{ "resourceType": "StructureDefinition", "id": "MedicationDispense", "meta": { "lastUpdated": "2017-04-18T21:44:43.294+00:00" }, "text": { "status": "generated", "div": "
NameFlagsCard.TypeDescription & Constraints\"doco\"
\".\"\".\"MedicationDispenseIDomainResourceDispensing a medication to a named patient\n
+ whenHandedOver cannot be before whenPrepared
Elements defined in Ancestors: \n id, \n meta, \n implicitRules, \n language, \n text, \n contained, \n extension, \n modifierExtension
\".\"\".\"\".\"identifier0..*IdentifierExternal identifier\n
\".\"\".\"\".\"partOf0..*Reference(\n Procedure)\n Event that dispense is part of\n
\".\"\".\"\".\"status?!Σ0..1codepreparation | in-progress | on-hold | completed | entered-in-error | stopped\n
MedicationDispenseStatus (\n Required)\n
\".\"\".\"\".\"category0..1CodeableConceptType of medication dispense\n
MedicationDispenseCategory (\n Preferred)\n
\".\"\".\"\".\"medication[x]Σ1..1What medication was supplied\n
SNOMED CT Medication Codes (\n Example)\n
\".\"\".\"\".\"\".\"medicationCodeableConceptCodeableConcept
\".\"\".\"\".\"\".\" medicationReference\n Reference(\n Medication)\n
\".\"\".\"\".\"subjectΣ0..1Reference(\n Patient | \n Group)\n Who the dispense is for
\".\"\".\"\".\"context0..1Reference(\n Encounter | \n EpisodeOfCare)\n Encounter / Episode associated with event
\".\"\".\"\".\"supportingInformation0..*Reference(\n Any)\n Information that supports the dispensing of the medication\n
\".\"\".\"\".\"performer0..*BackboneElementWho performed event\n
\".\"\".\"\".\"\".\"actor1..1Reference(\n Practitioner | \n Organization | \n Patient | \n Device | \n RelatedPerson)\n Individual who was performing
\".\"\".\"\".\"\".\"onBehalfOf0..1Reference(\n Organization)\n Organization organization was acting for
\".\"\".\"\".\"authorizingPrescription0..*Reference(\n MedicationRequest)\n Medication order that authorizes the dispense\n
\".\"\".\"\".\"type0..1CodeableConceptTrial fill, partial fill, emergency fill, etc.\n
ActPharmacySupplyType (\n Example)\n
\".\"\".\"\".\"quantity0..1SimpleQuantityAmount dispensed
\".\"\".\"\".\"daysSupply0..1SimpleQuantityAmount of medication expressed as a timing amount
\".\"\".\"\".\"whenPreparedΣ0..1dateTimeWhen product was packaged and reviewed
\".\"\".\"\".\"whenHandedOver0..1dateTimeWhen product was given out
\".\"\".\"\".\"destination0..1Reference(\n Location)\n Where the medication was sent
\".\"\".\"\".\"receiver0..*Reference(\n Patient | \n Practitioner)\n Who collected the medication\n
\".\"\".\"\".\"note0..*AnnotationInformation about the dispense\n
\".\"\".\"\".\"dosageInstruction0..*DosageHow the medication is to be used by the patient or administered by the caregiver\n
\".\"\".\"\".\"substitution0..1BackboneElementWhether a substitution was performed on the dispense
\".\"\".\"\".\"\".\"wasSubstituted1..1booleanWhether a substitution was or was not performed on the dispense
\".\"\".\"\".\"\".\"type0..1CodeableConceptCode signifying whether a different drug was dispensed from what was prescribed\n
ActSubstanceAdminSubstitutionCode (\n Example)\n
\".\"\".\"\".\"\".\"reason0..*CodeableConceptWhy was substitution made\n
SubstanceAdminSubstitutionReason (\n Example)\n
\".\"\".\"\".\"\".\"responsibleParty0..*Reference(\n Practitioner)\n Who is responsible for the substitution\n
\".\"\".\"\".\"detectedIssue0..*Reference(\n DetectedIssue)\n Clinical issue with action\n
\".\"\".\"\".\"notDone0..1booleanWhether the dispense was or was not performed
\".\"\".\"\".\"notDoneReason[x]0..1Why a dispense was not performed
\".\"\".\"\".\"\".\"notDoneReasonCodeableConceptCodeableConcept
\".\"\".\"\".\"\".\" notDoneReasonReference\n Reference(\n DetectedIssue)\n
\".\"\".\"\".\"eventHistory0..*Reference(\n Provenance)\n A list of releveant lifecycle events\n

\"doco\" Documentation for this format\n
" }, "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm", "valueInteger": 2 }, { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg", "valueCode": "phx" } ], "url": "http://hl7.org/fhir/StructureDefinition/MedicationDispense", "name": "MedicationDispense", "status": "draft", "date": "2017-04-18T21:44:43+00:00", "publisher": "Health Level Seven International (Pharmacy)", "contact": [ { "telecom": [ { "system": "url", "value": "http://hl7.org/fhir" } ] }, { "telecom": [ { "system": "url", "value": "http://www.hl7.org/Special/committees/medication/index.cfm" } ] } ], "description": "Base StructureDefinition for MedicationDispense Resource", "fhirVersion": "3.0.1", "mapping": [ { "identity": "workflow", "uri": "http://hl7.org/fhir/workflow", "name": "Workflow Mapping" }, { "identity": "rim", "uri": "http://hl7.org/v3", "name": "RIM Mapping" }, { "identity": "w5", "uri": "http://hl7.org/fhir/w5", "name": "W5 Mapping" }, { "identity": "v2", "uri": "http://hl7.org/v2", "name": "HL7 v2 Mapping" } ], "kind": "resource", "abstract": false, "type": "MedicationDispense", "baseDefinition": "http://hl7.org/fhir/StructureDefinition/DomainResource", "derivation": "specialization", "snapshot": { "element": [ { "id": "MedicationDispense", "path": "MedicationDispense", "short": "Dispensing a medication to a named patient", "definition": "Indicates that a medication product is to be or has been dispensed for a named person/patient. This includes a description of the medication product (supply) provided and the instructions for administering the medication. The medication dispense is the result of a pharmacy system responding to a medication order.", "comment": "The WG will be updating the MedicationDispense resource to adjust each affected resource to align with the workflow pattern (see workflow.html).", "min": 0, "max": "*", "base": { "path": "Resource", "min": 0, "max": "*" }, "constraint": [ { "key": "dom-2", "severity": "error", "human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources", "expression": "contained.contained.empty()", "xpath": "not(parent::f:contained and f:contained)", "source": "http://hl7.org/fhir/StructureDefinition/DomainResource" }, { "key": "dom-1", "severity": "error", "human": "If the resource is contained in another resource, it SHALL NOT contain any narrative", "expression": "contained.text.empty()", "xpath": "not(parent::f:contained and f:text)", "source": "http://hl7.org/fhir/StructureDefinition/DomainResource" }, { "key": "dom-4", "severity": "error", "human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated", "expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()", "xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))", "source": "http://hl7.org/fhir/StructureDefinition/DomainResource" }, { "key": "dom-3", "severity": "error", "human": "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource", "expression": "contained.where(('#'+id in %resource.descendants().reference).not()).empty()", "xpath": "not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))]))", "source": "http://hl7.org/fhir/StructureDefinition/DomainResource" }, { "key": "mdd-1", "severity": "error", "human": "whenHandedOver cannot be before whenPrepared", "expression": "whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared", "xpath": "not(exists(f:whenHandedOver/@value)) or not(exists(f:whenPrepared/@value)) or ( f:whenHandedOver/@value >= f:whenPrepared/@value)", "source": "http://hl7.org/fhir/StructureDefinition/MedicationDispense" } ], "mapping": [ { "identity": "rim", "map": "Entity. Role, or