AU Base Implementation Guide
6.0.0-draft - Draft

Publication Build: This will be filled in by the publication tooling

## Resource Profile: AU Base MedicationDispense

Official URL: http://hl7.org.au/fhir/StructureDefinition/au-medicationdispense | Version: 6.0.0-draft
Standards status: Trial-use | Maturity Level: 2 | Computable Name: AUBaseMedicationDispense
Copyright/Legal: HL7 Australia© 2018+; Licensed Under Creative Commons No Rights Reserved.

This profile defines a medication dispense structure that localises core concepts, including identifiers and terminology, for use in an Australian context. The purpose of this profile is to provide national level agreement on core localised concepts. This profile does not force conformance to core localised concepts. It enables implementers and modellers to make their own rules, i.e. profiling, about how to support these concepts for specific implementation needs.

### Usage Notes

Profile specific implementation guidance:

- When identifying a medication, this resource can use either a code or refer to a Medication resource.
- If making use of `MedicationDispense.code`, this profile includes coding as:
  - PBS Item Code - Pharmaceutical Benefits Scheme coding, claiming context is not relevant as medicine coding
  - Medication Package Global Trade Item Number - Global Trade Item Number (GTIN) physical product reference
  - AMT Medicines - Australian Medicines Terminology, national drug terminology
  - MIMS Package - commonly used medicine coding
- If a medication is compounded and is a list of ingredients, `MedicationDispense.code` is still present and may contain only the list of ingredients as text in `MedicationDispense.code.text`.
- Where additional medicinal product information is needed, `MedicationDispense.medicationReference` is preferred to `MedicationDispense.code` and use of extensions, see guidance on AU Base Medication.
- See each Identifier profile page for guidance related to that identifier type.

Potentially useful extensions:

- MedicationDispense: Medication Brand Name
- MedicationDispense: Medication Generic Name

Usages:

- Examples for this Profile: MedicationDispense/example0 and MedicationDispense/example1

Changes since version 5.0.0:

- The resource metadata has changed (title)

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

- Differential Table
- Key Elements Table
- Snapshot Table
- Statistics/References
- All

This structure is derived from MedicationDispense

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationDispense |  | 0..* | MedicationDispense | A dispense record for a medication for a patient in an Australian healthcare context
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:subsidisedConcurrentSupply |  | 0..1 | Coding | Grounds for concurrent supply of medication URL: http://hl7.org.au/fhir/StructureDefinition/subsidised-concurrent-supply Binding: Concurrent Supply Grounds (required)
extension:dispenseNumber |  | 0..1 | integer | Number of this dispense URL: http://hl7.org.au/fhir/StructureDefinition/dispense-number
identifier |  | 0..* | Identifier, AULocalDispenseIdentifier | External identifier
Slices for medication[x] |  | 1..1 | CodeableConcept, Reference(Medication) | What medication was supplied Slice: Unordered, Closed by type:$this
medication[x]:medicationCodeableConcept |  | 0..1 | CodeableConcept | Coded Dispensed Medication Binding: SNOMEDCTMedicationCodes (example)
Additional Bindings | Purpose
Australian Medication | Preferred
PBS Item Codes | Preferred
MIMS | Preferred
GTIN | Preferred
coding |  |  |  |
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:medicationClass |  | 0..1 | Coding | Medication type URL: http://hl7.org.au/fhir/StructureDefinition/medication-type Binding: Medication Type (required)
text |  | 0..1 | string | Medication primary text
medication[x]:medicationReference |  | 0..1 | Reference(Medication) | Dispensed Medication
dosageInstruction |  | 0..* | AUBaseDosage | How the medication is to be used by the patient or administered by the caregiver
substitution |  | 0..1 | BackboneElement | Whether a substitution was performed on the dispense
reason |  | 0..1 | CodeableConcept | Why was substitution made Binding: Medicine Substitution Reason (preferred)
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
MedicationDispense.medication[x]:medicationCodeableConcept | example | SNOMEDCTMedicationCodes
MedicationDispense.substitution.reason | preferred | MedicineSubstitutionReason `https://healthterminologies.gov.au/fhir/ValueSet/medicine-substitution-reason-1` From https://tx.ontoserver.csiro.au/fhir

