UK Core Implementation Guide 0.2.0 - STU1

StructureDefinition-UKCore-MedicationDispense

Defines the UK Core constraints and extensions on the MedicationDispense resource for the minimal set of data to query and retrieve dispensed medication information.

Profile Purpose

This profile covers the supply of medications to an individual. 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 an individual for consumption. The medication dispense is the result of a pharmacy system responding to a medication order.

Snapshot View

useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
statusΣ ?!1..1codeBinding
statusReasonCodeableConceptCodeableConcept
statusReasonReferenceReference(DetectedIssue)
category0..1CodeableConceptBinding
medicationCodeableConceptCodeableConcept
medicationReferenceReference(UK Core Medication)
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
function0..1CodeableConcept
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
type0..1CodeableConceptBinding
quantityI0..1SimpleQuantity
daysSupplyI0..1SimpleQuantity
whenPreparedΣ0..1dateTime
whenHandedOver0..1dateTime
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
authorStringstring
authorReferenceReference(UK Core Organization | UK Core Practitioner | UK Core Patient | UK Core RelatedPerson)
timeΣ0..1dateTime
textΣ1..1markdown
sequenceΣ0..1integer
textΣ0..1string
additionalInstructionΣ0..*CodeableConcept
patientInstructionΣ0..1string
timingΣ0..1Timing
asNeededBooleanboolean
asNeededCodeableConceptCodeableConcept
siteΣ0..1CodeableConceptBinding
routeΣ0..1CodeableConceptBinding
methodΣ0..1CodeableConceptBinding
typeΣ0..1CodeableConcept
doseRangeRange
doseQuantitySimpleQuantity
rateRatioRatio
rateRangeRange
rateQuantitySimpleQuantity
maxDosePerPeriodΣ I0..1Ratio
maxDosePerAdministrationΣ I0..1SimpleQuantity
maxDosePerLifetimeΣ I0..1SimpleQuantity
wasSubstituted1..1boolean
type0..1CodeableConcept
reason0..*CodeableConcept
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string

Differential View

useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
statusΣ ?!1..1codeBinding
statusReasonCodeableConceptCodeableConcept
statusReasonReferenceReference(DetectedIssue)
category0..1CodeableConceptBinding
medicationCodeableConceptCodeableConcept
medicationReferenceReference(UK Core Medication)
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
function0..1CodeableConcept
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
type0..1CodeableConceptBinding
quantityI0..1SimpleQuantity
daysSupplyI0..1SimpleQuantity
whenPreparedΣ0..1dateTime
whenHandedOver0..1dateTime
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
authorStringstring
authorReferenceReference(UK Core Organization | UK Core Practitioner | UK Core Patient | UK Core RelatedPerson)
timeΣ0..1dateTime
textΣ1..1markdown
sequenceΣ0..1integer
textΣ0..1string
additionalInstructionΣ0..*CodeableConcept
patientInstructionΣ0..1string
timingΣ0..1Timing
asNeededBooleanboolean
asNeededCodeableConceptCodeableConcept
siteΣ0..1CodeableConceptBinding
routeΣ0..1CodeableConceptBinding
methodΣ0..1CodeableConceptBinding
typeΣ0..1CodeableConcept
doseRangeRange
doseQuantitySimpleQuantity
rateRatioRatio
rateRangeRange
rateQuantitySimpleQuantity
maxDosePerPeriodΣ I0..1Ratio
maxDosePerAdministrationΣ I0..1SimpleQuantity
maxDosePerLifetimeΣ I0..1SimpleQuantity
wasSubstituted1..1boolean
type0..1CodeableConcept
reason0..*CodeableConcept
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string

Hybrid View

useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
statusΣ ?!1..1codeBinding
statusReasonCodeableConceptCodeableConcept
statusReasonReferenceReference(DetectedIssue)
category0..1CodeableConceptBinding
medicationCodeableConceptCodeableConcept
medicationReferenceReference(UK Core Medication)
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
function0..1CodeableConcept
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
type0..1CodeableConceptBinding
quantityI0..1SimpleQuantity
daysSupplyI0..1SimpleQuantity
whenPreparedΣ0..1dateTime
whenHandedOver0..1dateTime
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
authorStringstring
authorReferenceReference(UK Core Organization | UK Core Practitioner | UK Core Patient | UK Core RelatedPerson)
timeΣ0..1dateTime
textΣ1..1markdown
sequenceΣ0..1integer
textΣ0..1string
additionalInstructionΣ0..*CodeableConcept
patientInstructionΣ0..1string
timingΣ0..1Timing
asNeededBooleanboolean
asNeededCodeableConceptCodeableConcept
siteΣ0..1CodeableConceptBinding
routeΣ0..1CodeableConceptBinding
methodΣ0..1CodeableConceptBinding
typeΣ0..1CodeableConcept
doseRangeRange
doseQuantitySimpleQuantity
rateRatioRatio
rateRangeRange
rateQuantitySimpleQuantity
maxDosePerPeriodΣ I0..1Ratio
maxDosePerAdministrationΣ I0..1SimpleQuantity
maxDosePerLifetimeΣ I0..1SimpleQuantity
wasSubstituted1..1boolean
type0..1CodeableConcept
reason0..*CodeableConcept
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string

