- This version of the UK Core is a development copy.
- This contains BREAKING CHANGES as a result of the C&TA Sprint 7 Review, and STU2 Sequence ballot reconciliation.
- This version is not yet reviewed for implementation. Other versions are available on the UK Core Version History Guide
- Please follow the guidance on the Contact Us page if you need any assistance.
- A summary of changes is available on the STU3 Sequence Change Log
StructureDefinition UKCore-MedicationDispense
Canonical_URL | Status | Current_Version | Last_Updated | Description |
---|---|---|---|---|
https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationDispense | active | 2.4.0 | 2024-07-11 | This profile defines the UK constraints and extensions on the International FHIR resource MedicationDispense. |
Profile_Purpose |
---|
This profile covers the supply of medications to a patient. Examples include dispensing and pick-up from an outpatient or community pharmacy, dispensing patient-specific medications from inpatient pharmacy to ward, as well as issuing a single dose from ward stock to a patient for consumption. The medication dispense is the result of a pharmacy system responding to a medication order. |
Detailed Descriptions
MedicationDispense | |
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. |
Cardinality | 0...* |
Invariants |
|
Mappings |
|
MedicationDispense.id | |
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. |
Cardinality | 0...1 |
Type | string |
Summary | True |
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. |
MedicationDispense.meta | |
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. |
Cardinality | 0...1 |
Type | Meta |
Summary | True |
Invariants |
|
Mappings |
|
MedicationDispense.implicitRules | |
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. |
Cardinality | 0...1 |
Type | uri |
Modifier | True |
Summary | True |
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. |
Invariants |
|
Mappings |
|
MedicationDispense.language | |
Definition | The base language in which the resource is written. |
Cardinality | 0...1 |
Type | code |
Binding | A human language. |
Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). |
Invariants |
|
Mappings |
|
MedicationDispense.text | |
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. |
Cardinality | 0...1 |
Type | Narrative |
Alias | narrative, html, xhtml, display |
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. |
Invariants |
|
Mappings |
|
MedicationDispense.contained | |
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. |
Cardinality | 0...* |
Type | Resource |
Alias | inline resources, anonymous resources, contained resources |
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. |
Mappings |
|
MedicationDispense.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
|
Mappings |
|
MedicationDispense.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
Cardinality | 0...* |
Type | Extension |
Modifier | True |
Alias | extensions, user content |
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
|
Mappings |
|
MedicationDispense.identifier | |
Definition | Identifiers associated with this Medication Dispense that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server. |
Cardinality | 0...* |
Type | Identifier |
Must Support | True |
Comments | This is a business identifier, not a resource identifier. |
Invariants |
|
Mappings |
|
MedicationDispense.partOf | |
Definition | The procedure that trigger the dispense. |
Cardinality | 0...* |
Type | Reference(Procedure) |
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. |
Invariants |
|
Mappings |
|
MedicationDispense.status | |
Definition | A code specifying the state of the set of dispense events. |
Cardinality | 1...1 |
Type | code |
Binding | A coded concept specifying the state of the dispense event. |
Must Support | True |
Modifier | True |
Summary | True |
Comments | This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. |
Invariants |
|
Mappings |
|
MedicationDispense.statusReason[x] | |
Definition | Indicates the reason why a dispense was not performed. |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | A code describing why a dispense was not performed. |
Invariants |
|
Mappings |
|
MedicationDispense.category | |
Definition | Indicates the type of medication dispense (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)). |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | A code describing where the dispensed medication is expected to be consumed or administered. |
Comments | The category can be used to include where the medication is expected to be consumed or other types of dispenses. Invariants can be used to bind to different value sets when profiling to bind. |
Invariants |
|
Mappings |
|
MedicationDispense.medication[x] | |
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. |
Cardinality | 1...1 |
Type | CodeableConcept |
Binding | A coded concept identifying which substance or product can be dispensed. |
Must Support | True |
Summary | True |
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. |
Invariants |
|
Mappings |
|
MedicationDispense.subject | |
Definition | A link to a resource representing the person or the group to whom the medication will be given. |
Cardinality | 0...1 |
Type | Reference(Patient | Group) |