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationDispense | C | 0..* | MedicationDispense | A dispense record for a medication for a patient in an Australian healthcare context Constraints: mdd-1
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:subsidisedConcurrentSupply |  | 0..1 | Coding | Grounds for concurrent supply of medication URL: http://hl7.org.au/fhir/StructureDefinition/subsidised-concurrent-supply Binding: Concurrent Supply Grounds (required)
extension:dispenseNumber |  | 0..1 | integer | Number of this dispense URL: http://hl7.org.au/fhir/StructureDefinition/dispense-number
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier |  | 0..* | Identifier, AULocalDispenseIdentifier | External identifier
status | ?!Σ | 1..1 | code | preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown Binding: MedicationDispense Status Codes (required): A coded concept specifying the state of the dispense event.
Slices for medication[x] | Σ | 1..1 |  | What medication was supplied Slice: Unordered, Closed by type:$this Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying which substance or product can be dispensed.
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication) |
medication[x]:medicationCodeableConcept | Σ | 0..1 | CodeableConcept | Coded Dispensed Medication Binding: SNOMEDCTMedicationCodes (example)
Additional Bindings | Purpose
Australian Medication | Preferred
PBS Item Codes | Preferred
MIMS | Preferred
GTIN | Preferred
text | Σ | 0..1 | string | Medication primary text
medication[x]:medicationReference | Σ | 0..1 | Reference(Medication) | Dispensed Medication
dosageInstruction |  | 0..* | AUBaseDosage | How the medication is to be used by the patient or administered by the caregiver
substitution |  | 0..1 | BackboneElement | Whether a substitution was performed on the dispense
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
wasSubstituted |  | 1..1 | boolean | Whether a substitution was or was not performed on the dispense
reason |  | 0..1 | CodeableConcept | Why was substitution made Binding: Medicine Substitution Reason (preferred)
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
MedicationDispense.status | required | MedicationDispense Status Codes `http://hl7.org/fhir/ValueSet/medicationdispense-status|4.0.1` From the FHIR Standard
MedicationDispense.medication[x] | example | SNOMEDCTMedicationCodes `http://hl7.org/fhir/ValueSet/medication-codes` From the FHIR Standard
MedicationDispense.medication[x]:medicationCodeableConcept | example | SNOMEDCTMedicationCodes `http://hl7.org/fhir/ValueSet/medication-codes` From the FHIR Standard
MedicationDispense.substitution.reason | preferred | MedicineSubstitutionReason `https://healthterminologies.gov.au/fhir/ValueSet/medicine-substitution-reason-1` From https://tx.ontoserver.csiro.au/fhir

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | MedicationDispense | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | MedicationDispense | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | MedicationDispense | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | MedicationDispense | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | MedicationDispense | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
mdd-1 | error | MedicationDispense | whenHandedOver cannot be before whenPrepared : whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared |

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationDispense | C | 0..* | MedicationDispense | A dispense record for a medication for a patient in an Australian healthcare context Constraints: mdd-1
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:subsidisedConcurrentSupply |  | 0..1 | Coding | Grounds for concurrent supply of medication URL: http://hl7.org.au/fhir/StructureDefinition/subsidised-concurrent-supply Binding: Concurrent Supply Grounds (required)
extension:dispenseNumber |  | 0..1 | integer | Number of this dispense URL: http://hl7.org.au/fhir/StructureDefinition/dispense-number
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier |  | 0..* | Identifier, AULocalDispenseIdentifier | External identifier
partOf |  | 0..* | Reference(Procedure) | Event that dispense is part of
status | ?!Σ | 1..1 | code | preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown Binding: MedicationDispense Status Codes (required): A coded concept specifying the state of the dispense event.
statusReason[x] |  | 0..1 |  | Why a dispense was not performed Binding: MedicationDispense Status Reason Codes (example): A code describing why a dispense was not performed.
statusReasonCodeableConcept |  |  | CodeableConcept |
statusReasonReference |  |  | Reference(DetectedIssue) |
category |  | 0..1 | CodeableConcept | Type of medication dispense Binding: MedicationDispense Category Codes (preferred): A code describing where the dispensed medication is expected to be consumed or administered.
Slices for medication[x] | Σ | 1..1 |  | What medication was supplied Slice: Unordered, Closed by type:$this Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying which substance or product can be dispensed.
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication) |
medication[x]:medicationCodeableConcept | Σ | 0..1 | CodeableConcept | Coded Dispensed Medication Binding: SNOMEDCTMedicationCodes (example)
Additional Bindings | Purpose
Australian Medication | Preferred
PBS Item Codes | Preferred
MIMS | Preferred
GTIN | Preferred
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 0..* | Coding | Code defined by a terminology system
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:medicationClass |  | 0..1 | Coding | Medication type URL: http://hl7.org.au/fhir/StructureDefinition/medication-type Binding: Medication Type (required)
system | Σ | 0..1 | uri | Identity of the terminology system
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 0..1 | code | Symbol in syntax defined by the system
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Medication primary text
medication[x]:medicationReference | Σ | 0..1 | Reference(Medication) | Dispensed Medication
subject | Σ | 0..1 | Reference(Patient | Group) | Who the dispense is for
context |  | 0..1 | Reference(Encounter | EpisodeOfCare) | Encounter / Episode associated with event
supportingInformation |  | 0..* | Reference(Resource) | Information that supports the dispensing of the medication
performer |  | 0..* | BackboneElement | Who performed event
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
function |  | 0..1 | CodeableConcept | Who performed the dispense and what they did Binding: MedicationDispense Performer Function Codes (example): A code describing the role an individual played in dispensing a medication.
actor |  | 1..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson) | Individual who was performing
location |  | 0..1 | Reference(Location) | Where the dispense occurred
authorizingPrescription |  | 0..* | Reference(MedicationRequest) | Medication order that authorizes the dispense
type |  | 0..1 | CodeableConcept | Trial fill, partial fill, emergency fill, etc. Binding: ActPharmacySupplyType (example): Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.
quantity |  | 0..1 | SimpleQuantity | Amount dispensed
daysSupply |  | 0..1 | SimpleQuantity | Amount of medication expressed as a timing amount
whenPrepared | Σ | 0..1 | dateTime | When product was packaged and reviewed
whenHandedOver |  | 0..1 | dateTime | When product was given out
destination |  | 0..1 | Reference(Location) | Where the medication was sent
receiver |  | 0..* | Reference(Patient | Practitioner) | Who collected the medication
note |  | 0..* | Annotation | Information about the dispense
dosageInstruction |  | 0..* | AUBaseDosage | How the medication is to be used by the patient or administered by the caregiver
substitution |  | 0..1 | BackboneElement | Whether a substitution was performed on the dispense
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
wasSubstituted |  | 1..1 | boolean | Whether a substitution was or was not performed on the dispense
type |  | 0..1 | CodeableConcept | Code signifying whether a different drug was dispensed from what was prescribed Binding: ActSubstanceAdminSubstitutionCode (example): A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription.
reason |  | 0..1 | CodeableConcept | Why was substitution made Binding: Medicine Substitution Reason (preferred)
responsibleParty |  | 0..* | Reference(Practitioner | PractitionerRole) | Who is responsible for the substitution
detectedIssue |  | 0..* | Reference(DetectedIssue) | Clinical issue with action
eventHistory |  | 0..* | Reference(Provenance) | A list of relevant lifecycle events
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
MedicationDispense.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` From the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
MedicationDispense.status | required | MedicationDispense Status Codes `http://hl7.org/fhir/ValueSet/medicationdispense-status|4.0.1` From the FHIR Standard
MedicationDispense.statusReason[x] | example | MedicationDispense Status Reason Codes `http://hl7.org/fhir/ValueSet/medicationdispense-status-reason` From the FHIR Standard
MedicationDispense.category | preferred | MedicationDispense Category Codes `http://hl7.org/fhir/ValueSet/medicationdispense-category` From the FHIR Standard
MedicationDispense.medication[x] | example | SNOMEDCTMedicationCodes `http://hl7.org/fhir/ValueSet/medication-codes` From the FHIR Standard
MedicationDispense.medication[x]:medicationCodeableConcept | example | SNOMEDCTMedicationCodes `http://hl7.org/fhir/ValueSet/medication-codes` From the FHIR Standard
MedicationDispense.performer.function | example | MedicationDispense Performer Function Codes `http://hl7.org/fhir/ValueSet/medicationdispense-performer-function` From the FHIR Standard
MedicationDispense.type | example | ActPharmacySupplyType `http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType`
MedicationDispense.substitution.type | example | ActSubstanceAdminSubstitutionCode `http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode`
MedicationDispense.substitution.reason | preferred | MedicineSubstitutionReason `https://healthterminologies.gov.au/fhir/ValueSet/medicine-substitution-reason-1` From https://tx.ontoserver.csiro.au/fhir