Table View

MedicationDispense..
MedicationDispense.identifier..
MedicationDispense.identifier.assignerReference(UK Core Organization)..
MedicationDispense.partOfReference(UK Core Procedure)..
MedicationDispense.partOf.identifier..
MedicationDispense.partOf.identifier.assignerReference(UK Core Organization)..
MedicationDispense.medication[x]CodeableConcept, Reference(UK Core Medication)..
MedicationDispense.subjectReference(Group | UK Core Patient)..
MedicationDispense.subject.identifier..
MedicationDispense.subject.identifier.assignerReference(UK Core Organization)..
MedicationDispense.contextReference(EpisodeOfCare | UK Core Encounter)..
MedicationDispense.context.identifier..
MedicationDispense.context.identifier.assignerReference(UK Core Organization)..
MedicationDispense.supportingInformation..
MedicationDispense.supportingInformation.identifier..
MedicationDispense.supportingInformation.identifier.assignerReference(UK Core Organization)..
MedicationDispense.performer..
MedicationDispense.performer.actorReference(UK Core Organization | UK Core Practitioner | UK Core PractitionerRole | UK Core Patient | UK Core RelatedPerson | UK Core Device)..
MedicationDispense.performer.actor.identifier..
MedicationDispense.performer.actor.identifier.assignerReference(UK Core Organization)..
MedicationDispense.locationReference(UK Core Location)..
MedicationDispense.location.identifier..
MedicationDispense.location.identifier.assignerReference(UK Core Organization)..
MedicationDispense.authorizingPrescriptionReference(UK Core MedicationRequest)..
MedicationDispense.authorizingPrescription.identifier..
MedicationDispense.authorizingPrescription.identifier.assignerReference(UK Core Organization)..
MedicationDispense.type..
MedicationDispense.destinationReference(UK Core Location)..
MedicationDispense.destination.identifier..
MedicationDispense.destination.identifier.assignerReference(UK Core Organization)..
MedicationDispense.receiverReference(UK Core Patient | UK Core Practitioner)..
MedicationDispense.receiver.identifier..
MedicationDispense.receiver.identifier.assignerReference(UK Core Organization)..
MedicationDispense.note..
MedicationDispense.note.author[x]Reference(UK Core Organization | UK Core Practitioner | UK Core Patient | UK Core RelatedPerson), string..
MedicationDispense.dosageInstruction..
MedicationDispense.dosageInstruction.asNeeded[x]..
MedicationDispense.dosageInstruction.site..
MedicationDispense.dosageInstruction.route..
MedicationDispense.dosageInstruction.method..
MedicationDispense.substitution..
MedicationDispense.substitution.responsiblePartyReference(UK Core Practitioner | UK Core PractitionerRole)..
MedicationDispense.substitution.responsibleParty.identifier..
MedicationDispense.substitution.responsibleParty.identifier.assignerReference(UK Core Organization)..
MedicationDispense.detectedIssue..
MedicationDispense.detectedIssue.identifier..
MedicationDispense.detectedIssue.identifier.assignerReference(UK Core Organization)..
MedicationDispense.eventHistoryReference(UK Core Provenance)..
MedicationDispense.eventHistory.identifier..
MedicationDispense.eventHistory.identifier.assignerReference(UK Core Organization)..