Act" }, { "identity": "workflow", "map": "..Event" }, { "identity": "rim", "map": "Supply[moodCode=EVN]" }, { "identity": "w5", "map": "clinical.medication" } ] }, { "id": "MedicationDispense.id", "path": "MedicationDispense.id", "short": "Logical id of this artifact", "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.", "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.", "min": 0, "max": "1", "base": { "path": "Resource.id", "min": 0, "max": "1" }, "type": [ { "code": "id" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationDispense.meta", "path": "MedicationDispense.meta", "short": "Metadata about the resource", "definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.", "min": 0, "max": "1", "base": { "path": "Resource.meta", "min": 0, "max": "1" }, "type": [ { "code": "Meta" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "N/A" } ] }, { "id": "MedicationDispense.implicitRules", "path": "MedicationDispense.implicitRules", "short": "A set of rules under which this content was created", "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.", "comment": "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. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.", "min": 0, "max": "1", "base": { "path": "Resource.implicitRules", "min": 0, "max": "1" }, "type": [ { "code": "uri" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div" } ], "isModifier": true, "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationDispense.language", "path": "MedicationDispense.language", "short": "Language of the resource content", "definition": "The base language in which the resource is written.", "comment": "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).", "min": 0, "max": "1", "base": { "path": "Resource.language", "min": 0, "max": "1" }, "type": [ { "code": "code" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div" } ], "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet", "valueReference": { "reference": "http://hl7.org/fhir/ValueSet/all-languages" } }, { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "Language" } ], "strength": "extensible", "description": "A human language.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/languages" } }, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationDispense.text", "path": "MedicationDispense.text", "short": "Text summary of the resource, for human interpretation", "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.", "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.", "alias": [ "narrative", "html", "xhtml", "display" ], "min": 0, "max": "1", "base": { "path": "DomainResource.text", "min": 0, "max": "1" }, "type": [ { "code": "Narrative" } ], "condition": [ "ele-1", "dom-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div" } ], "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "N/A" }, { "identity": "rim", "map": "Act.text?" } ] }, { "id": "MedicationDispense.contained", "path": "MedicationDispense.contained", "short": "Contained, inline Resources", "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.", "comment": "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.", "alias": [ "inline resources", "anonymous resources", "contained resources" ], "min": 0, "max": "*", "base": { "path": "DomainResource.contained", "min": 0, "max": "*" }, "type": [ { "code": "Resource" } ], "mapping": [ { "identity": "rim", "map": "Entity. Role, or Act" }, { "identity": "rim", "map": "N/A" } ] }, { "id": "MedicationDispense.extension", "path": "MedicationDispense.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional Content defined by implementations", "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.", "comment": "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.", "alias": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "DomainResource.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Extension" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "N/A" } ] }, { "id": "MedicationDispense.modifierExtension", "path": "MedicationDispense.modifierExtension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Extensions that cannot be ignored", "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.", "comment": "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.", "alias": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "DomainResource.modifierExtension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Extension" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "isModifier": true, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "N/A" } ] }, { "id": "MedicationDispense.identifier", "path": "MedicationDispense.identifier", "short": "External identifier", "definition": "Identifier assigned by the dispensing facility - this is an identifier assigned outside FHIR.", "min": 0, "max": "*", "type": [ { "code": "Identifier" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div" } ], "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "v2", "map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)" }, { "identity": "rim", "map": "II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]" }, { "identity": "servd", "map": "Identifier" }, { "identity": "workflow", "map": "…identifier" }, { "identity": "rim", "map": ".id" }, { "identity": "w5", "map": "id" } ] }, { "id": "MedicationDispense.partOf", "path": "MedicationDispense.partOf", "short": "Event that dispense is part of", "definition": "The procedure that the dispense is done because of.", "comment": "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.", "min": 0, "max": "*", "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Procedure" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Reference" }, { "key": "ref-1", "severity": "error", "human": "SHALL have a contained resource if a local reference is provided", "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))", "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])", "source": "http://hl7.org/fhir/StructureDefinition/Reference" } ], "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)" }, { "identity": "workflow", "map": "…part of" }, { "identity": "rim", "map": ".outboundRelationship[typeCode=COMP]/target[classCode=PROC,moodCode=EVN]" } ] }, { "id": "MedicationDispense.status", "path": "MedicationDispense.status", "short": "preparation | in-progress | on-hold | completed | entered-in-error | stopped", "definition": "A code specifying the state of the set of dispense events.", "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.", "min": 0, "max": "1", "type": [ { "code": "code" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div" } ], "isModifier": true, "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "MedicationDispenseStatus" } ], "strength": "required", "description": "A coded concept specifying the state of the dispense event.