounter or episode of care that establishes the context for this event. Data type Reference(CareConnect-EpisodeOfCare-1 \| CareConnect-Encounter-1) Mappings workflow: …context rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]
supportingInformation		0..*	Reference(Resource)	There are no (further) constraints on this element Element id MedicationDispense.supportingInformation Short description Information that supports the dispensing of the medication Definition Additional information that supports the medication being dispensed. Data type Reference(Resource) Mappings rim: .outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)] w5: context
performer		0..*	BackboneElement	There are no (further) constraints on this element Element id MedicationDispense.performer Short description Who performed event Definition Indicates who or what performed the event. It should be assumed that the performer is the dispenser of the medication. Comments The performer will be reviewed as part of STU4. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings workflow: …performer rim: .participation[typeCode=PRF]
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.performer.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension		0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.performer.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Mappings rim: n/a
modifierExtension	Σ ?!	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.performer.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Mappings rim: N/A
actor		1..1	Reference(Device \| CareConnect-RelatedPerson-1 \| CareConnect-Organization-1 \| CareConnect-Patient-1 \| CareConnect-Practitioner-1)	Element id MedicationDispense.performer.actor Short description Individual who was performing Definition The device, practitioner, etc. who performed the action. It should be assumed that the actor is the dispenser of the medication. Data type Reference(Device \| CareConnect-RelatedPerson-1 \| CareConnect-Organization-1 \| CareConnect-Patient-1 \| CareConnect-Practitioner-1) Mappings workflow: ….actor rim: .role
onBehalfOf		0..1	Reference(CareConnect-Organization-1)	Element id MedicationDispense.performer.onBehalfOf Short description Organization organization was acting for Definition The organization the device or practitioner was acting on behalf of. Data type Reference(CareConnect-Organization-1) Mappings workflow: ….onBehalfOf rim: .role.scopingOrganization
authorizingPrescription		0..*	Reference(CareConnect-MedicationRequest-1)	Element id MedicationDispense.authorizingPrescription Short description Medication order that authorizes the dispense Definition Indicates the medication order that is being dispensed against. Comments Maps to basedOn in Event logical model. Data type Reference(CareConnect-MedicationRequest-1) Mappings workflow: …basedOn v2: ORC-2 Placer Order Number rim: .outboundRelationship[typeCode=FLFS].target[moodCode=RQO]
type		0..1	CodeableConceptBinding	Element id MedicationDispense.type Short description To identify the type of medication supply. Definition Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc. Data type CodeableConcept Binding A ValueSet to identify the type of medication supply. Care Connect Medication Supply Type (preferred) Mappings v2: RXD-33-Dispense Type rim: .code
quantity		0..1	SimpleQuantity	There are no (further) constraints on this element Element id MedicationDispense.quantity Short description Amount dispensed Definition The amount of medication that has been dispensed. Includes unit of measure. Data type SimpleQuantity Mappings v2: RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense Units.name of coding system rim: .quantity
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.quantity.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension		0..*	Extension	Element id MedicationDispense.quantity.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings rim: n/a
quantityText	I	0..1	Extension(string)	Element id MedicationDispense.quantity.extension:quantityText Short description Quantity representation Alternate names extensions, user content Definition Quantity representation. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(string) Extension URL https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationQuantityText-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
value	Σ	0..1	decimal	There are no (further) constraints on this element Element id MedicationDispense.quantity.value Short description Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value. Requirements Precision is handled implicitly in almost all cases of measurement. Comments The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books). Data type decimal Mappings v2: SN.2 / CQ - N/A rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