Must Support | True |
Summary | True |
Comments | SubstanceAdministration->subject->Patient. |
Invariants |
|
Mappings |
|
MedicationDispense.context | |
Definition | The encounter or episode of care that establishes the context for this event. |
Cardinality | 0...1 |
Type | Reference(Encounter | EpisodeOfCare) |
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. |
Invariants |
|
Mappings |
|
MedicationDispense.supportingInformation | |
Definition | Additional information that supports the medication being dispensed. |
Cardinality | 0...* |
Type | Reference(Resource) |
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. |
Invariants |
|
Mappings |
|
MedicationDispense.performer | |
Definition | Indicates who or what performed the event. |
Cardinality | 0...* |
Type | BackboneElement |
Must Support | True |
Invariants |
|
Mappings |
|
MedicationDispense.performer.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Mappings |
|
MedicationDispense.performer.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
|
Mappings |
|
MedicationDispense.performer.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
Cardinality | 0...* |
Type | Extension |
Modifier | True |
Summary | True |
Alias | extensions, user content, modifiers |
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Invariants |
|
Mappings |
|
MedicationDispense.performer.function | |
Definition | Distinguishes the type of performer in the dispense. For example, date enterer, packager, final checker. |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | A code describing the role an individual played in dispensing a medication. |
Requirements | Allows disambiguation of the types of involvement of different performers. |
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. |
Invariants |
|
Mappings |
|
MedicationDispense.performer.actor | |
Definition | The device, practitioner, etc. who performed the action. It should be assumed that the actor is the dispenser of the medication. |
Cardinality | 1...1 |
Type | Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson) |
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. |
Invariants |
|
Mappings |
|
MedicationDispense.location | |
Definition | The principal physical location where the dispense was performed. |
Cardinality | 0...1 |
Type | Reference(Location) |
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. |
Invariants |
|
Mappings |
|
MedicationDispense.authorizingPrescription | |
Definition | Indicates the medication order that is being dispensed against. |
Cardinality | 0...* |
Type | Reference(MedicationRequest) |
Comments | Maps to basedOn in Event logical model. |
Invariants |
|
Mappings |
|
MedicationDispense.type | |
Definition | Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc. |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc. |
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. |
Invariants |
|
Mappings |
|
MedicationDispense.quantity | |
Definition | The amount of medication that has been dispensed. Includes unit of measure. |
Cardinality | 0...1 |
Type | SimpleQuantity |
Must Support | True |
Comments | The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. |
Invariants |
|
Mappings |
|
MedicationDispense.daysSupply | |
Definition | The amount of medication expressed as a timing amount. |
Cardinality | 0...1 |
Type | SimpleQuantity |
Comments | The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. |
Invariants |
|
Mappings |
|
MedicationDispense.whenPrepared | |
Definition | The time when the dispensed product was packaged and reviewed. |
Cardinality | 0...1 |
Type | dateTime |
Must Support | True |
Summary | True |
Invariants |
|
Mappings |
|
MedicationDispense.whenHandedOver | |
Definition | The time the dispensed product was provided to the patient or their representative. |
Cardinality | 0...1 |
Type | dateTime |
Invariants |
|
Mappings |
|
MedicationDispense.destination | |
Definition | Identification of the facility/location where the medication was shipped to, as part of the dispense event. |
Cardinality | 0...1 |
Type | Reference(Location) |
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. |
Invariants |
|
Mappings |
|
MedicationDispense.receiver | |
Definition | Identifies the person who picked up the medication. This will usually be a patient or their caregiver, but some cases exist where it can be a healthcare professional. |
Cardinality | 0...* |
Type | Reference(Patient | Practitioner) |
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. |
Invariants |
|
Mappings |
|
MedicationDispense.note | |
Definition | Extra information about the dispense that could not be conveyed in the other attributes. |
Cardinality | 0...* |
Type | Annotation |
Comments | For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible). |
Invariants |
|
Mappings |
|
MedicationDispense.dosageInstruction | |
Definition | Indicates how the medication is to be used by the patient. |
Cardinality | 0...* |
Type | Dosage |
Must Support | True |
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. |
Invariants |
|
Mappings |
|
MedicationDispense.dosageInstruction.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Mappings |
|
MedicationDispense.dosageInstruction.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
|
Mappings |
|