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/medication-dispense-status" } }, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "workflow", "map": "…status" }, { "identity": "rim", "map": ".statusCode" }, { "identity": "w5", "map": "status" } ] }, { "id": "MedicationDispense.category", "path": "MedicationDispense.category", "short": "Type of medication dispense", "definition": "Indicates type of medication dispense and where the medication is expected to be consumed or administered.", "comment": "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.", "min": 0, "max": "1", "type": [ { "code": "CodeableConcept" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div" } ], "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "MedicationDispenseCategory" } ], "strength": "preferred", "description": "A code describing where the dispensed medication is expected to be consumed or administered", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/medication-dispense-category" } }, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "v2", "map": "CE/CNE/CWE" }, { "identity": "rim", "map": "CD" }, { "identity": "orim", "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD" }, { "identity": "rim", "map": ".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code=\"type of medication dispense\"].value" } ] }, { "id": "MedicationDispense.medication[x]", "path": "MedicationDispense.medication[x]", "short": "What medication was supplied", "definition": "Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.", "comment": "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. .", "min": 1, "max": "1", "type": [ { "code": "CodeableConcept" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Medication" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div" } ], "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "MedicationCode" } ], "strength": "example", "description": "A coded concept identifying which substance or product can be dispensed", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/medication-codes" } }, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "workflow", "map": "…code" }, { "identity": "v2", "map": "RXD-2-Dispense/Give Code" }, { "identity": "rim", "map": ".participation[typeCode=PRD].role" }, { "identity": "w5", "map": "what" } ] }, { "id": "MedicationDispense.subject", "path": "MedicationDispense.subject", "short": "Who the dispense is for", "definition": "A link to a resource representing the person or the group to whom the medication will be given.", "comment": "SubstanceAdministration->subject->Patient.", "min": 0, "max": "1", "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Group" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Reference" }, { "key": "ref-1", "severity": "error", "human": "SHALL have a contained resource if a local reference is provided", "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))", "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])", "source": "http://hl7.org/fhir/StructureDefinition/Reference" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)" }, { "identity": "workflow", "map": "…subject" }, { "identity": "v2", "map": "PID-3-Patient ID List" }, { "identity": "rim", "map": ".participation[typeCode=SBJ].role[classCode=PAT]" }, { "identity": "w5", "map": "who.focus" } ] }, { "id": "MedicationDispense.context", "path": "MedicationDispense.context", "short": "Encounter / Episode associated with event", "definition": "The encounter or episode of care that establishes the context for this event.", "comment": "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.", "min": 0, "max": "1", "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Encounter" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Reference" }, { "key": "ref-1", "severity": "error", "human": "SHALL have a contained resource if a local reference is provided", "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))", "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])", "source": "http://hl7.org/fhir/StructureDefinition/Reference" } ], "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)" }, { "identity": "workflow", "map": "…context" }, { "identity": "rim", "map": ".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code=\"type of encounter or episode\"]" } ] }, { "id": "MedicationDispense.supportingInformation", "path": "MedicationDispense.supportingInformation", "short": "Information that supports the dispensing of the medication", "definition": "Additional information that supports the medication being dispensed.", "comment": "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.", "min": 0, "max": "*", "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Reference" }, { "key": "ref-1", "severity": "error", "human": "SHALL have a contained resource if a local reference is provided", "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))", "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])", "source": "http://hl7.org/fhir/StructureDefinition/Reference" } ], "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)" }, { "identity": "rim", "map": ".outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]" }, { "identity": "w5", "map": "context" } ] }, { "id": "MedicationDispense.performer", "path": "MedicationDispense.performer", "short": "Who performed event", "definition": "Indicates who or what performed the event. It should be assumed that the performer is the dispenser of the medication.", "comment": "The performer will be reviewed as part of STU4.", "min": 0, "max": "*", "type": [ { "code": "BackboneElement" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div" } ], "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "workflow", "map": "…performer" }, { "identity": "rim", "map": ".participation[typeCode=PRF]" } ] }, { "id": "MedicationDispense.performer.id", "path": "MedicationDispense.performer.id", "representation": [ "xmlAttr" ], "short": "xml:id (or equivalent in JSON)", "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "comment": "Note that FHIR strings may not exceed 1MB in size", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationDispense.performer.extension", "path": "MedicationDispense.performer.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional Content defined by implementations", "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.", "comment": "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.", "alias": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Extension" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "N/A" } ] }, { "id": "MedicationDispense.performer.modifierExtension", "path": "MedicationDispense.performer.modifierExtension", "short": "Extensions that cannot be ignored", "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.", "comment": "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.", "alias": [ "extensions", "user content", "modifiers" ], "min": 0, "max": "*", "base": { "path": "BackboneElement.modifierExtension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Extension" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "isModifier": true, "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "N/A" } ] }, { "id": "MedicationDispense.performer.actor", "path": "MedicationDispense.performer.actor", "short": "Individual who was performing", "definition": "The device, practitioner, etc. who performed the action. It should be assumed that the actor is the dispenser of the medication.", "comment": "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.", "min": 1, "max": "1", "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Reference" }, { "key": "ref-1", "severity": "error", "human": "SHALL have a contained resource if a local reference is