comparator	Σ ?!	0..0	codeBinding	There are no (further) constraints on this element Element id MedicationDispense.quantity.comparator Short description < \| <= \| >= \| > - how to understand the value Definition Not allowed to be used in this context Requirements Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Comments This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value. Meaning when missing If there is no comparator, then there is no modification of the value Data type code Binding How the Quantity should be understood and represented. QuantityComparator (required) Mappings v2: SN.1 / CQ.1 rim: IVL properties
unit	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.quantity.unit Short description Unit representation Definition A human-readable form of the unit. Requirements There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Data type string Mappings v2: (see OBX.6 etc.) / CQ.2 rim: PQ.unit
system	Σ I	0..1	uri	There are no (further) constraints on this element Element id MedicationDispense.quantity.system Short description System that defines coded unit form Definition The identification of the system that provides the coded form of the unit. Requirements Need to know the system that defines the coded form of the unit. Data type uri Mappings v2: (see OBX.6 etc.) / CQ.2 rim: CO.codeSystem, PQ.translation.codeSystem
code	Σ	0..1	code	There are no (further) constraints on this element Element id MedicationDispense.quantity.code Short description Coded form of the unit Definition A computer processable form of the unit in some unit representation system. Requirements Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest. Comments The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system. Data type code Mappings v2: (see OBX.6 etc.) / CQ.2 rim: PQ.code, MO.currency, PQ.translation.code
daysSupply		0..1	SimpleQuantity	There are no (further) constraints on this element Element id MedicationDispense.daysSupply Short description Amount of medication expressed as a timing amount Definition The amount of medication expressed as a timing amount. Data type SimpleQuantity Mappings v2: TQ1.6 Timing/Quantity Segment Service Duration. Prior to v2.5, ORC.7.3 Common Order Segment / Quantity/Timing / Duration component. This is a formatted string, first character for the time unit (e.g., D=days), followed by the value. For example, “D14” represents “14 days supply” From v2.5 on, TQ1.6 Timing/Quantity Segment / Service Duration. This is a CQ data type (<Quantity (NM)> ^ <Units (CWE)>), thus for days supply, assuming the unit of measure is “days”, the numeric value is TQ1.6.1 (…\|14^ For backwards compatibility, ORC.7 was permitted through v2.6. Both forms (field and segment) may be present in v2.5, v2.5.1, and v2.6 rim: effectiveUseTime
whenPrepared	Σ	0..1	dateTime	There are no (further) constraints on this element Element id MedicationDispense.whenPrepared Short description When product was packaged and reviewed Definition The time when the dispensed product was packaged and reviewed. Data type dateTime Mappings v2: RXD-3-Date/Time Dispensed rim: .effectiveTime[xmi:type=IVL_TS].low
whenHandedOver		0..1	dateTime	There are no (further) constraints on this element Element id MedicationDispense.whenHandedOver Short description When product was given out Definition The time the dispensed product was provided to the patient or their representative. Data type dateTime Mappings workflow: …occurrenceDateTime v2: RXD-3-Date/Time Dispensed rim: .effectiveTime[xmi:type=IVL_TS].high
destination		0..1	Reference(CareConnect-Location-1)	Element id MedicationDispense.destination Short description Where the medication was sent Definition Identification of the facility/location where the medication was shipped to, as part of the dispense event. Data type Reference(CareConnect-Location-1) Mappings v2: RXD-13 Dispense-to Location; RXD-30 Dispense to Pharmacy; RXD-31 Dispense to Pharmacy Address rim: .participation[typeCode=DST].role
receiver		0..*	Reference(CareConnect-Patient-1 \| CareConnect-Practitioner-1)	Element id MedicationDispense.receiver Short description Who collected the medication Definition Identifies the person who picked up the medication. This will usually be a patient or their caregiver, but some cases exist where it can be a healthcare professional. Data type Reference(CareConnect-Patient-1 \| CareConnect-Practitioner-1) Mappings rim: .participation[typeCode=RCV].role
note		0..*	Annotation	There are no (further) constraints on this element Element id MedicationDispense.note Short description Information about the dispense Definition Extra information about the dispense that could not be conveyed in the other attributes. Data type Annotation Mappings workflow: …note v2: RXD-9 Dispense Notes rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=ACT,moodCode=EVN]
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.note.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension		0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.note.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings rim: n/a
author[x]	Σ	0..1		There are no (further) constraints on this element Element id MedicationDispense.note.author[x] Short description Individual responsible for the annotation Definition The individual responsible for making the annotation. Mappings v2: N/A rim: Act.participant[typeCode=AUT].role
authorString			string	Data type string