XML View

<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="UKCore-MedicationDispense" />
    <url value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationDispense" />
    <version value="2.1.0" />
    <name value="UKCoreMedicationDispense" />
    <title value="UK Core MedicationDispense" />
    <status value="active" />
    <date value="2021-09-10" />
    <publisher value="HL7 UK" />
    <contact>
        <name value="HL7 UK" />
        <telecom>
            <system value="email" />
            <value value="secretariat@hl7.org.uk" />
            <use value="work" />
            <rank value="1" />
        </telecom>
    </contact>
    <contact>
        <name value="NHS Digital" />
        <telecom>
            <system value="email" />
            <value value="interoperabilityteam@nhs.net" />
            <use value="work" />
            <rank value="2" />
        </telecom>
    </contact>
    <description value="Defines the UK Core constraints and extensions on the MedicationDispense resource for the minimal set of data to query and retrieve dispensed medication information." />
    <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 &#169; 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the &quot;License&quot;); 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 &quot;AS IS&quot; 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&#174; FHIR&#174; standard Copyright &#169; 2011+ HL7 The HL7&#174; FHIR&#174; 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" />
    <mapping>
        <identity value="workflow" />
        <uri value="http://hl7.org/fhir/workflow" />
        <name value="Workflow Pattern" />
    </mapping>
    <mapping>
        <identity value="rim" />
        <uri value="http://hl7.org/v3" />
        <name value="RIM Mapping" />
    </mapping>
    <mapping>
        <identity value="w5" />
        <uri value="http://hl7.org/fhir/fivews" />
        <name value="FiveWs Pattern Mapping" />
    </mapping>
    <mapping>
        <identity value="rx-dispense-rmim" />
        <uri value="http://www.hl7.org/v3/PORX_RM020070UV" />
        <name value="V3 Pharmacy Dispense RMIM" />
    </mapping>
    <mapping>
        <identity value="v2" />
        <uri value="http://hl7.org/v2" />
        <name value="HL7 v2 Mapping" />
    </mapping>
    <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.assigner">
            <path value="MedicationDispense.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="MedicationDispense.partOf">
            <path value="MedicationDispense.partOf" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Procedure" />
            </type>
        </element>
        <element id="MedicationDispense.partOf.identifier.assigner">
            <path value="MedicationDispense.partOf.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="MedicationDispense.medication[x]">
            <path value="MedicationDispense.medication[x]" />
            <type>
                <code value="CodeableConcept" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Medication" />
            </type>
            <binding>
                <strength value="extensible" />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationCode" />
            </binding>
        </element>
        <element id="MedicationDispense.subject">
            <path value="MedicationDispense.subject" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient" />
            </type>
        </element>
        <element id="MedicationDispense.subject.identifier.assigner">
            <path value="MedicationDispense.subject.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="MedicationDispense.context">
            <path value="MedicationDispense.context" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/EpisodeOfCare" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Encounter" />
            </type>
        </element>
        <element id="MedicationDispense.context.identifier.assigner">
            <path value="MedicationDispense.context.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="MedicationDispense.supportingInformation.identifier.assigner">
            <path value="MedicationDispense.supportingInformation.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="MedicationDispense.performer.actor">
            <path value="MedicationDispense.performer.actor" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Device" />
            </type>
        </element>
        <element id="MedicationDispense.performer.actor.identifier.assigner">
            <path value="MedicationDispense.performer.actor.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="MedicationDispense.location">
            <path value="MedicationDispense.location" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Location" />
            </type>
        </element>
        <element id="MedicationDispense.location.identifier.assigner">
            <path value="MedicationDispense.location.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="MedicationDispense.authorizingPrescription">
            <path value="MedicationDispense.authorizingPrescription" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest" />
            </type>
        </element>
        <element id="MedicationDispense.authorizingPrescription.identifier.assigner">
            <path value="MedicationDispense.authorizingPrescription.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </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.destination">
            <path value="MedicationDispense.destination" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Location" />
            </type>
        </element>
        <element id="MedicationDispense.destination.identifier.assigner">
            <path value="MedicationDispense.destination.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="MedicationDispense.receiver">
            <path value="MedicationDispense.receiver" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner" />
            </type>
        </element>
        <element id="MedicationDispense.receiver.identifier.assigner">
            <path value="MedicationDispense.receiver.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="MedicationDispense.note.author[x]">
            <path value="MedicationDispense.note.author[x]" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson" />
            </type>
            <type>
                <code value="string" />
            </type>
        </element>
        <element id="MedicationDispense.dosageInstruction.asNeeded[x]">
            <path value="MedicationDispense.dosageInstruction.asNeeded[x]" />
            <binding>
                <strength value="extensible" />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationPrecondition" />
            </binding>
        </element>
        <element id="MedicationDispense.dosageInstruction.site">
            <path value="MedicationDispense.dosageInstruction.site" />
            <binding>
                <strength value="extensible" />
                <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="extensible" />
                <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="extensible" />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationDosageMethod" />
            </binding>
        </element>
        <element id="MedicationDispense.substitution.responsibleParty">
            <path value="MedicationDispense.substitution.responsibleParty" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole" />
            </type>
        </element>
        <element id="MedicationDispense.substitution.responsibleParty.identifier.assigner">
            <path value="MedicationDispense.substitution.responsibleParty.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="MedicationDispense.detectedIssue.identifier.assigner">
            <path value="MedicationDispense.detectedIssue.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="MedicationDispense.eventHistory">
            <path value="MedicationDispense.eventHistory" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Provenance" />
            </type>
        </element>
        <element id="MedicationDispense.eventHistory.identifier.assigner">
            <path value="MedicationDispense.eventHistory.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
    </differential>
</StructureDefinition>