provided", "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))", "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])", "source": "http://hl7.org/fhir/StructureDefinition/Reference" } ], "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)" }, { "identity": "workflow", "map": "….actor" }, { "identity": "rim", "map": ".role" } ] }, { "id": "MedicationDispense.performer.onBehalfOf", "path": "MedicationDispense.performer.onBehalfOf", "short": "Organization organization was acting for", "definition": "The organization the device or practitioner was acting on behalf of.", "comment": "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.", "min": 0, "max": "1", "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Reference" }, { "key": "ref-1", "severity": "error", "human": "SHALL have a contained resource if a local reference is provided", "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))", "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])", "source": "http://hl7.org/fhir/StructureDefinition/Reference" } ], "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)" }, { "identity": "workflow", "map": "….onBehalfOf" }, { "identity": "rim", "map": ".role.scopingOrganization" } ] }, { "id": "MedicationDispense.authorizingPrescription", "path": "MedicationDispense.authorizingPrescription", "short": "Medication order that authorizes the dispense", "definition": "Indicates the medication order that is being dispensed against.", "comment": "Maps to basedOn in Event logical model.", "min": 0, "max": "*", "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Reference" }, { "key": "ref-1", "severity": "error", "human": "SHALL have a contained resource if a local reference is provided", "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))", "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])", "source": "http://hl7.org/fhir/StructureDefinition/Reference" } ], "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)" }, { "identity": "workflow", "map": "…basedOn" }, { "identity": "v2", "map": "ORC-2 Placer Order Number" }, { "identity": "rim", "map": ".outboundRelationship[typeCode=FLFS].target[moodCode=RQO]" } ] }, { "id": "MedicationDispense.type", "path": "MedicationDispense.type", "short": "Trial fill, partial fill, emergency fill, etc.", "definition": "Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.", "comment": "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.", "min": 0, "max": "1", "type": [ { "code": "CodeableConcept" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div" } ], "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "MedicationDispenseType" } ], "strength": "example", "description": "Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/v3-ActPharmacySupplyType" } }, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "v2", "map": "CE/CNE/CWE" }, { "identity": "rim", "map": "CD" }, { "identity": "orim", "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD" }, { "identity": "v2", "map": "RXD-33-Dispense Type" }, { "identity": "rim", "map": ".code" } ] }, { "id": "MedicationDispense.quantity", "path": "MedicationDispense.quantity", "short": "Amount dispensed", "definition": "The amount of medication that has been dispensed. Includes unit of measure.", "comment": "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.", "min": 0, "max": "1", "type": [ { "code": "Quantity", "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Quantity" }, { "key": "qty-3", "severity": "error", "human": "If a code for the unit is present, the system SHALL also be present", "expression": "code.empty() or system.exists()", "xpath": "not(exists(f:code)) or exists(f:system)", "source": "http://hl7.org/fhir/StructureDefinition/Quantity" }, { "key": "sqty-1", "severity": "error", "human": "The comparator is not used on a SimpleQuantity", "expression": "comparator.empty()", "xpath": "not(exists(f:comparator))", "source": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" } ], "isModifier": false, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "v2", "map": "SN (see also Range) or CQ" }, { "identity": "rim", "map": "PQ, IVL, MO, CO, depending on the values" }, { "identity": "v2", "map": "RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense Units.name of coding system" }, { "identity": "rim", "map": ".quantity" } ] }, { "id": "MedicationDispense.daysSupply", "path": "MedicationDispense.daysSupply", "short": "Amount of medication expressed as a timing amount", "definition": "The amount of medication expressed as a timing amount.", "comment": "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.", "min": 0, "max": "1", "type": [ { "code": "Quantity", "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Quantity" }, { "key": "qty-3", "severity": "error", "human": "If a code for the unit is present, the system SHALL also be present", "expression": "code.empty() or system.exists()", "xpath": "not(exists(f:code)) or exists(f:system)", "source": "http://hl7.org/fhir/StructureDefinition/Quantity" }, { "key": "sqty-1", "severity": "error", "human": "The comparator is not used on a SimpleQuantity", "expression": "comparator.empty()", "xpath": "not(exists(f:comparator))", "source": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" } ], "isModifier": false, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "v2", "map": "SN (see also Range) or CQ" }, { "identity": "rim", "map": "PQ, IVL, MO, CO, depending on the values" }, { "identity": "v2", "map": "TQ1.6 Timing/Quantity Segment Service Duration.\rPrior to v2.5, ORC.7.3 Common Order Segment / Quantity/Timing / Duration component. This is a formatted string, first character for the time unit (e.g., D=days), followed by the value. For example, “D14” represents “14 days supply”\rFrom v2.5 on, TQ1.6 Timing/Quantity Segment / Service Duration. This is a CQ data type ( ^ ), thus for days supply, assuming the unit of measure is “days”, the numeric value is TQ1.6.1 (…|14^\rFor backwards compatibility, ORC.7 was permitted through v2.6. Both forms (field and segment) may be present in v2.5, v2.5.1, and v2.6" }, { "identity": "rim", "map": "effectiveUseTime" } ] }, { "id": "MedicationDispense.whenPrepared", "path": "MedicationDispense.whenPrepared", "short": "When product was packaged and reviewed", "definition": "The time when the dispensed product was packaged and reviewed.", "min": 0, "max": "1", "type": [ { "code": "dateTime" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "v2", "map": "RXD-3-Date/Time Dispensed" }, { "identity": "rim", "map": ".effectiveTime[xmi:type=IVL_TS].low" } ] }, { "id": "MedicationDispense.whenHandedOver", "path": "MedicationDispense.whenHandedOver", "short": "When product was given out", "definition": "The time the dispensed product was provided to the patient or their representative.", "min": 0, "max": "1", "type": [ { "code": "dateTime" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div" } ], "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "workflow", "map": "…occurrenceDateTime" }, { "identity": "v2", "map": "RXD-3-Date/Time Dispensed" }, { "identity": "rim", "map": ".effectiveTime[xmi:type=IVL_TS].high" } ] }, { "id": "MedicationDispense.destination", "path": "MedicationDispense.destination", "short": "Where the medication was sent", "definition": "Identification of the facility/location where the medication was shipped to, as part of the dispense event.", "comment": "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.", "min": 0, "max": "1", "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Location" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Reference" }, { "key": "ref-1", "severity": "error", "human": "SHALL