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | MedicationDispense | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | MedicationDispense | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | MedicationDispense | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | MedicationDispense | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | MedicationDispense | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
mdd-1 | error | MedicationDispense | whenHandedOver cannot be before whenPrepared : whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared |

This structure is derived from MedicationDispense

Summary

Structures

This structure refers to these other structures:

- AU Base Dosage (http://hl7.org.au/fhir/StructureDefinition/au-dosage)

Extensions

This structure refers to these extensions:

- http://hl7.org.au/fhir/StructureDefinition/subsidised-concurrent-supply
- http://hl7.org.au/fhir/StructureDefinition/dispense-number
- http://hl7.org.au/fhir/StructureDefinition/medication-type

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of MedicationDispense.medication[x] (Closed)

Maturity: 2

Differential View

This structure is derived from MedicationDispense

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationDispense |  | 0..* | MedicationDispense | A dispense record for a medication for a patient in an Australian healthcare context
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:subsidisedConcurrentSupply |  | 0..1 | Coding | Grounds for concurrent supply of medication URL: http://hl7.org.au/fhir/StructureDefinition/subsidised-concurrent-supply Binding: Concurrent Supply Grounds (required)
extension:dispenseNumber |  | 0..1 | integer | Number of this dispense URL: http://hl7.org.au/fhir/StructureDefinition/dispense-number
identifier |  | 0..* | Identifier, AULocalDispenseIdentifier | External identifier
Slices for medication[x] |  | 1..1 | CodeableConcept, Reference(Medication) | What medication was supplied Slice: Unordered, Closed by type:$this
medication[x]:medicationCodeableConcept |  | 0..1 | CodeableConcept | Coded Dispensed Medication Binding: SNOMEDCTMedicationCodes (example)
Additional Bindings | Purpose
Australian Medication | Preferred
PBS Item Codes | Preferred
MIMS | Preferred
GTIN | Preferred
coding |  |  |  |
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:medicationClass |  | 0..1 | Coding | Medication type URL: http://hl7.org.au/fhir/StructureDefinition/medication-type Binding: Medication Type (required)
text |  | 0..1 | string | Medication primary text
medication[x]:medicationReference |  | 0..1 | Reference(Medication) | Dispensed Medication
dosageInstruction |  | 0..* | AUBaseDosage | How the medication is to be used by the patient or administered by the caregiver
substitution |  | 0..1 | BackboneElement | Whether a substitution was performed on the dispense
reason |  | 0..1 | CodeableConcept | Why was substitution made Binding: Medicine Substitution Reason (preferred)
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
MedicationDispense.medication[x]:medicationCodeableConcept | example | SNOMEDCTMedicationCodes
MedicationDispense.substitution.reason | preferred | MedicineSubstitutionReason `https://healthterminologies.gov.au/fhir/ValueSet/medicine-substitution-reason-1` From https://tx.ontoserver.csiro.au/fhir