MedicationDispense.dosageInstruction.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
Cardinality | 0...* |
Type | Extension |
Modifier | True |
Summary | True |
Alias | extensions, user content, modifiers |
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Invariants |
|
Mappings |
|
MedicationDispense.dosageInstruction.sequence | |
Definition | Indicates the order in which the dosage instructions should be applied or interpreted. |
Cardinality | 0...1 |
Type | integer |
Summary | True |
Requirements | If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential. |
Comments | 32 bit number; for values larger than this, use decimal |
Invariants |
|
Mappings |
|
MedicationDispense.dosageInstruction.text | |
Definition | Free text dosage instructions e.g. SIG. |
Cardinality | 0...1 |
Type | string |
Must Support | True |
Summary | True |
Requirements | Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text. |
Comments | Note that FHIR strings SHALL NOT exceed 1MB in size |
Invariants |
|
Mappings |
|
MedicationDispense.dosageInstruction.additionalInstruction | |
Definition | Supplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps"). |
Cardinality | 0...* |
Type | CodeableConcept |
Binding | A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". |
Summary | True |
Requirements | Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded. |
Comments | Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text. |
Invariants |
|
Mappings |
|
MedicationDispense.dosageInstruction.patientInstruction | |
Definition | Instructions in terms that are understood by the patient or consumer. |
Cardinality | 0...1 |
Type | string |
Summary | True |
Comments | Note that FHIR strings SHALL NOT exceed 1MB in size |
Invariants |
|
Mappings |
|
MedicationDispense.dosageInstruction.timing | |
Definition | When medication should be administered. |
Cardinality | 0...1 |
Type | Timing |
Must Support | True |
Summary | True |
Requirements | The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. |
Comments | This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing. |
Invariants |
|
Mappings |
|
MedicationDispense.dosageInstruction.asNeeded[x] | |
Definition | Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept). |
Cardinality | 0...1 |
Type | boolean |
Binding | A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc. |
Summary | True |
Comments | Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed". |
Invariants |
|
Mappings |
|
MedicationDispense.dosageInstruction.site | |
Definition | Body site to administer to. |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | A coded concept describing the site location the medicine enters into or onto the body. |
Summary | True |
Requirements | A coded specification of the anatomic site where the medication first enters the body. |
Comments | If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both. |
Invariants |
|
Mappings |
|
MedicationDispense.dosageInstruction.route | |
Definition | How drug should enter body. |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. |
Summary | True |
Requirements | A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body. |
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. |
Invariants |
|
Mappings |
|
MedicationDispense.dosageInstruction.method | |
Definition | Technique for administering medication. |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | A coded concept describing the technique by which the medicine is administered. |
Summary | True |
Requirements | A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV. |
Comments | Terminologies used often pre-coordinate this term with the route and or form of administration. |
Invariants |
|
Mappings |
|
MedicationDispense.dosageInstruction.doseAndRate | |
Definition | The amount of medication administered. |
Cardinality | 0...* |
Type | Element |
Must Support | True |
Summary | True |
Invariants |
|
Mappings |
|
MedicationDispense.dosageInstruction.doseAndRate.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Mappings |
|
MedicationDispense.dosageInstruction.doseAndRate.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
|
Mappings |
|
MedicationDispense.dosageInstruction.doseAndRate.type | |
Definition | The kind of dose or rate specified, for example, ordered or calculated. |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | The kind of dose or rate specified. |
Summary | True |
Requirements | If the type is not populated, assume to be "ordered". |
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. |
Invariants |
|
Mappings |
|
MedicationDispense.dosageInstruction.doseAndRate.dose[x] | |
Definition | Amount of medication per dose. |
Cardinality | 0...1 |
Type | Range |
Must Support | True |
Summary | True |
Requirements | The amount of therapeutic or other substance given at one administration event. |
Comments | Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours. |
Invariants |
|
Mappings |
|
MedicationDispense.dosageInstruction.doseAndRate.rate[x] | |
Definition | Amount of medication per unit of time. |
Cardinality | 0...1 |
Type | Ratio |
Must Support | True |
Summary | True |
Requirements | Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. |
Comments | It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate. It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour. |