have a contained resource if a local reference is provided", "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))", "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])", "source": "http://hl7.org/fhir/StructureDefinition/Reference" } ], "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)" }, { "identity": "v2", "map": "RXD-13 Dispense-to Location; RXD-30 Dispense to Pharmacy; RXD-31 Dispense to Pharmacy Address" }, { "identity": "rim", "map": ".participation[typeCode=DST].role" } ] }, { "id": "MedicationDispense.receiver", "path": "MedicationDispense.receiver", "short": "Who collected the medication", "definition": "Identifies the person who picked up the medication. This will usually be a patient or their caregiver, but some cases exist where it can be a healthcare professional.", "comment": "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.", "min": 0, "max": "*", "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Reference" }, { "key": "ref-1", "severity": "error", "human": "SHALL have a contained resource if a local reference is provided", "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))", "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])", "source": "http://hl7.org/fhir/StructureDefinition/Reference" } ], "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)" }, { "identity": "rim", "map": ".participation[typeCode=RCV].role" } ] }, { "id": "MedicationDispense.note", "path": "MedicationDispense.note", "short": "Information about the dispense", "definition": "Extra information about the dispense that could not be conveyed in the other attributes.", "comment": "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).", "min": 0, "max": "*", "type": [ { "code": "Annotation" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div" } ], "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "v2", "map": "N/A" }, { "identity": "rim", "map": "Act" }, { "identity": "workflow", "map": "…note" }, { "identity": "v2", "map": "RXD-9 Dispense Notes" }, { "identity": "rim", "map": ".inboundRelationship[typeCode=SUBJ]/source[classCode=ACT,moodCode=EVN]" } ] }, { "id": "MedicationDispense.dosageInstruction", "path": "MedicationDispense.dosageInstruction", "short": "How the medication is to be used by the patient or administered by the caregiver", "definition": "Indicates how the medication is to be used by the patient.", "comment": "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.\rThe pharmacist reviews the medication order prior to dispense and updates the dosageInstruction based on the actual product being dispensed.", "min": 0, "max": "*", "type": [ { "code": "Dosage" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div" } ], "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": ".outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]" } ] }, { "id": "MedicationDispense.substitution", "path": "MedicationDispense.substitution", "short": "Whether a substitution was performed on the dispense", "definition": "Indicates whether or not substitution was made as part of the dispense. In some cases substitution will be expected but does not happen, in other cases substitution is not expected but does happen. This block explains what substitution did or did not happen and why. If nothing is specified, substitution was not done.", "min": 0, "max": "1", "type": [ { "code": "BackboneElement" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div" } ], "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": ".outboundRelationship[typeCode=COMP].target[classCode=SUBST, moodCode=EVN]" } ] }, { "id": "MedicationDispense.substitution.id", "path": "MedicationDispense.substitution.id", "representation": [ "xmlAttr" ], "short": "xml:id (or equivalent in JSON)", "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "comment": "Note that FHIR strings may not exceed 1MB in size", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "MedicationDispense.substitution.extension", "path": "MedicationDispense.substitution.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional Content defined by implementations", "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.", "comment": "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.", "alias": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Extension" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "N/A" } ] }, { "id": "MedicationDispense.substitution.modifierExtension", "path": "MedicationDispense.substitution.modifierExtension", "short": "Extensions that cannot be ignored", "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.", "comment": "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.", "alias": [ "extensions", "user content", "modifiers" ], "min": 0, "max": "*", "base": { "path": "BackboneElement.modifierExtension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Extension" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "isModifier": true, "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "N/A" } ] }, { "id": "MedicationDispense.substitution.wasSubstituted", "path": "MedicationDispense.substitution.wasSubstituted", "short": "Whether a substitution was or was not performed on the dispense", "definition": "True if the dispenser dispensed a different drug or product from what was prescribed.", "min": 1, "max": "1", "type": [ { "code": "boolean" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div" } ], "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": ".actionNegationInd" } ] }, { "id": "MedicationDispense.substitution.type", "path": "MedicationDispense.substitution.type", "short": "Code signifying whether a different drug was dispensed from what was prescribed", "definition": "A code signifying whether a different drug was dispensed from what was prescribed.", "comment": "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.", "min": 0, "max": "1", "type": [ { "code": "CodeableConcept" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div" } ], "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "MedicationIntendedSubstitutionType" } ], "strength": "example", "description": "A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/v3-ActSubstanceAdminSubstitutionCode" } }, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "v2", "map": "CE/CNE/CWE" }, { "identity": "rim", "map": "CD" }, { "identity": "orim", "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD" }, { "identity": "v2", "map": "RXO-9-Allow Substitutions / RXE-9-Substitution Status" }, { "identity": "rim", "map": ".code" } ] }, { "id": "MedicationDispense.substitution.reason", "path": "MedicationDispense.substitution.reason", "short": "Why was substitution made", "definition": "Indicates the reason for the substitution of (or lack of substitution) from what was prescribed.", "comment": "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.", "min": 0, "max": "*", "type": [ { "code": "CodeableConcept" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div" } ], "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "MedicationIntendedSubstitutionReason" } ], "strength": "example", "description": "A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/v3-SubstanceAdminSubstitutionReason" } }, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "v2", "map": "CE/CNE/CWE" }, { "identity": "rim", "map": "CD" }, { "identity": "orim", "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD" }, { "identity": "rim", "map": ".reasonCode" } ] }, { "id": "MedicationDispense.substitution.responsibleParty", "path": "MedicationDispense.substitution.responsibleParty", "short": "Who