authorReference			Reference(CareConnect-RelatedPerson-1 \| CareConnect-Patient-1 \| CareConnect-Practitioner-1)	Data type Reference(CareConnect-RelatedPerson-1 \| CareConnect-Patient-1 \| CareConnect-Practitioner-1)
time	Σ	0..1	dateTime	There are no (further) constraints on this element Element id MedicationDispense.note.time Short description When the annotation was made Definition Indicates when this particular annotation was made. Data type dateTime Mappings v2: N/A rim: Act.effectiveTime
text		1..1	string	There are no (further) constraints on this element Element id MedicationDispense.note.text Short description The annotation - text content Definition The text of the annotation. Data type string Mappings v2: N/A rim: Act.text
dosageInstruction		0..*	Dosage	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction Short description How the medication is to be used by the patient or administered by the caregiver Definition Indicates how the medication is to be used by the patient. Comments 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. Data type Dosage Mappings rim: .outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]
substitution		0..1	BackboneElement	There are no (further) constraints on this element Element id MedicationDispense.substitution Short description Whether a substitution was performed on the dispense Definition Indicates whether or not substitution was made as part of the dispense. In some cases substitution will be expected but does not happen, in other cases substitution is not expected but does happen. This block explains what substitution did or did not happen and why. If nothing is specified, substitution was not done. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=COMP].target[classCode=SUBST, moodCode=EVN]
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.substitution.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension		0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.substitution.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Mappings rim: n/a
modifierExtension	Σ ?!	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.substitution.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Mappings rim: N/A
wasSubstituted		1..1	boolean	There are no (further) constraints on this element Element id MedicationDispense.substitution.wasSubstituted Short description Whether a substitution was or was not performed on the dispense Definition True if the dispenser dispensed a different drug or product from what was prescribed. Data type boolean Mappings rim: .actionNegationInd
type		0..1	CodeableConcept	There are no (further) constraints on this element Element id MedicationDispense.substitution.type Short description Code signifying whether a different drug was dispensed from what was prescribed Definition A code signifying whether a different drug was dispensed from what was prescribed. Data type CodeableConcept Binding A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription ActSubstanceAdminSubstitutionCode (example) Mappings v2: RXO-9-Allow Substitutions / RXE-9-Substitution Status rim: .code
reason		0..*	CodeableConcept	There are no (further) constraints on this element Element id MedicationDispense.substitution.reason Short description Why was substitution made Definition Indicates the reason for the substitution of (or lack of substitution) from what was prescribed. Data type CodeableConcept Binding A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed SubstanceAdminSubstitutionReason (example) Mappings rim: .reasonCode
responsibleParty		0..*	Reference(CareConnect-Practitioner-1)	Element id MedicationDispense.substitution.responsibleParty Short description Who is responsible for the substitution Definition The person or organization that has primary responsibility for the substitution. Data type Reference(CareConnect-Practitioner-1) Mappings rim: .participation[typeCode=PFM].role[classCode=ASSIGN]
detectedIssue		0..*	Reference(DetectedIssue)	There are no (further) constraints on this element Element id MedicationDispense.detectedIssue Short description Clinical issue with action Alternate names Contraindication, Drug Utilization Review (DUR), Alert Definition Indicates 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. Data type Reference(DetectedIssue) Mappings rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value
notDone		0..1	boolean	There are no (further) constraints on this element Element id MedicationDispense.notDone Short description Whether the dispense was or was not performed Definition True if the dispense was not performed for some reason. Data type boolean Mappings workflow: …notDone rim: .actionNegationInd
notDoneReason[x]		0..1		There are no (further) constraints on this element Element id MedicationDispense.notDoneReason[x] Short description Why a dispense was not performed Definition Indicates the reason why a dispense was not performed. Mappings workflow: …notDoneReason rim: .outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code="not done reason"].value
notDoneReasonCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data type CodeableConcept