Invariants |
|
Mappings |
|
MedicationDispense.dosageInstruction.maxDosePerPeriod | |
Definition | Upper limit on medication per unit of time. |
Cardinality | 0...1 |
Type | Ratio |
Summary | True |
Requirements | The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours. |
Comments | This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day". |
Invariants |
|
Mappings |
|
MedicationDispense.dosageInstruction.maxDosePerAdministration | |
Definition | Upper limit on medication per administration. |
Cardinality | 0...1 |
Type | SimpleQuantity |
Summary | True |
Requirements | The maximum total quantity of a therapeutic substance that may be administered to a subject per administration. |
Comments | This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg. |
Invariants |
|
Mappings |
|
MedicationDispense.dosageInstruction.maxDosePerLifetime | |
Definition | Upper limit on medication per lifetime of the patient. |
Cardinality | 0...1 |
Type | SimpleQuantity |
Summary | True |
Requirements | The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject. |
Comments | The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. |
Invariants |
|
Mappings |
|
MedicationDispense.substitution | |
Definition | Indicates whether or not substitution was made as part of the dispense. In some cases, substitution will be expected but does not happen, in other cases substitution is not expected but does happen. This block explains what substitution did or did not happen and why. If nothing is specified, substitution was not done. |
Cardinality | 0...1 |
Type | BackboneElement |
Invariants |
|
Mappings |
|
MedicationDispense.substitution.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Mappings |
|
MedicationDispense.substitution.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
|
Mappings |
|
MedicationDispense.substitution.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
Cardinality | 0...* |
Type | Extension |
Modifier | True |
Summary | True |
Alias | extensions, user content, modifiers |
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Invariants |
|
Mappings |
|
MedicationDispense.substitution.wasSubstituted | |
Definition | True if the dispenser dispensed a different drug or product from what was prescribed. |
Cardinality | 1...1 |
Type | boolean |
Invariants |
|
Mappings |
|
MedicationDispense.substitution.type | |
Definition | A code signifying whether a different drug was dispensed from what was prescribed. |
Cardinality | 0...1 |
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. |
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. |
Invariants |
|
Mappings |
|
MedicationDispense.substitution.reason | |
Definition | Indicates the reason for the substitution (or lack of substitution) from what was prescribed. |
Cardinality | 0...* |
Type | CodeableConcept |
Binding | A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed. |
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. |
Invariants |
|
Mappings |
|
MedicationDispense.substitution.responsibleParty | |
Definition | The person or organization that has primary responsibility for the substitution. |
Cardinality | 0...* |
Type | Reference(Practitioner | PractitionerRole) |
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. |
Invariants |
|
Mappings |
|
MedicationDispense.detectedIssue | |
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. |
Cardinality | 0...* |
Type | Reference(DetectedIssue) |
Alias | Contraindication, Drug Utilization Review (DUR), Alert |
Comments | This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue. |
Invariants |
|
Mappings |
|
MedicationDispense.eventHistory | |
Definition | A summary of the events of interest that have occurred, such as when the dispense was verified. |
Cardinality | 0...* |
Type | Reference(Provenance) |
Comments | This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.). |
Invariants |
|
Mappings |
|
Table View
MedicationDispense | .. | |
MedicationDispense.identifier | .. | |
MedicationDispense.status | .. | |
MedicationDispense.medication[x] | .. | |
MedicationDispense.subject | .. | |
MedicationDispense.performer | .. | |
MedicationDispense.type | .. | |
MedicationDispense.quantity | .. | |
MedicationDispense.whenPrepared | .. | |
MedicationDispense.dosageInstruction | .. | |
MedicationDispense.dosageInstruction.text | .. | |
MedicationDispense.dosageInstruction.timing | .. | |
MedicationDispense.dosageInstruction.asNeeded[x] | .. | |
MedicationDispense.dosageInstruction.site | .. | |
MedicationDispense.dosageInstruction.route | .. | |
MedicationDispense.dosageInstruction.method | .. | |
MedicationDispense.dosageInstruction.doseAndRate | .. | |
MedicationDispense.dosageInstruction.doseAndRate.dose[x] | .. | |
MedicationDispense.dosageInstruction.doseAndRate.rate[x] | .. |
XML View