JSON View

{
    "resourceType": "StructureDefinition",
    "id": "UKCore-MedicationDispense",
    "url": "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationDispense",
    "version": "2.1.0",
    "name": "UKCoreMedicationDispense",
    "title": "UK Core MedicationDispense",
    "status": "active",
    "date": "2021-09-10",
    "publisher": "HL7 UK",
    "contact":  [
        {
            "name": "HL7 UK",
            "telecom":  [
                {
                    "system": "email",
                    "value": "secretariat@hl7.org.uk",
                    "use": "work",
                    "rank": 1
                }
            ]
        },
        {
            "name": "NHS Digital",
            "telecom":  [
                {
                    "system": "email",
                    "value": "interoperabilityteam@nhs.net",
                    "use": "work",
                    "rank": 2
                }
            ]
        }
    ],
    "description": "Defines the UK Core constraints and extensions on the MedicationDispense resource for the minimal set of data to query and retrieve dispensed medication information.",
    "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",
    "mapping":  [
        {
            "identity": "workflow",
            "uri": "http://hl7.org/fhir/workflow",
            "name": "Workflow Pattern"
        },
        {
            "identity": "rim",
            "uri": "http://hl7.org/v3",
            "name": "RIM Mapping"
        },
        {
            "identity": "w5",
            "uri": "http://hl7.org/fhir/fivews",
            "name": "FiveWs Pattern Mapping"
        },
        {
            "identity": "rx-dispense-rmim",
            "uri": "http://www.hl7.org/v3/PORX_RM020070UV",
            "name": "V3 Pharmacy Dispense RMIM"
        },
        {
            "identity": "v2",
            "uri": "http://hl7.org/v2",
            "name": "HL7 v2 Mapping"
        }
    ],
    "kind": "resource",
    "abstract": false,
    "type": "MedicationDispense",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/MedicationDispense",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "MedicationDispense.identifier.assigner",
                "path": "MedicationDispense.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationDispense.partOf",
                "path": "MedicationDispense.partOf",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Procedure"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationDispense.partOf.identifier.assigner",
                "path": "MedicationDispense.partOf.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationDispense.medication[x]",
                "path": "MedicationDispense.medication[x]",
                "type":  [
                    {
                        "code": "CodeableConcept"
                    },
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Medication"
                        ]
                    }
                ],
                "binding": {
                    "strength": "extensible",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationCode"
                }
            },
            {
                "id": "MedicationDispense.subject",
                "path": "MedicationDispense.subject",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Group",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationDispense.subject.identifier.assigner",
                "path": "MedicationDispense.subject.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationDispense.context",
                "path": "MedicationDispense.context",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Encounter"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationDispense.context.identifier.assigner",
                "path": "MedicationDispense.context.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationDispense.supportingInformation.identifier.assigner",
                "path": "MedicationDispense.supportingInformation.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationDispense.performer.actor",
                "path": "MedicationDispense.performer.actor",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Device"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationDispense.performer.actor.identifier.assigner",
                "path": "MedicationDispense.performer.actor.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationDispense.location",
                "path": "MedicationDispense.location",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Location"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationDispense.location.identifier.assigner",
                "path": "MedicationDispense.location.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationDispense.authorizingPrescription",
                "path": "MedicationDispense.authorizingPrescription",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationDispense.authorizingPrescription.identifier.assigner",
                "path": "MedicationDispense.authorizingPrescription.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationDispense.type",
                "path": "MedicationDispense.type",
                "binding": {
                    "strength": "extensible",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationSupplyType"
                }
            },
            {
                "id": "MedicationDispense.destination",
                "path": "MedicationDispense.destination",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Location"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationDispense.destination.identifier.assigner",
                "path": "MedicationDispense.destination.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationDispense.receiver",
                "path": "MedicationDispense.receiver",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationDispense.receiver.identifier.assigner",
                "path": "MedicationDispense.receiver.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationDispense.note.author[x]",
                "path": "MedicationDispense.note.author[x]",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson"
                        ]
                    },
                    {
                        "code": "string"
                    }
                ]
            },
            {
                "id": "MedicationDispense.dosageInstruction.asNeeded[x]",
                "path": "MedicationDispense.dosageInstruction.asNeeded[x]",
                "binding": {
                    "strength": "extensible",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationPrecondition"
                }
            },
            {
                "id": "MedicationDispense.dosageInstruction.site",
                "path": "MedicationDispense.dosageInstruction.site",
                "binding": {
                    "strength": "extensible",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-BodySite"
                }
            },
            {
                "id": "MedicationDispense.dosageInstruction.route",
                "path": "MedicationDispense.dosageInstruction.route",
                "binding": {
                    "strength": "extensible",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-SubstanceOrProductAdministrationRoute"
                }
            },
            {
                "id": "MedicationDispense.dosageInstruction.method",
                "path": "MedicationDispense.dosageInstruction.method",
                "binding": {
                    "strength": "extensible",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationDosageMethod"
                }
            },
            {
                "id": "MedicationDispense.substitution.responsibleParty",
                "path": "MedicationDispense.substitution.responsibleParty",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationDispense.substitution.responsibleParty.identifier.assigner",
                "path": "MedicationDispense.substitution.responsibleParty.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationDispense.detectedIssue.identifier.assigner",
                "path": "MedicationDispense.detectedIssue.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationDispense.eventHistory",
                "path": "MedicationDispense.eventHistory",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Provenance"
                        ]
                    }
                ]
            },
            {
                "id": "MedicationDispense.eventHistory.identifier.assigner",
                "path": "MedicationDispense.eventHistory.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            }
        ]
    }
}