notDoneReasonReference			Reference(DetectedIssue)	There are no (further) constraints on this element Data type Reference(DetectedIssue)
eventHistory		0..*	Reference(Provenance)	There are no (further) constraints on this element Element id MedicationDispense.eventHistory Short description A list of releveant lifecycle events Definition A summary of the events of interest that have occurred, such as when the dispense was verified. Comments This may not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.). Data type Reference(Provenance) Mappings rim: .inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]

Hybrid View

CareConnect-MedicationDispense-1 (MedicationDispense)	I		MedicationDispense	There are no (further) constraints on this element Element id MedicationDispense Short description Dispensing a medication to a named patient Definition Indicates 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. Comments The WG will be updating the MedicationDispense resource to adjust each affected resource to align with the workflow pattern (see workflow.html). Data type MedicationDispense Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative `contained.text.empty()` dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource `contained.where(('#'+id in %resource.descendants().reference).not()).empty()` mdd-1: whenHandedOver cannot be before whenPrepared `whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared` Mappings rim: Entity. Role, or Act workflow: ..Event rim: Supply[moodCode=EVN] w5: clinical.medication
id	Σ	0..1	id	There are no (further) constraints on this element Element id MedicationDispense.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type id
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id MedicationDispense.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource. Data type Meta
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id MedicationDispense.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation. Data type uri
language		0..1	codeBinding	There are no (further) constraints on this element Element id MedicationDispense.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. Common Languages (extensible)
text	I	0..1	Narrative	There are no (further) constraints on this element Element id MedicationDispense.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later. Data type Narrative Mappings rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id MedicationDispense.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Data type Resource Mappings rim: N/A
extension		0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Mappings rim: N/A
modifierExtension	?!	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Mappings rim: N/A
identifier		0..*	Identifier	There are no (further) constraints on this element Element id MedicationDispense.identifier Short description External identifier Definition Identifier assigned by the dispensing facility - this is an identifier assigned outside FHIR. Data type Identifier Mappings workflow: …identifier rim: .id w5: id
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.identifier.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension		0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.identifier.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings rim: n/a
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id MedicationDispense.identifier.use Short description usual \| official \| temp \| secondary (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Mappings v2: N/A rim: Role.code or implied by context
type	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id MedicationDispense.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments 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. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) Mappings v2: CX.5 rim: Role.code or implied by context
system	Σ	1..1	uri	There are no (further) constraints on this element Element id MedicationDispense.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements 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. Data type uri Examples General http://www.acme.com/identifiers/patient Mappings v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType
value	Σ	1..1	string	There are no (further) constraints on this element Element id MedicationDispense.identifier.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments 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. Data type string Examples General 123456 Mappings v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value
period	Σ	0..1	Period	There are no (further) constraints on this element Element id MedicationDispense.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Data type Period Mappings v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
assigner	Σ	0..1	Reference(CareConnect-Organization-1)	Element id MedicationDispense.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments 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. Data type Reference(CareConnect-Organization-1) Mappings v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