<StructureDefinition xmlns="http://hl7.org/fhir"> <id value="UKCore-MedicationDispense" /> <url value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationDispense" /> <version value="2.4.0" /> <name value="UKCoreMedicationDispense" /> <title value="UK Core Medication Dispense" /> <status value="active" /> <date value="2024-07-11" /> <publisher value="HL7 UK" /> <contact> <name value="HL7 UK" /> <telecom> <system value="email" /> <value value="ukcore@hl7.org.uk" /> <use value="work" /> <rank value="1" /> </telecom> </contact> <description value="This profile defines the UK constraints and extensions on the International FHIR resource [MedicationDispense](https://hl7.org/fhir/R4/MedicationDispense.html)." /> <purpose value="This profile covers the supply of medications to a patient. Examples include dispensing and pick-up from an outpatient or community pharmacy, dispensing patient-specific medications from inpatient pharmacy to ward, as well as issuing a single dose from ward stock to a patient for consumption. The medication dispense is the result of a pharmacy system responding to a medication order." /> <copyright value="Copyright © 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the "License"); you may not use this file except in compliance with the License. You may obtain a copy of the License at http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an "AS IS" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at https://www.hl7.org/fhir/license.html." /> <fhirVersion value="4.0.1" /> <kind value="resource" /> <abstract value="false" /> <type value="MedicationDispense" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/MedicationDispense" /> <derivation value="constraint" /> <differential> <element id="MedicationDispense.identifier"> <path value="MedicationDispense.identifier" /> <short value="Allows the resource to be referenced within / by other resources." /> <mustSupport value="true" /> </element> <element id="MedicationDispense.status"> <path value="MedicationDispense.status" /> <short value="A code that describes the status of the dispensing event." /> <mustSupport value="true" /> </element> <element id="MedicationDispense.medication[x]"> <path value="MedicationDispense.medication[x]" /> <short value="What medication was supplied." /> <mustSupport value="true" /> <binding> <strength value="preferred" /> <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationCode" /> </binding> </element> <element id="MedicationDispense.subject"> <path value="MedicationDispense.subject" /> <short value="Identifies the patient." /> <mustSupport value="true" /> </element> <element id="MedicationDispense.performer"> <path value="MedicationDispense.performer" /> <short value="Who or what performed the dispensing event." /> <mustSupport value="true" /> </element> <element id="MedicationDispense.type"> <path value="MedicationDispense.type" /> <binding> <strength value="extensible" /> <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationSupplyType" /> </binding> </element> <element id="MedicationDispense.quantity"> <path value="MedicationDispense.quantity" /> <short value="Quantity of medication dispensed." /> <mustSupport value="true" /> </element> <element id="MedicationDispense.whenPrepared"> <path value="MedicationDispense.whenPrepared" /> <short value="Timestamp for when the medication was prepared." /> <mustSupport value="true" /> </element> <element id="MedicationDispense.dosageInstruction"> <path value="MedicationDispense.dosageInstruction" /> <short value="Dosage instruction for the dispensed medication." /> <mustSupport value="true" /> </element> <element id="MedicationDispense.dosageInstruction.text"> <path value="MedicationDispense.dosageInstruction.text" /> <short value="Free text dosage instructions." /> <mustSupport value="true" /> </element> <element id="MedicationDispense.dosageInstruction.timing"> <path value="MedicationDispense.dosageInstruction.timing" /> <short value="When medication should be administered." /> <mustSupport value="true" /> </element> <element id="MedicationDispense.dosageInstruction.asNeeded[x]"> <path value="MedicationDispense.dosageInstruction.asNeeded[x]" /> <binding> <strength value="preferred" /> </binding> </element> <element id="MedicationDispense.dosageInstruction.site"> <path value="MedicationDispense.dosageInstruction.site" /> <binding> <strength value="preferred" /> <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-BodySite" /> </binding> </element> <element id="MedicationDispense.dosageInstruction.route"> <path value="MedicationDispense.dosageInstruction.route" /> <binding> <strength value="preferred" /> <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-SubstanceOrProductAdministrationRoute" /> </binding> </element> <element id="MedicationDispense.dosageInstruction.method"> <path value="MedicationDispense.dosageInstruction.method" /> <binding> <strength value="preferred" /> <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationDosageMethod" /> </binding> </element> <element id="MedicationDispense.dosageInstruction.doseAndRate"> <path value="MedicationDispense.dosageInstruction.doseAndRate" /> <short value="Dosage instructions for the medication." /> <mustSupport value="true" /> </element> <element id="MedicationDispense.dosageInstruction.doseAndRate.dose[x]"> <path value="MedicationDispense.dosageInstruction.doseAndRate.dose[x]" /> <short value="Quantity of medication administered." /> <mustSupport value="true" /> </element> <element id="MedicationDispense.dosageInstruction.doseAndRate.rate[x]"> <path value="MedicationDispense.dosageInstruction.doseAndRate.rate[x]" /> <short value="Rate at which the medication is to be administered." /> <mustSupport value="true" /> </element> </differential> </StructureDefinition>