Examples

Eye drops - An example to illustrate a dispense eye drops.

Example UKCore-MedicationDispense-EyeDrops

Example 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.

Minimum Viable Content

The minimum viable content that all provider and consumer systems should support is the following elements.

Element Reason
identifer Allows the resource to be referenced within/by other resources
status Mandatory element
statusReason To expand on the intent of the status
medication[x] Mandatory element
subject Identify the patient
performer Who or what performed the dispernsing event
authorizingPrescription Link to a prescription, when available
quantity Quantity of medication dispensed
whenPrepared Timestamp the event
dosageInstruction Dosage instruction for the dispensed medication

Context For Provider Systems

Providers systems should view elements listed as part of the minimum viable dataset in the same way as FHIR Must Support elements. Where the data is available, the provider system should include this data within the resource. Additional elements populated may be ignored by consumer systems.

Context For Consumer Systems

Consumer systems should expect the elements listed as part of the minimum viable dataset to be populated, with business data that should be relevant for the processing of the resource. Additional elements may not be populated by provider systems.


identifier

This should be populated with a globally unique and persistent identifier. This should be scoped by a provider specific namespace for the identifier.

Where consuming systems are integrating data from this resource to their local system, they should persist this identifier.

This will allow cross-referencing of a MedicationDispense within a prescribing system, and unique identification of a MedicationDispense within a shared record.


partOf

This element could be useful in two scenarios:

  • sending a bag of medicines to a ward for discharge, as this could indicate whether there is partOf the order elsewhere.
  • could also be used to interpret as 'owings' in the event of a partial supply being dispensed.

status (Mandatory)

MUST be populated with a fixed valueset defined within the FHIR standard.

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 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 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 now known which one. Avoid the use of this status value where possible.


statusReason

A coded reason for why a dispense was not performed.

Should only be populated when the status is stopped.


category

Could be used for month-end finance reporting.

Routing (such as inpatient, outpatient pharmacy, homecare, community pharmacy etc) should be catered for within the initial MedicationRequest.


medication[x] (Mandatory)

This is a mandatory element and is recommended to be used to represent the medication that was supplied - even if it differs to the original MedicationRequest.

Where the dispensed medication is contained within the NHS dm+d then it must be recorded using the dm+d standard.

When referencing a Medication resource, it is recommended that the medicationReference.display is populated with the medication description as selected by the clinician. This may be slightly different to the medication described as returned by a SNOMED/dm+d terminology FHIR server if the dispensing system has not fully implemented dm+d into their medication picking list.

Requested medication with no dm+d code

Medication not published within the dm+d may be dispensed in the Acute care setting.