is responsible for the substitution", "definition": "The person or organization that has primary responsibility for the substitution.", "comment": "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.", "min": 0, "max": "*", "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Reference" }, { "key": "ref-1", "severity": "error", "human": "SHALL have a contained resource if a local reference is provided", "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))", "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])", "source": "http://hl7.org/fhir/StructureDefinition/Reference" } ], "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)" }, { "identity": "rim", "map": ".participation[typeCode=PFM].role[classCode=ASSIGN]" } ] }, { "id": "MedicationDispense.detectedIssue", "path": "MedicationDispense.detectedIssue", "short": "Clinical issue with action", "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.", "comment": "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.", "alias": [ "Contraindication", "Drug Utilization Review (DUR)", "Alert" ], "min": 0, "max": "*", "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/DetectedIssue" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Reference" }, { "key": "ref-1", "severity": "error", "human": "SHALL have a contained resource if a local reference is provided", "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))", "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])", "source": "http://hl7.org/fhir/StructureDefinition/Reference" } ], "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)" }, { "identity": "rim", "map": ".inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value" } ] }, { "id": "MedicationDispense.notDone", "path": "MedicationDispense.notDone", "short": "Whether the dispense was or was not performed", "definition": "True if the dispense was not performed for some reason.", "min": 0, "max": "1", "type": [ { "code": "boolean" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div" } ], "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "workflow", "map": "…notDone" }, { "identity": "rim", "map": ".actionNegationInd" } ] }, { "id": "MedicationDispense.notDoneReason[x]", "path": "MedicationDispense.notDoneReason[x]", "short": "Why a dispense was not performed", "definition": "Indicates the reason why a dispense was not performed.", "min": 0, "max": "1", "type": [ { "code": "CodeableConcept" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/DetectedIssue" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div" } ], "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "workflow", "map": "…notDoneReason" }, { "identity": "rim", "map": ".outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code=\"not done reason\"].value" } ] }, { "id": "MedicationDispense.eventHistory", "path": "MedicationDispense.eventHistory", "short": "A list of releveant lifecycle events", "definition": "A summary of the events of interest that have occurred, such as when the dispense was verified.", "comment": "This may not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).", "min": 0, "max": "*", "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Provenance" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Reference" }, { "key": "ref-1", "severity": "error", "human": "SHALL have a contained resource if a local reference is provided", "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))", "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])", "source": "http://hl7.org/fhir/StructureDefinition/Reference" } ], "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)" }, { "identity": "rim", "map": ".inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]" } ] } ] }, "differential": { "element": [ { "id": "MedicationDispense", "path": "MedicationDispense", "short": "Dispensing a medication to a named patient", "definition": "Indicates that a medication product is to be or has been dispensed for a named person/patient. This includes a description of the medication product (supply) provided and the instructions for administering the medication. The medication dispense is the result of a pharmacy system responding to a medication order.", "comment": "The WG will be updating the MedicationDispense resource to adjust each affected resource to align with the workflow pattern (see workflow.html).", "min": 0, "max": "*", "constraint": [ { "key": "mdd-1", "severity": "error", "human": "whenHandedOver cannot be before whenPrepared", "expression": "whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared", "xpath": "not(exists(f:whenHandedOver/@value)) or not(exists(f:whenPrepared/@value)) or ( f:whenHandedOver/@value >= f:whenPrepared/@value)" } ], "mapping": [ { "identity": "workflow", "map": "..Event" }, { "identity": "rim", "map": "Supply[moodCode=EVN]" }, { "identity": "w5", "map": "clinical.medication" } ] }, { "id": "MedicationDispense.identifier", "path": "MedicationDispense.identifier", "short": "External identifier", "definition": "Identifier assigned by the dispensing facility - this is an identifier assigned outside FHIR.", "min": 0, "max": "*", "type": [ { "code": "Identifier" } ], "mapping": [ { "identity": "workflow", "map": "…identifier" }, { "identity": "rim", "map": ".id" }, { "identity": "w5", "map": "id" } ] }, { "id": "MedicationDispense.partOf", "path": "MedicationDispense.partOf", "short": "Event that dispense is part of", "definition": "The procedure that the dispense is done because of.", "min": 0, "max": "*", "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Procedure" } ], "mapping": [ { "identity": "workflow", "map": "…part of" }, { "identity": "rim", "map": ".outboundRelationship[typeCode=COMP]/target[classCode=PROC,moodCode=EVN]" } ] }, { "id": "MedicationDispense.status", "path": "MedicationDispense.status", "short": "preparation | in-progress | on-hold | completed | entered-in-error | stopped", "definition": "A code specifying the state of the set of dispense events.", "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.", "min": 0, "max": "1", "type": [ { "code": "code" } ], "isModifier": true, "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "MedicationDispenseStatus" } ], "strength": "required", "description": "A coded concept specifying the state of the dispense event.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/medication-dispense-status" } }, "mapping": [ { "identity": "workflow", "map": "…status" }, { "identity": "rim", "map": ".statusCode" }, { "identity": "w5", "map": "status" } ] }, { "id": "MedicationDispense.category", "path": "MedicationDispense.category", "short": "Type of medication dispense", "definition": "Indicates type of medication dispense and where the medication is expected to be consumed or administered.", "min": 0, "max": "1", "type": [ { "code": "CodeableConcept" } ], "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "MedicationDispenseCategory" } ], "strength": "preferred", "description": "A code describing where the dispensed medication is expected to be consumed or administered", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/medication-dispense-category" } }, "mapping": [ { "identity": "rim", "map": ".