JSON View
{ "resourceType": "StructureDefinition", "id": "UKCore-MedicationDispense", "url": "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationDispense", "version": "2.4.0", "name": "UKCoreMedicationDispense", "title": "UK Core Medication Dispense", "status": "active", "date": "2024-07-11", "publisher": "HL7 UK", "contact": [ { "name": "HL7 UK", "telecom": [ { "system": "email", "value": "ukcore@hl7.org.uk", "use": "work", "rank": 1 } ] } ], "description": "This profile defines the UK constraints and extensions on the International FHIR resource [MedicationDispense](https://hl7.org/fhir/R4/MedicationDispense.html).", "purpose": "This profile covers the supply of medications to a patient. Examples include dispensing and pick-up from an outpatient or community pharmacy, dispensing patient-specific medications from inpatient pharmacy to ward, as well as issuing a single dose from ward stock to a patient for consumption. The medication dispense is the result of a pharmacy system responding to a medication order.", "copyright": "Copyright © 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the \"License\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \"AS IS\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at https://www.hl7.org/fhir/license.html.", "fhirVersion": "4.0.1", "kind": "resource", "abstract": false, "type": "MedicationDispense", "baseDefinition": "http://hl7.org/fhir/StructureDefinition/MedicationDispense", "derivation": "constraint", "differential": { "element": [ { "id": "MedicationDispense.identifier", "path": "MedicationDispense.identifier", "short": "Allows the resource to be referenced within / by other resources.", "mustSupport": true }, { "id": "MedicationDispense.status", "path": "MedicationDispense.status", "short": "A code that describes the status of the dispensing event.", "mustSupport": true }, { "id": "MedicationDispense.medication[x]", "path": "MedicationDispense.medication[x]", "short": "What medication was supplied.", "mustSupport": true, "binding": { "strength": "preferred", "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationCode" } }, { "id": "MedicationDispense.subject", "path": "MedicationDispense.subject", "short": "Identifies the patient.", "mustSupport": true }, { "id": "MedicationDispense.performer", "path": "MedicationDispense.performer", "short": "Who or what performed the dispensing event.", "mustSupport": true }, { "id": "MedicationDispense.type", "path": "MedicationDispense.type", "binding": { "strength": "extensible", "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationSupplyType" } }, { "id": "MedicationDispense.quantity", "path": "MedicationDispense.quantity", "short": "Quantity of medication dispensed.", "mustSupport": true }, { "id": "MedicationDispense.whenPrepared", "path": "MedicationDispense.whenPrepared", "short": "Timestamp for when the medication was prepared.", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction", "path": "MedicationDispense.dosageInstruction", "short": "Dosage instruction for the dispensed medication.", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.text", "path": "MedicationDispense.dosageInstruction.text", "short": "Free text dosage instructions.", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.timing", "path": "MedicationDispense.dosageInstruction.timing", "short": "When medication should be administered.", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.asNeeded[x]", "path": "MedicationDispense.dosageInstruction.asNeeded[x]", "binding": { "strength": "preferred" } }, { "id": "MedicationDispense.dosageInstruction.site", "path": "MedicationDispense.dosageInstruction.site", "binding": { "strength": "preferred", "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-BodySite" } }, { "id": "MedicationDispense.dosageInstruction.route", "path": "MedicationDispense.dosageInstruction.route", "binding": { "strength": "preferred", "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-SubstanceOrProductAdministrationRoute" } }, { "id": "MedicationDispense.dosageInstruction.method", "path": "MedicationDispense.dosageInstruction.method", "binding": { "strength": "preferred", "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationDosageMethod" } }, { "id": "MedicationDispense.dosageInstruction.doseAndRate", "path": "MedicationDispense.dosageInstruction.doseAndRate", "short": "Dosage instructions for the medication.", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.doseAndRate.dose[x]", "path": "MedicationDispense.dosageInstruction.doseAndRate.dose[x]", "short": "Quantity of medication administered.", "mustSupport": true }, { "id": "MedicationDispense.dosageInstruction.doseAndRate.rate[x]", "path": "MedicationDispense.dosageInstruction.doseAndRate.rate[x]", "short": "Rate at which the medication is to be administered.", "mustSupport": true } ] } }
Feedback
Click here to:Report issue for UKCore-MedicationDispense, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,
Examples
Eye drops - An example to illustrate a dispense eye drops. Example UKCore-MedicationDispense-EyeDropsExample Usage Scenarios
The following are example usage scenarios for the UK Core MedicationDispense profile:
- Query for a patient's specific dispensed medication
- Record or update a dispensed medication.