In this scenario it is recommended to use the CodeableConcept variant for this element. Software logic can then clearly distinguish this from nationally coded dm+d medication.

If the dispensing system has both a locally assigned code and description for the medication then;

  • The medicationCodeableConcept.text should be the description for the medication.
  • The medicationCodeableConcept.coding.code should be the code for the medication.
  • The medicationCodeableConcept.coding.display should be the description for the medication, i.e. the same value as medicationCodeableConcept.text.

If the dispensing system only has a description for the medication then;

  • The medicationCodeableConcept.text should be the locally assigned description for the medication.

Multiple dispense requests for a single medication request

In the event that multiple dispense requests are required to fulfil a MedicationRequest, the same requesting identifier should be used with the appropriate status.

An example of this could be the Cosopt medication where one medication request would be received; however, two dispense messages would be returned for Dorzolamide and Timolol.


subject

A reference to the patient.

Within a FHIR Messaging or FHIR Document implementation, include a Profile UKCore-Patient> resource within the Bundle with at least the minimum dataset populated as defined within the UK Core standard. The reference points to the resource in the Bundle.

JSON

// within the MedicationDispense resource...

  "subject": {
    "reference": "urn:patient-011223344",
    "display": "Richard Smith"
  }

// elsewhere in the Bundle...

  {
    "fullUrl": "urn:patient-011223344",
    "resource": {
      "resourceType": "Patient",
      "id": "urn:patient-011223344",
      "identifier": {
        "system": "https://fhir.nhs.uk/Id/nhs-number",
        "value": "9912003888"
      },
      "name": {
        "use": "official",
        "text": "Mr Richard Smith",
        "family": "Smith",
        "given": "Richard",
        "prefix": "Mr"
      },
      "gender": "male",
      "birthDate": "1956-02-04"
    }
  }

Within a RESTful implemementation a reference and/or identifier MUST be provided that allows the consumer system to query another API if they need to access the complete UKCore-Patient resource. The reference points to the resource in the Bundle.

For implementations within England and Wales, the identifier could be the patient's NHS Number, allowing consumer system to use the NHS Digital Personal Demographics Service FHIR API return a Patient resource.

JSON

{
  "subject": {
    "reference": "urn:patient-011223344",
    "display": "Richard Smith",
    "identifier": {
      "system": "https://fhir.nhs.uk/Id/nhs-number",
      "value": "9912003888"
    }
  }
}

For implementations within Scotland, the identifier could be the patient's CHI Number.

JSON

{
  "subject": {
    "reference": "urn:patient-011223344",
    "display": "Richard Smith",
    "identifier": {
      "system": "https://fhir.nhs.uk/Id/chi-number",
      "value": "0402568876"
    }
  }
}


context

Optional.


supportingInformation

Optional.


performer

It is recommended that the performer.actor element either references a practioner or organization resource.


location

Optional.


authorizingPrescription

This is a required element where the prescription is known and available when constructing the MedicationDispense resource.

Supply Events

Examples of where medications can be supplied without as a prescription below:

  • Emergency supply
  • Over The Counter (OTC)
  • Patient Group Directions (PGD)
  • Minor Ailment Schemes.

Dispense Events


type

Optional.


quantity

This element could be useful in particular 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.

daysSupply

Optional.


whenPrepared

A timestamp, as close as business processes allow for when the dispensed medication was prepared, i.e. labelled and checked.


whenHandedOver

Optional.


destination

If used, consider interpreting as the Intended Destination as 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.


receiver

Optional.


note

Not required as part of a minimum viable product; however, if this field is populated, the receiving system must consume the information in the event that it contains important information (and should be treat as required)


dosageInstructions

Preferable as a structured dosage aligned to the FHIR Dose Syntax Guidance but as a minimum, dosage.text.

Where a structured dosage is provided, populate dosage.text with a human readable dosage string that is clinically equivilant to the coded dosage instruction. This is for interoperability with consuming systems that do not yet support fully structured dosing instructions.


substitution

If omitted or has a value of false then substitution has not occured.

Important: Additional guidance for the use of this element is pending further clinical consultation. A suitable definition and example use-cases for a substitution need to be defined.

For example;

  • Is a sugar-free variant classed as a substitution?
  • Is a generic variant of a drug classed as a substitution?
  • Can a substitution be an entirely different medication, or should it be a new request?

  • Should a substitution only be used, for example, if supplied in a different strength than requested?


detectedIssue

Optional.


eventHistory

Optional.

This element could be used to indicate when something has been verified.


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