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code=\"type of medication dispense\"].value" } ] }, { "id": "MedicationDispense.medication[x]", "path": "MedicationDispense.medication[x]", "short": "What medication was supplied", "definition": "Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.", "comment": "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. .", "min": 1, "max": "1", "type": [ { "code": "CodeableConcept" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Medication" } ], "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "MedicationCode" } ], "strength": "example", "description": "A coded concept identifying which substance or product can be dispensed", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/medication-codes" } }, "mapping": [ { "identity": "workflow", "map": "…code" }, { "identity": "v2", "map": "RXD-2-Dispense/Give Code" }, { "identity": "rim", "map": ".participation[typeCode=PRD].role" }, { "identity": "w5", "map": "what" } ] }, { "id": "MedicationDispense.subject", "path": "MedicationDispense.subject", "short": "Who the dispense is for", "definition": "A link to a resource representing the person or the group to whom the medication will be given.", "comment": "SubstanceAdministration->subject->Patient.", "min": 0, "max": "1", "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Group" } ], "isSummary": true, "mapping": [ { "identity": "workflow", "map": "…subject" }, { "identity": "v2", "map": "PID-3-Patient ID List" }, { "identity": "rim", "map": ".participation[typeCode=SBJ].role[classCode=PAT]" }, { "identity": "w5", "map": "who.focus" } ] }, { "id": "MedicationDispense.context", "path": "MedicationDispense.context", "short": "Encounter / Episode associated with event", "definition": "The encounter or episode of care that establishes the context for this event.", "min": 0, "max": "1", "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Encounter" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare" } ], "mapping": [ { "identity": "workflow", "map": "…context" }, { "identity": "rim", "map": ".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code=\"type of encounter or episode\"]" } ] }, { "id": "MedicationDispense.supportingInformation", "path": "MedicationDispense.supportingInformation", "short": "Information that supports the dispensing of the medication", "definition": "Additional information that supports the medication being dispensed.", "min": 0, "max": "*", "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource" } ], "mapping": [ { "identity": "rim", "map": ".outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]" }, { "identity": "w5", "map": "context" } ] }, { "id": "MedicationDispense.performer", "path": "MedicationDispense.performer", "short": "Who performed event", "definition": "Indicates who or what performed the event. It should be assumed that the performer is the dispenser of the medication.", "comment": "The performer will be reviewed as part of STU4.", "min": 0, "max": "*", "type": [ { "code": "BackboneElement" } ], "mapping": [ { "identity": "workflow", "map": "…performer" }, { "identity": "rim", "map": ".participation[typeCode=PRF]" } ] }, { "id": "MedicationDispense.performer.actor", "path": "MedicationDispense.performer.actor", "short": "Individual who was performing", "definition": "The device, practitioner, etc. who performed the action. It should be assumed that the actor is the dispenser of the medication.", "min": 1, "max": "1", "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson" } ], "mapping": [ { "identity": "workflow", "map": "….actor" }, { "identity": "rim", "map": ".role" } ] }, { "id": "MedicationDispense.performer.onBehalfOf", "path": "MedicationDispense.performer.onBehalfOf", "short": "Organization organization was acting for", "definition": "The organization the device or practitioner was acting on behalf of.", "min": 0, "max": "1", "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization" } ], "mapping": [ { "identity": "workflow", "map": "….onBehalfOf" }, { "identity": "rim", "map": ".role.scopingOrganization" } ] }, { "id": "MedicationDispense.authorizingPrescription", "path": "MedicationDispense.authorizingPrescription", "short": "Medication order that authorizes the dispense", "definition": "Indicates the medication order that is being dispensed against.", "comment": "Maps to basedOn in Event logical model.", "min": 0, "max": "*", "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationRequest" } ], "mapping": [ { "identity": "workflow", "map": "…basedOn" }, { "identity": "v2", "map": "ORC-2 Placer Order Number" }, { "identity": "rim", "map": ".outboundRelationship[typeCode=FLFS].target[moodCode=RQO]" } ] }, { "id": "MedicationDispense.type", "path": "MedicationDispense.type", "short": "Trial fill, partial fill, emergency fill, etc.", "definition": "Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.", "min": 0, "max": "1", "type": [ { "code": "CodeableConcept" } ], "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "MedicationDispenseType" } ], "strength": "example", "description": "Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/v3-ActPharmacySupplyType" } }, "mapping": [ { "identity": "v2", "map": "RXD-33-Dispense Type" }, { "identity": "rim", "map": ".code" } ] }, { "id": "MedicationDispense.quantity", "path": "MedicationDispense.quantity", "short": "Amount dispensed", "definition": "The amount of medication that has been dispensed. Includes unit of measure.", "min": 0, "max": "1", "type": [ { "code": "Quantity", "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" } ], "mapping": [ { "identity": "v2", "map": "RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense Units.name of coding system" }, { "identity": "rim", "map": ".quantity" } ] }, { "id": "MedicationDispense.daysSupply", "path": "MedicationDispense.daysSupply", "short": "Amount of medication expressed as a timing amount", "definition": "The amount of medication expressed as a timing amount.", "min": 0, "max": "1", "type": [ { "code": "Quantity", "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" } ], "mapping": [ { "identity": "v2", "map": "TQ1.6 Timing/Quantity Segment Service Duration.\rPrior to v2.5, ORC.7.3 Common Order Segment / Quantity/Timing / Duration component. This is a formatted string, first character for the time unit (e.g., D=days), followed by the value. For example, “D14” represents “14 days supply”\rFrom v2.5 on, TQ1.6 Timing/Quantity Segment / Service Duration. This is a CQ data type ( ^ ), thus for days supply, assuming the unit of measure is “days”, the numeric value is TQ1.6.1 (…|14^\rFor backwards compatibility, ORC.7 was permitted through v2.6. Both forms (field and segment) may be present in v2.5, v2.5.1, and v2.6" }, { "identity": "rim", "map": "effectiveUseTime" } ] }, { "id": "MedicationDispense.whenPrepared", "path": "MedicationDispense.whenPrepared", "short": "When product was packaged and reviewed", "definition": "The time when the dispensed product was packaged and reviewed.", "min": 0, "max": "1", "type": [ { "code": "dateTime" } ], "isSummary": true, "mapping": [ { "identity": "v2", "map": "RXD-3-Date/Time Dispensed" }, { "identity": "rim", "map": ".effectiveTime[xmi:type=IVL_TS].low" } ] }, { "id": "MedicationDispense.whenHandedOver", "path": "MedicationDispense.whenHandedOver", "short": "When