Profile Specific Implementation Guidance:
Mandatory and Must Support Data Elements
The following elements are identified as MustSupport, and it is expected that consumers and suppliers SHALL support these as per the MustSupport Guidance.
Element | Reason |
---|---|
MedicationDispense.identifier | Allows the resource to be referenced within / by other resources. |
MedicationDispense.status | A code that describes the status of the dispensing event. |
MedicationDispense.medication[x] | What medication was supplied. |
MedicationDispense.subject | Identifies the patient. |
MedicationDispense.performer | Who or what performed the dispensing event. |
MedicationDispense.quantity | Quantity of medication dispensed. |
MedicationDispense.whenPrepared | Timestamp for when the medication was prepared. |
MedicationDispense.dosageInstruction | Dosage instruction for the dispensed medication. |
MedicationDispense.dosageInstruction.text | Free text dosage instructions. |
MedicationDispense.dosageInstruction.timing | When medication should be administered. |
MedicationDispense.dosageInstruction.doseAndRate | Dosage instructions for the medication. |
MedicationDispense.dosageInstruction.doseAndRate.dose[x] | Quantity of medication administered. |
MedicationDispense.dosageInstruction.doseAndRate.rate[x] | Rate at which the medication is to be administered. |
Bindings (differential)
More information about the bindings to UK Core ValueSets can be found below.
Context | Strength | Link |
---|---|---|
MedicationDispense.medication[x] | preferred | https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationCode |
MedicationDispense.type | extensible | https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationSupplyType |
MedicationDispense.dosageInstruction.site | preferred | https://fhir.hl7.org.uk/ValueSet/UKCore-BodySite |
MedicationDispense.dosageInstruction.route | preferred | https://fhir.hl7.org.uk/ValueSet/UKCore-SubstanceOrProductAdministrationRoute |
MedicationDispense.dosageInstruction.method | preferred | https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationDosageMethod |
status
It is expected that most implementations will require the use of status to support workflow.
The status can be used to determine the overall status of dispense request; however, it does not cater for the granularity that prescription tracking software can offer.
It is recommended that the MedicationDispense.status
is used to indicate the status at a high-level so that integrated systems can determine how to represent this information.
Status | FHIR Definition | Implementation Guidance |
---|---|---|
preparation |
The core event has not started yet, but some staging activities have begun (e.g. initial compounding or packaging of medication). Preparation stages MAY be tracked for billing purposes. |
Consider how the status preparation is presented to the end-user to avoid confusion with in-progress .
|
in-progress |
The dispensed product is ready for pickup. |
Consider how the status in-progress is presented to the end-user to avoid confusion with complete when dispensed medication is in-transit to a ward, or to a patient via a delivery service.
|
cancelled |
The dispensed product was not and will never be picked up by the patient. |
Avoid the use of this status value where possible as very similar to stopped and therefore potentially confusing.
|
on-hold |
The dispense process is paused while waiting for an external event to reactivate the dispense. For example, new stock has arrived or the prescriber has called. | Probably most useful as a pharmacy-facing status. If exposed to users outside the pharmacy, such users may want to know how long the dispensing event will be on hold in case alternative dispensing arrangements need to be identified. |
completed |
The dispensed product has been picked up. | This would be a suitable trigger to post / share the medication dispense with the requesting ePMA system. |
entered-in-error |
The dispense was entered in error and therefore nullified. | Not to be used unless specific use-cases can be identified. |
stopped |
Actions implied by the dispense have been permanently halted, before all of them occurred. |
A MedicationDispense.statusReason SHOULD be populated with a coded reason for stopping the medication administration. This would be a suitable trigger to post / share the medication dispense with the requesting ePMA system.
|
declined |
The dispense was declined and not performed | This would be a suitable trigger to post / share the declined medication dispense event with the requesting ePMA system. |
unknown |
The authoring system does not know which of the status values applies for this medication dispense. Note: this concept is not to be used for other - one of the listed statuses is presumed to apply, it's just not known which one. | Avoid the use of this status value where possible. |
statusReason[x]
A reason for why a dispense was not performed, either as a reference to a DetectedIssue resource, or a coded reason from the medicationdispense-status-reason valueset.