partOf		0..*	Reference(CareConnect-Procedure-1)	Element id MedicationDispense.partOf Short description Event that dispense is part of Definition The procedure that the dispense is done because of. Data type Reference(CareConnect-Procedure-1) Mappings workflow: …part of rim: .outboundRelationship[typeCode=COMP]/target[classCode=PROC,moodCode=EVN]
status	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id MedicationDispense.status Short description preparation \| in-progress \| on-hold \| completed \| entered-in-error \| stopped Definition A code specifying the state of the set of dispense events. Comments This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. Data type code Binding A coded concept specifying the state of the dispense event. MedicationDispenseStatus (required) Mappings workflow: …status rim: .statusCode w5: status
category		0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id MedicationDispense.category Short description Type of medication dispense Definition Indicates type of medication dispense and where the medication is expected to be consumed or administered. Data type CodeableConcept Binding A code describing where the dispensed medication is expected to be consumed or administered MedicationDispenseCategory (preferred) Mappings rim: .inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication dispense"].value
medication[x]	Σ	1..1		Element id MedicationDispense.medication[x] Short description What medication was supplied Definition Identifies 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. Comments 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. . Binding A coded concept identifying which substance or product can be dispensed SNOMED CT Medication Codes (example) Mappings workflow: …code v2: RXD-2-Dispense/Give Code rim: .participation[typeCode=PRD].role w5: what
medicationCodeableConcept			CodeableConcept	Data type CodeableConcept
medicationReference			Reference(CareConnect-Medication-1)	Data type Reference(CareConnect-Medication-1)
subject	Σ	0..1	Reference(Group \| CareConnect-Patient-1)	Element id MedicationDispense.subject Short description Who the dispense is for Definition A link to a resource representing the person or the group to whom the medication will be given. Comments SubstanceAdministration->subject->Patient. Data type Reference(Group \| CareConnect-Patient-1) Mappings workflow: …subject v2: PID-3-Patient ID List rim: .participation[typeCode=SBJ].role[classCode=PAT] w5: who.focus
context		0..1	Reference(CareConnect-EpisodeOfCare-1 \| CareConnect-Encounter-1)	Element id MedicationDispense.context Short description Encounter / Episode associated with event Definition The encounter or episode of care that establishes the context for this event. Data type Reference(CareConnect-EpisodeOfCare-1 \| CareConnect-Encounter-1) Mappings workflow: …context rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]
supportingInformation		0..*	Reference(Resource)	There are no (further) constraints on this element Element id MedicationDispense.supportingInformation Short description Information that supports the dispensing of the medication Definition Additional information that supports the medication being dispensed. Data type Reference(Resource) Mappings rim: .outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)] w5: context
performer		0..*	BackboneElement	There are no (further) constraints on this element Element id MedicationDispense.performer Short description Who performed event Definition Indicates who or what performed the event. It should be assumed that the performer is the dispenser of the medication. Comments The performer will be reviewed as part of STU4. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings workflow: …performer rim: .participation[typeCode=PRF]
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.performer.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension		0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.performer.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Mappings rim: n/a
modifierExtension	Σ ?!	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.performer.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Mappings rim: N/A
actor		1..1	Reference(Device \| CareConnect-RelatedPerson-1 \| CareConnect-Organization-1 \| CareConnect-Patient-1 \| CareConnect-Practitioner-1)	Element id MedicationDispense.performer.actor Short description Individual who was performing Definition The device, practitioner, etc. who performed the action. It should be assumed that the actor is the dispenser of the medication. Data type Reference(Device \| CareConnect-RelatedPerson-1 \| CareConnect-Organization-1 \| CareConnect-Patient-1 \| CareConnect-Practitioner-1) Mappings workflow: ….actor rim: .role
onBehalfOf		0..1	Reference(CareConnect-Organization-1)	Element id MedicationDispense.performer.onBehalfOf Short description Organization organization was acting for Definition The organization the device or practitioner was acting on behalf of. Data type Reference(CareConnect-Organization-1) Mappings workflow: ….onBehalfOf rim: .role.scopingOrganization