product was given out", "definition": "The time the dispensed product was provided to the patient or their representative.", "min": 0, "max": "1", "type": [ { "code": "dateTime" } ], "mapping": [ { "identity": "workflow", "map": "…occurrenceDateTime" }, { "identity": "v2", "map": "RXD-3-Date/Time Dispensed" }, { "identity": "rim", "map": ".effectiveTime[xmi:type=IVL_TS].high" } ] }, { "id": "MedicationDispense.destination", "path": "MedicationDispense.destination", "short": "Where the medication was sent", "definition": "Identification of the facility/location where the medication was shipped to, as part of the dispense event.", "min": 0, "max": "1", "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Location" } ], "mapping": [ { "identity": "v2", "map": "RXD-13 Dispense-to Location; RXD-30 Dispense to Pharmacy; RXD-31 Dispense to Pharmacy Address" }, { "identity": "rim", "map": ".participation[typeCode=DST].role" } ] }, { "id": "MedicationDispense.receiver", "path": "MedicationDispense.receiver", "short": "Who collected the medication", "definition": "Identifies the person who picked up the medication. This will usually be a patient or their caregiver, but some cases exist where it can be a healthcare professional.", "min": 0, "max": "*", "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner" } ], "mapping": [ { "identity": "rim", "map": ".participation[typeCode=RCV].role" } ] }, { "id": "MedicationDispense.note", "path": "MedicationDispense.note", "short": "Information about the dispense", "definition": "Extra information about the dispense that could not be conveyed in the other attributes.", "min": 0, "max": "*", "type": [ { "code": "Annotation" } ], "mapping": [ { "identity": "workflow", "map": "…note" }, { "identity": "v2", "map": "RXD-9 Dispense Notes" }, { "identity": "rim", "map": ".inboundRelationship[typeCode=SUBJ]/source[classCode=ACT,moodCode=EVN]" } ] }, { "id": "MedicationDispense.dosageInstruction", "path": "MedicationDispense.dosageInstruction", "short": "How the medication is to be used by the patient or administered by the caregiver", "definition": "Indicates how the medication is to be used by the patient.", "comment": "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.\rThe pharmacist reviews the medication order prior to dispense and updates the dosageInstruction based on the actual product being dispensed.", "min": 0, "max": "*", "type": [ { "code": "Dosage" } ], "mapping": [ { "identity": "rim", "map": ".outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]" } ] }, { "id": "MedicationDispense.substitution", "path": "MedicationDispense.substitution", "short": "Whether a substitution was performed on the dispense", "definition": "Indicates whether or not substitution was made as part of the dispense. In some cases substitution will be expected but does not happen, in other cases substitution is not expected but does happen. This block explains what substitution did or did not happen and why. If nothing is specified, substitution was not done.", "min": 0, "max": "1", "type": [ { "code": "BackboneElement" } ], "mapping": [ { "identity": "rim", "map": ".outboundRelationship[typeCode=COMP].target[classCode=SUBST, moodCode=EVN]" } ] }, { "id": "MedicationDispense.substitution.wasSubstituted", "path": "MedicationDispense.substitution.wasSubstituted", "short": "Whether a substitution was or was not performed on the dispense", "definition": "True if the dispenser dispensed a different drug or product from what was prescribed.", "min": 1, "max": "1", "type": [ { "code": "boolean" } ], "mapping": [ { "identity": "rim", "map": ".actionNegationInd" } ] }, { "id": "MedicationDispense.substitution.type", "path": "MedicationDispense.substitution.type", "short": "Code signifying whether a different drug was dispensed from what was prescribed", "definition": "A code signifying whether a different drug was dispensed from what was prescribed.", "min": 0, "max": "1", "type": [ { "code": "CodeableConcept" } ], "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "MedicationIntendedSubstitutionType" } ], "strength": "example", "description": "A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/v3-ActSubstanceAdminSubstitutionCode" } }, "mapping": [ { "identity": "v2", "map": "RXO-9-Allow Substitutions / RXE-9-Substitution Status" }, { "identity": "rim", "map": ".code" } ] }, { "id": "MedicationDispense.substitution.reason", "path": "MedicationDispense.substitution.reason", "short": "Why was substitution made", "definition": "Indicates the reason for the substitution of (or lack of substitution) from what was prescribed.", "min": 0, "max": "*", "type": [ { "code": "CodeableConcept" } ], "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "MedicationIntendedSubstitutionReason" } ], "strength": "example", "description": "A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/v3-SubstanceAdminSubstitutionReason" } }, "mapping": [ { "identity": "rim", "map": ".reasonCode" } ] }, { "id": "MedicationDispense.substitution.responsibleParty", "path": "MedicationDispense.substitution.responsibleParty", "short": "Who is responsible for the substitution", "definition": "The person or organization that has primary responsibility for the substitution.", "min": 0, "max": "*", "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner" } ], "mapping": [ { "identity": "rim", "map": ".participation[typeCode=PFM].role[classCode=ASSIGN]" } ] }, { "id": "MedicationDispense.detectedIssue", "path": "MedicationDispense.detectedIssue", "short": "Clinical issue with action", "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.", "alias": [ "Contraindication", "Drug Utilization Review (DUR)", "Alert" ], "min": 0, "max": "*", "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/DetectedIssue" } ], "mapping": [ { "identity": "rim", "map": ".inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value" } ] }, { "id": "MedicationDispense.notDone", "path": "MedicationDispense.notDone", "short": "Whether the dispense was or was not performed", "definition": "True if the dispense was not performed for some reason.", "min": 0, "max": "1", "type": [ { "code": "boolean" } ], "mapping": [ { "identity": "workflow", "map": "…notDone" }, { "identity": "rim", "map": ".actionNegationInd" } ] }, { "id": "MedicationDispense.notDoneReason[x]", "path": "MedicationDispense.notDoneReason[x]", "short": "Why a dispense was not performed", "definition": "Indicates the reason why a dispense was not performed.", "min": 0, "max": "1", "type": [ { "code": "CodeableConcept" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/DetectedIssue" } ], "mapping": [ { "identity": "workflow", "map": "…notDoneReason" }, { "identity": "rim", "map": ".outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code=\"not done reason\"].value" } ] }, { "id": "MedicationDispense.eventHistory", "path": "MedicationDispense.eventHistory", "short": "A list of releveant lifecycle events", "definition": "A summary of the events of interest that have occurred, such as when the dispense was verified.", "comment": "This may not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).", "min": 0, "max": "*", "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Provenance" } ], "mapping": [ { "identity": "rim", "map": ".inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]" } ] } ] } }