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationDispense | C | 0..* | MedicationDispense | A dispense record for a medication for a patient in an Australian healthcare context Constraints: mdd-1
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:subsidisedConcurrentSupply |  | 0..1 | Coding | Grounds for concurrent supply of medication URL: http://hl7.org.au/fhir/StructureDefinition/subsidised-concurrent-supply Binding: Concurrent Supply Grounds (required)
extension:dispenseNumber |  | 0..1 | integer | Number of this dispense URL: http://hl7.org.au/fhir/StructureDefinition/dispense-number
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier |  | 0..* | Identifier, AULocalDispenseIdentifier | External identifier
status | ?!Σ | 1..1 | code | preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown Binding: MedicationDispense Status Codes (required): A coded concept specifying the state of the dispense event.
Slices for medication[x] | Σ | 1..1 |  | What medication was supplied Slice: Unordered, Closed by type:$this Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying which substance or product can be dispensed.
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication) |
medication[x]:medicationCodeableConcept | Σ | 0..1 | CodeableConcept | Coded Dispensed Medication Binding: SNOMEDCTMedicationCodes (example)
Additional Bindings | Purpose
Australian Medication | Preferred
PBS Item Codes | Preferred
MIMS | Preferred
GTIN | Preferred
text | Σ | 0..1 | string | Medication primary text
medication[x]:medicationReference | Σ | 0..1 | Reference(Medication) | Dispensed Medication
dosageInstruction |  | 0..* | AUBaseDosage | How the medication is to be used by the patient or administered by the caregiver
substitution |  | 0..1 | BackboneElement | Whether a substitution was performed on the dispense
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
wasSubstituted |  | 1..1 | boolean | Whether a substitution was or was not performed on the dispense
reason |  | 0..1 | CodeableConcept | Why was substitution made Binding: Medicine Substitution Reason (preferred)
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
MedicationDispense.status | required | MedicationDispense Status Codes `http://hl7.org/fhir/ValueSet/medicationdispense-status|4.0.1` From the FHIR Standard
MedicationDispense.medication[x] | example | SNOMEDCTMedicationCodes `http://hl7.org/fhir/ValueSet/medication-codes` From the FHIR Standard
MedicationDispense.medication[x]:medicationCodeableConcept | example | SNOMEDCTMedicationCodes `http://hl7.org/fhir/ValueSet/medication-codes` From the FHIR Standard
MedicationDispense.substitution.reason | preferred | MedicineSubstitutionReason `https://healthterminologies.gov.au/fhir/ValueSet/medicine-substitution-reason-1` From https://tx.ontoserver.csiro.au/fhir

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | MedicationDispense | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | MedicationDispense | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | MedicationDispense | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | MedicationDispense | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | MedicationDispense | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
mdd-1 | error | MedicationDispense | whenHandedOver cannot be before whenPrepared : whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared |

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationDispense | C | 0..* | MedicationDispense | A dispense record for a medication for a patient in an Australian healthcare context Constraints: mdd-1
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:subsidisedConcurrentSupply |  | 0..1 | Coding | Grounds for concurrent supply of medication URL: http://hl7.org.au/fhir/StructureDefinition/subsidised-concurrent-supply Binding: Concurrent Supply Grounds (required)
extension:dispenseNumber |  | 0..1 | integer | Number of this dispense URL: http://hl7.org.au/fhir/StructureDefinition/dispense-number
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier |  | 0..* | Identifier, AULocalDispenseIdentifier | External identifier
partOf |  | 0..* | Reference(Procedure) | Event that dispense is part of
status | ?!Σ | 1..1 | code | preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown Binding: MedicationDispense Status Codes (required): A coded concept specifying the state of the dispense event.
statusReason[x] |  | 0..1 |  | Why a dispense was not performed Binding: MedicationDispense Status Reason Codes (example): A code describing why a dispense was not performed.
statusReasonCodeableConcept |  |  | CodeableConcept |
statusReasonReference |  |  | Reference(DetectedIssue) |
category |  | 0..1 | CodeableConcept | Type of medication dispense Binding: MedicationDispense Category Codes (preferred): A code describing where the dispensed medication is expected to be consumed or administered.
Slices for medication[x] | Σ | 1..1 |  | What medication was supplied Slice: Unordered, Closed by type:$this Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying which substance or product can be dispensed.
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication) |
medication[x]:medicationCodeableConcept | Σ | 0..1 | CodeableConcept | Coded Dispensed Medication Binding: SNOMEDCTMedicationCodes (example)
Additional Bindings | Purpose
Australian Medication | Preferred
PBS Item Codes | Preferred
MIMS | Preferred
GTIN | Preferred
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 0..* | Coding | Code defined by a terminology system
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:medicationClass |  | 0..1 | Coding | Medication type URL: http://hl7.org.au/fhir/StructureDefinition/medication-type Binding: Medication Type (required)
system | Σ | 0..1 | uri | Identity of the terminology system
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 0..1 | code | Symbol in syntax defined by the system
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Medication primary text
medication[x]:medicationReference | Σ | 0..1 | Reference(Medication) | Dispensed Medication
subject | Σ | 0..1 | Reference(Patient | Group) | Who the dispense is for
context |  | 0..1 | Reference(Encounter | EpisodeOfCare) | Encounter / Episode associated with event
supportingInformation |  | 0..* | Reference(Resource) | Information that supports the dispensing of the medication
performer |  | 0..* | BackboneElement | Who performed event
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
function |  | 0..1 | CodeableConcept | Who performed the dispense and what they did Binding: MedicationDispense Performer Function Codes (example): A code describing the role an individual played in dispensing a medication.
actor |  | 1..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson) | Individual who was performing
location |  | 0..1 | Reference(Location) | Where the dispense occurred
authorizingPrescription |  | 0..* | Reference(MedicationRequest) | Medication order that authorizes the dispense
type |  | 0..1 | CodeableConcept | Trial fill, partial fill, emergency fill, etc. Binding: ActPharmacySupplyType (example): Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.
quantity |  | 0..1 | SimpleQuantity | Amount dispensed
daysSupply |  | 0..1 | SimpleQuantity | Amount of medication expressed as a timing amount
whenPrepared | Σ | 0..1 | dateTime | When product was packaged and reviewed
whenHandedOver |  | 0..1 | dateTime | When product was given out
destination |  | 0..1 | Reference(Location) | Where the medication was sent
receiver |  | 0..* | Reference(Patient | Practitioner) | Who collected the medication
note |  | 0..* | Annotation | Information about the dispense
dosageInstruction |  | 0..* | AUBaseDosage | How the medication is to be used by the patient or administered by the caregiver
substitution |  | 0..1 | BackboneElement | Whether a substitution was performed on the dispense
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
wasSubstituted |  | 1..1 | boolean | Whether a substitution was or was not performed on the dispense
type |  | 0..1 | CodeableConcept | Code signifying whether a different drug was dispensed from what was prescribed Binding: ActSubstanceAdminSubstitutionCode (example): A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription.
reason |  | 0..1 | CodeableConcept | Why was substitution made Binding: Medicine Substitution Reason (preferred)
responsibleParty |  | 0..* | Reference(Practitioner | PractitionerRole) | Who is responsible for the substitution
detectedIssue |  | 0..* | Reference(DetectedIssue) | Clinical issue with action
eventHistory |  | 0..* | Reference(Provenance) | A list of relevant lifecycle events
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
MedicationDispense.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` From the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
MedicationDispense.status | required | MedicationDispense Status Codes `http://hl7.org/fhir/ValueSet/medicationdispense-status|4.0.1` From the FHIR Standard
MedicationDispense.statusReason[x] | example | MedicationDispense Status Reason Codes `http://hl7.org/fhir/ValueSet/medicationdispense-status-reason` From the FHIR Standard
MedicationDispense.category | preferred | MedicationDispense Category Codes `http://hl7.org/fhir/ValueSet/medicationdispense-category` From the FHIR Standard
MedicationDispense.medication[x] | example | SNOMEDCTMedicationCodes `http://hl7.org/fhir/ValueSet/medication-codes` From the FHIR Standard
MedicationDispense.medication[x]:medicationCodeableConcept | example | SNOMEDCTMedicationCodes `http://hl7.org/fhir/ValueSet/medication-codes` From the FHIR Standard
MedicationDispense.performer.function | example | MedicationDispense Performer Function Codes `http://hl7.org/fhir/ValueSet/medicationdispense-performer-function` From the FHIR Standard
MedicationDispense.type | example | ActPharmacySupplyType `http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType`
MedicationDispense.substitution.type | example | ActSubstanceAdminSubstitutionCode `http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode`
MedicationDispense.substitution.reason | preferred | MedicineSubstitutionReason `https://healthterminologies.gov.au/fhir/ValueSet/medicine-substitution-reason-1` From https://tx.ontoserver.csiro.au/fhir

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | MedicationDispense | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | MedicationDispense | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | MedicationDispense | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | MedicationDispense | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | MedicationDispense | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
mdd-1 | error | MedicationDispense | whenHandedOver cannot be before whenPrepared : whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared |

This structure is derived from MedicationDispense

Summary

Structures

This structure refers to these other structures:

- AU Base Dosage (http://hl7.org.au/fhir/StructureDefinition/au-dosage)

Extensions

This structure refers to these extensions:

- http://hl7.org.au/fhir/StructureDefinition/subsidised-concurrent-supply
- http://hl7.org.au/fhir/StructureDefinition/dispense-number
- http://hl7.org.au/fhir/StructureDefinition/medication-type

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of MedicationDispense.medication[x] (Closed)

Maturity: 2

Other representations of profile: CSV, Excel, Schematron