This SHOULD only be populated when the MedicationDispense.status
is either cancelled
, stopped
or declined
.
medication[x]
Medication WITH dm+d code
Where a dm+d code exists it SHALL be used either as MedicationDispense.medicationCodeableConcept.coding
or as MedicationDispense.medicationReference.Medication.code
Where CodeableConcept is used, MedicationDispense.medicationCodeableConcept.coding
is the dm+d code and MedicationDispense.medicationCodeableConcept.text
is dm+d concept name/description.
Can be either a dm+d code as a CodeableConcept or reference to UK Core Profile UKCore-Medication resource. Using a CodeableConcept is preferred unless additional data if required that would be contained within a UK Core Profile UKCore-Medication resource.
The elements MedicationDispense.medicationCodeableConcept.coding
and MedicationDispense.medicationReference.Medication.code
are both bound to ValueSet UKCore-MedicationCode
Examples where a reference to a UK Core Profile UKCore-Medication would be applicable include:
- Record a VTM with a specific form
- Record manufacturer with a concept as described in ValueSet UKCore-MedicationCode
- Record batch number
- Record ingredients (for example with a magisterial prescription or an excipient).
Medication WITHOUT dm+d code
Medication not published within the dm+d may be requested in the Acute care setting.
In this scenario it is recommended to use the MedicationDispense.medicationCodeableConcept
variant for this element.
If the prescribing system has both a locally assigned code and description for the medication then;
- The
MedicationDispense.medicationCodeableConcept.text
SHOULD be the description for the medication. - The
MedicationDispense.medicationCodeableConcept.coding.code
SHOULD be the code for the medication. - The
MedicationDispense.medicationCodeableConcept.coding.display
SHOULD be the description for the medication, i.e. the same value asMedicationDispense.medicationCodeableConcept.text
.
If the prescribing system only has a description for the medication then;
- The
MedicationDispense.medicationCodeableConcept.text
SHOULD be the locally assigned description for the medication.
subject
Where possible, it is expected that the resource being referenced SHOULD conform to one of the following UK Core profiles:
context
Where possible, it is expected that the resource being referenced SHOULD conform to one of the following UK Core profiles:
supportingInformation
Where a UK Core profile exists the resource being referenced SHOULD conform to the profile.
performer
The MedicationDispense.performer.actor
element SHOULD conform to one the following:
- UKCore-Device (draft)
- Profile UKCore-Organization
- Profile UKCore-Patient
- Profile UKCore-Practitioner
- Profile UKCore-PractitionerRole
- Profile UKCore-RelatedPerson
location
Where possible, it is expected that the resource being referenced SHOULD conform to Profile UKCore-Location
quantity
This element could be useful for discharge prescriptions (TTO) when representing "1 of something", for example:
- 1 pack
- 1 tablet
- 1 bottle.
It may be simpler to always express as dose units. For example;
- 14 tablets
- 50 ml.
whenPrepared
A timestamp, as close as business processes allow for when the dispensed medication was prepared, i.e. labelled and checked.
destination
If used, consider interpreting as the Intended Destination in the real world, this could change between being marked as "dispensed" and the patient receiving the medication.
For example, within an inpatient setting, the patient could have been transferred to a different ward before the dispensed medication is delivered.
Where possible, it is expected that the resource being referenced SHOULD conform to Profile UKCore-Location
receiver
Where possible, it is expected that the resource being referenced SHOULD conform to one of the following UK Core profiles:
note
Not required as part of a minimum viable content; however, if this field is populated, the receiving system SHALL consume the information in the event that it contains important information (and should be treat as required)
Important
If the system offers an end-user the option to create aMedicationDispense.note
, it is advised that the scope of the MedicationDispense.note
should be the dispense event only.dosageInstruction
Consider aligning to the Implementation Guide for Digital Medicines, but as a minimum, MedicationDispense.dosageInstruction.text
.
Where a structured dosage is provided, populate MedicationDispense.dosageInstruction.text
with a human readable dosage string that is clinically equivalent to the coded dosage instruction. This is for interoperability with consuming systems that do not yet support fully structured dosing instructions.
eventHistory
Where possible, it is expected that the resource being referenced SHOULD conform to UKCore-Provenance (draft).