authorizingPrescription		0..*	Reference(CareConnect-MedicationRequest-1)	Element id MedicationDispense.authorizingPrescription Short description Medication order that authorizes the dispense Definition Indicates the medication order that is being dispensed against. Comments Maps to basedOn in Event logical model. Data type Reference(CareConnect-MedicationRequest-1) Mappings workflow: …basedOn v2: ORC-2 Placer Order Number rim: .outboundRelationship[typeCode=FLFS].target[moodCode=RQO]
type		0..1	CodeableConceptBinding	Element id MedicationDispense.type Short description To identify the type of medication supply. Definition Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc. Data type CodeableConcept Binding A ValueSet to identify the type of medication supply. Care Connect Medication Supply Type (preferred) Mappings v2: RXD-33-Dispense Type rim: .code
quantity		0..1	SimpleQuantity	There are no (further) constraints on this element Element id MedicationDispense.quantity Short description Amount dispensed Definition The amount of medication that has been dispensed. Includes unit of measure. Data type SimpleQuantity Mappings v2: RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense Units.name of coding system rim: .quantity
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.quantity.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension		0..*	Extension	Element id MedicationDispense.quantity.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings rim: n/a
quantityText	I	0..1	Extension(string)	Element id MedicationDispense.quantity.extension:quantityText Short description Quantity representation Alternate names extensions, user content Definition Quantity representation. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(string) Extension URL https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-MedicationQuantityText-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
value	Σ	0..1	decimal	There are no (further) constraints on this element Element id MedicationDispense.quantity.value Short description Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value. Requirements Precision is handled implicitly in almost all cases of measurement. Comments The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books). Data type decimal Mappings v2: SN.2 / CQ - N/A rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
comparator	Σ ?!	0..0	codeBinding	There are no (further) constraints on this element Element id MedicationDispense.quantity.comparator Short description < \| <= \| >= \| > - how to understand the value Definition Not allowed to be used in this context Requirements Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Comments This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value. Meaning when missing If there is no comparator, then there is no modification of the value Data type code Binding How the Quantity should be understood and represented. QuantityComparator (required) Mappings v2: SN.1 / CQ.1 rim: IVL properties
unit	Σ	0..1	string	There are no (further) constraints on this element Element id MedicationDispense.quantity.unit Short description Unit representation Definition A human-readable form of the unit. Requirements There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Data type string Mappings v2: (see OBX.6 etc.) / CQ.2 rim: PQ.unit
system	Σ I	0..1	uri	There are no (further) constraints on this element Element id MedicationDispense.quantity.system Short description System that defines coded unit form Definition The identification of the system that provides the coded form of the unit. Requirements Need to know the system that defines the coded form of the unit. Data type uri Mappings v2: (see OBX.6 etc.) / CQ.2 rim: CO.codeSystem, PQ.translation.codeSystem
code	Σ	0..1	code	There are no (further) constraints on this element Element id MedicationDispense.quantity.code Short description Coded form of the unit Definition A computer processable form of the unit in some unit representation system. Requirements Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest. Comments The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system. Data type code Mappings v2: (see OBX.6 etc.) / CQ.2 rim: PQ.code, MO.currency, PQ.translation.code
daysSupply		0..1	SimpleQuantity	There are no (further) constraints on this element Element id MedicationDispense.daysSupply Short description Amount of medication expressed as a timing amount Definition The amount of medication expressed as a timing amount. Data type SimpleQuantity Mappings v2: TQ1.6 Timing/Quantity Segment Service Duration. Prior to v2.5, ORC.7.3 Common Order Segment / Quantity/Timing / Duration component. This is a formatted string, first character for the time unit (e.g., D=days), followed by the value. For example, “D14” represents “14 days supply” From v2.5 on, TQ1.6 Timing/Quantity Segment / Service Duration. This is a CQ data type (<Quantity (NM)> ^ <Units (CWE)>), thus for days supply, assuming the unit of measure is “days”, the numeric value is TQ1.6.1 (…\|14^ For backwards compatibility, ORC.7 was permitted through v2.6. Both forms (field and segment) may be present in v2.5, v2.5.1, and v2.6 rim: effectiveUseTime
whenPrepared	Σ	0..1	dateTime	There are no (further) constraints on this element Element id MedicationDispense.whenPrepared Short description When product was packaged and reviewed Definition The time when the dispensed product was packaged and reviewed. Data type dateTime Mappings v2: RXD-3-Date/Time Dispensed rim: .effectiveTime[xmi:type=IVL_TS].low
whenHandedOver		0..1	dateTime	There are no (further) constraints on this element Element id MedicationDispense.whenHandedOver Short description When product was given out Definition The time the dispensed product was provided to the patient or their representative. Data type dateTime Mappings workflow: …occurrenceDateTime v2: RXD-3-Date/Time Dispensed rim: .effectiveTime[xmi:type=IVL_TS].high
destination		0..1	Reference(CareConnect-Location-1)	Element id MedicationDispense.destination Short description Where the medication was sent Definition Identification of the facility/location where the medication was shipped to, as part of the dispense event. Data type Reference(CareConnect-Location-1) Mappings v2: RXD-13 Dispense-to Location; RXD-30 Dispense to Pharmacy; RXD-31 Dispense to Pharmacy Address rim: .participation[typeCode=DST].role
receiver		0..*	Reference(CareConnect-Patient-1 \| CareConnect-Practitioner-1)	Element id MedicationDispense.receiver Short description Who collected the medication Definition Identifies the person who picked up the medication. This will usually be a patient or their caregiver, but some cases exist where it can be a healthcare professional. Data type Reference(CareConnect-Patient-1 \| CareConnect-Practitioner-1) Mappings rim: .participation[typeCode=RCV].role
note		0..*	Annotation	There are no (further) constraints on this element Element id MedicationDispense.note Short description Information about the dispense Definition Extra information about the dispense that could not be conveyed in the other attributes. Data type Annotation Mappings workflow: …note v2: RXD-9 Dispense Notes rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=ACT,moodCode=EVN]
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.note.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension		0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.note.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings rim: n/a
author[x]	Σ	0..1		There are no (further) constraints on this element Element id MedicationDispense.note.author[x] Short description Individual responsible for the annotation Definition The individual responsible for making the annotation. Mappings v2: N/A rim: Act.participant[typeCode=AUT].role
authorString			string	Data type string
authorReference			Reference(CareConnect-RelatedPerson-1 \| CareConnect-Patient-1 \| CareConnect-Practitioner-1)	Data type Reference(CareConnect-RelatedPerson-1 \| CareConnect-Patient-1 \| CareConnect-Practitioner-1)
time	Σ	0..1	dateTime	There are no (further) constraints on this element Element id MedicationDispense.note.time Short description When the annotation was made Definition Indicates when this particular annotation was made. Data type dateTime Mappings v2: N/A rim: Act.effectiveTime
text		1..1	string	There are no (further) constraints on this element Element id MedicationDispense.note.text Short description The annotation - text content Definition The text of the annotation. Data type string Mappings v2: N/A rim: Act.text
dosageInstruction		0..*	Dosage	There are no (further) constraints on this element Element id MedicationDispense.dosageInstruction Short description How the medication is to be used by the patient or administered by the caregiver Definition Indicates how the medication is to be used by the patient. Comments 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. Data type Dosage Mappings rim: .outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]
substitution		0..1	BackboneElement	There are no (further) constraints on this element Element id MedicationDispense.substitution Short description Whether a substitution was performed on the dispense Definition Indicates whether or not substitution was made as part of the dispense. In some cases substitution will be expected but does not happen, in other cases substitution is not expected but does happen. This block explains what substitution did or did not happen and why. If nothing is specified, substitution was not done. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: .outboundRelationship[typeCode=COMP].target[classCode=SUBST, moodCode=EVN]
id		0..1	string	There are no (further) constraints on this element Element id MedicationDispense.substitution.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension		0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.substitution.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Mappings rim: n/a
modifierExtension	Σ ?!	0..*	Extension	There are no (further) constraints on this element Element id MedicationDispense.substitution.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Mappings rim: N/A
wasSubstituted		1..1	boolean	There are no (further) constraints on this element Element id MedicationDispense.substitution.wasSubstituted Short description Whether a substitution was or was not performed on the dispense Definition True if the dispenser dispensed a different drug or product from what was prescribed. Data type boolean Mappings rim: .actionNegationInd
type		0..1	CodeableConcept	There are no (further) constraints on this element Element id MedicationDispense.substitution.type Short description Code signifying whether a different drug was dispensed from what was prescribed Definition A code signifying whether a different drug was dispensed from what was prescribed. Data type CodeableConcept Binding A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription ActSubstanceAdminSubstitutionCode (example) Mappings v2: RXO-9-Allow Substitutions / RXE-9-Substitution Status rim: .code
reason		0..*	CodeableConcept	There are no (further) constraints on this element Element id MedicationDispense.substitution.reason Short description Why was substitution made Definition Indicates the reason for the substitution of (or lack of substitution) from what was prescribed. Data type CodeableConcept Binding A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed SubstanceAdminSubstitutionReason (example) Mappings rim: .reasonCode
responsibleParty		0..*	Reference(CareConnect-Practitioner-1)	Element id MedicationDispense.substitution.responsibleParty Short description Who is responsible for the substitution Definition The person or organization that has primary responsibility for the substitution. Data type Reference(CareConnect-Practitioner-1) Mappings rim: .participation[typeCode=PFM].role[classCode=ASSIGN]
detectedIssue		0..*	Reference(DetectedIssue)	There are no (further) constraints on this element Element id MedicationDispense.detectedIssue Short description Clinical issue with action Alternate names Contraindication, Drug Utilization Review (DUR), Alert Definition Indicates 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. Data type Reference(DetectedIssue) Mappings rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value
notDone		0..1	boolean	There are no (further) constraints on this element Element id MedicationDispense.notDone Short description Whether the dispense was or was not performed Definition True if the dispense was not performed for some reason. Data type boolean Mappings workflow: …notDone rim: .actionNegationInd
notDoneReason[x]		0..1		There are no (further) constraints on this element Element id MedicationDispense.notDoneReason[x] Short description Why a dispense was not performed Definition Indicates the reason why a dispense was not performed. Mappings workflow: …notDoneReason rim: .outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code="not done reason"].value
notDoneReasonCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data type CodeableConcept
notDoneReasonReference			Reference(DetectedIssue)	There are no (further) constraints on this element Data type Reference(DetectedIssue)
eventHistory		0..*	Reference(Provenance)	There are no (further) constraints on this element Element id MedicationDispense.eventHistory Short description A list of releveant lifecycle events Definition A summary of the events of interest that have occurred, such as when the dispense was verified. Comments This may not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.). Data type Reference(Provenance) Mappings rim: .inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]

Table View

MedicationDispense		..
MedicationDispense.identifier		..
MedicationDispense.identifier.system		1..
MedicationDispense.identifier.value		1..
MedicationDispense.identifier.assigner	Reference(CareConnect-Organization-1)	..
MedicationDispense.partOf	Reference(CareConnect-Procedure-1)	..
MedicationDispense.medication[x]	Reference(CareConnect-Medication-1), CodeableConcept	..
MedicationDispense.subject	Reference(Group \| CareConnect-Patient-1)	..
MedicationDispense.context	Reference(CareConnect-EpisodeOfCare-1 \| CareConnect-Encounter-1)	..
MedicationDispense.performer		..
MedicationDispense.performer.actor	Reference(Device \| CareConnect-RelatedPerson-1 \| CareConnect-Organization-1 \| CareConnect-Patient-1 \| CareConnect-Practitioner-1)	..
MedicationDispense.performer.onBehalfOf	Reference(CareConnect-Organization-1)	..
MedicationDispense.authorizingPrescription	Reference(CareConnect-MedicationRequest-1)	..
MedicationDispense.type		..
MedicationDispense.quantity		..
MedicationDispense.quantity.extension		0..
MedicationDispense.quantity.extension	Extension	0..1
MedicationDispense.destination	Reference(CareConnect-Location-1)	..
MedicationDispense.receiver	Reference(CareConnect-Patient-1 \| CareConnect-Practitioner-1)	..
MedicationDispense.note		..
MedicationDispense.note.author[x]	Reference(CareConnect-RelatedPerson-1 \| CareConnect-Patient-1 \| CareConnect-Practitioner-1), string	..
MedicationDispense.substitution		..
MedicationDispense.substitution.responsibleParty	Reference(CareConnect-Practitioner-1)	..

Examples

Profile specific implementation guidance:

There is no specific guidance for this profile.