Usage scenarios

The following are supported usage scenarios for this profile:

• Query medications dispensed for a patient
• Record or update a record of dispense for a patient

Comparison with other national and international specifications

A resource conforming to this profile is conformant to:

• US Core MedicationDispense

No equivalent International Patient Access or International Patient Summary profile.

Conformance in reverse is not guaranteed, i.e. a resource conforming to US Core MAY NOT conform to AU Core.

Profile specific implementation guidance

• See the Medicine information section for guidance
• MedicationDispense resources can represent the reason a dispense was not performed using either a code with MedicationDispense.statusReasonCodeableConcept, or reference a DetectedIssue resource with MedicationDispense.statusReasonReference.
  • Although both are marked as must support, servers are not required to support both a code and a reference, but they SHALL support at least one of these elements
  • A client application SHALL support both elements
• MedicationDispense resources can represent a medication using either a code with MedicationDispense.medicationCodeableConcept, or reference a Medication resource with MedicationDispense.medicationReference.
  • Although both are marked as must support, servers are not required to support both a code and a reference, but they SHALL support at least one of these elements
  • A client application SHALL support both elements
  • When referencing a Medication resource, it is preferred the resource is contained but it may be an external resource
• Source system identifiers SHOULD be included as AU Local Dispense Identifier to support electronic medication management (EMM) workflow and deduplication across medication resources.
  • See guidance on the construction of an identifier on the relevant Identifier profile page and the section on Business Identifiers in AU Base.

  Specific feedback is sought on supporting the reason a dispense was not performed. Is support for text or a code sufficient? What is the case for supporting a referenced DetectedIssue resource?

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

This structure is derived from AUBaseMedicationDispense

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	AUBaseMedicationDispense	A dispense record for a medication for a patient in an Australian healthcare context au-core-mdd-01: The location shall at least have a valid identifier or address or type
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
dispenseNumber	S	0..1	integer	Number of this dispense URL: http://hl7.org.au/fhir/StructureDefinition/dispense-number
identifier	S	0..*	Identifier, AULocalDispenseIdentifier	External identifier
status	S	1..1	code	preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown
statusReason[x]	S	0..1	CodeableConcept, Reference(DetectedIssue)	Why a dispense was not performed
category	S	0..1	CodeableConcept	Type of medication dispense
Slices for medication[x]	S	1..1	CodeableConcept, Reference(Medication)	What medication was supplied Slice: Unordered, Closed by type:$this
medication[x]:medicationCodeableConcept		0..1	CodeableConcept	Coded Dispensed Medication
Slices for coding		0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:pbs	S	0..*	Coding	PBS Item Code
coding:amt	S	0..*	Coding	AMT Medicines
medication[x]:medicationReference		0..1	Reference(AU Core Medication)	Dispensed Medication
subject	S	1..1	Reference(AU Core Patient)	Who the dispense is for
context	S	0..1	Reference(AU Core Encounter)	Encounter / Episode associated with event
performer	SC	0..*	BackboneElement	Who performed event
function	S	0..1	CodeableConcept	Who performed the dispense and what they did
actor	S	1..1	Reference(AU Core Practitioner | AU Core PractitionerRole | AU Core Organization | AU Core Patient | AU Core RelatedPerson)	Individual who was performing
location	SC	0..1	Reference(AU Core Location)	Where the dispense occurred
authorizingPrescription	S	0..*	Reference(AU Core MedicationRequest)	Medication order that authorizes the dispense
quantity	S	0..1	SimpleQuantity	Amount dispensed
daysSupply	S	0..1	SimpleQuantity	Amount of medication expressed as a timing amount
whenHandedOver	S	1..1	dateTime	When product was given out
note	S	0..*	Annotation	Information about the dispense
dosageInstruction	S	0..*	AUBaseDosage	Dosage information in an Australian healthcare context
substitution	S	0..1	BackboneElement	Whether a substitution was performed on the dispense
wasSubstituted	S	1..1	boolean	Whether a substitution was or was not performed on the dispense
Documentation for this format

Constraints

Id	Grade	Path(s)	Details	Requirements
au-core-mdd-01	error	MedicationDispense	The location shall at least have a valid identifier or address or type : performer.exists() or location.exists()

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	AUBaseMedicationDispense	A dispense record for a medication for a patient in an Australian healthcare context au-core-mdd-01: The location shall at least have a valid identifier or address or type
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
subsidisedConcurrentSupply		0..1	Coding	Grounds for concurrent supply of medication URL: http://hl7.org.au/fhir/StructureDefinition/subsidised-concurrent-supply Binding: https://healthterminologies.gov.au/fhir/ValueSet/concurrent-supply-grounds-1 (required)
dispenseNumber	S	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	S	0..*	Identifier, AULocalDispenseIdentifier	External identifier
status	?!SΣ	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]	S	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	S	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]	SΣ	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): A coded concept identifying which substance or product can be dispensed.
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:pbs	SΣ	0..*	Coding	PBS Item Code Binding: PBS Item Codes (preferred)
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://pbs.gov.au/code/item
coding:gtin	Σ	0..*	Coding	Medication Package Global Trade Item Number (GTIN) Binding: GTIN (preferred)
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://www.gs1.org/gtin
coding:amt	SΣ	0..*	Coding	AMT Medicines Binding: https://healthterminologies.gov.au/fhir/ValueSet/australian-medication-1 (preferred)
medicationClass		0..1	Coding	Medication type URL: http://hl7.org.au/fhir/StructureDefinition/medication-type Binding: Medication Type (required)
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
coding:mimsPackage	Σ	0..1	Coding	MIMS Package Binding: MIMS (preferred)
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://www.mims.com.au/codes
medication[x]:medicationReference	Σ	0..1	Reference(AU Core Medication)	Dispensed Medication
subject	SΣ	1..1	Reference(AU Core Patient)	Who the dispense is for
context	S	0..1	Reference(AU Core Encounter)	Encounter / Episode associated with event
performer	SC	0..*	BackboneElement	Who performed event
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function	S	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	S	1..1	Reference(AU Core Practitioner | AU Core PractitionerRole | AU Core Organization | AU Core Patient | AU Core RelatedPerson)	Individual who was performing
location	SC	0..1	Reference(AU Core Location)	Where the dispense occurred
authorizingPrescription	S	0..*	Reference(AU Core MedicationRequest)	Medication order that authorizes the dispense
quantity	S	0..1	SimpleQuantity	Amount dispensed
daysSupply	S	0..1	SimpleQuantity	Amount of medication expressed as a timing amount
whenHandedOver	S	1..1	dateTime	When product was given out
note	S	0..*	Annotation	Information about the dispense
dosageInstruction	S	0..*	AUBaseDosage	Dosage information in an Australian healthcare context
substitution	S	0..1	BackboneElement	Whether a substitution was performed on the dispense
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
wasSubstituted	S	1..1	boolean	Whether a substitution was or was not performed on the dispense
reason		0..1	CodeableConcept	Why was substitution made Binding: https://healthterminologies.gov.au/fhir/ValueSet/medicine-substitution-reason-1 (preferred)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
MedicationDispense.status	required	MedicationDispense Status Codes
MedicationDispense.statusReason[x]	example	MedicationDispense Status Reason Codes
MedicationDispense.category	preferred	MedicationDispense Category Codes
MedicationDispense.medication[x]	example	SNOMEDCTMedicationCodes
MedicationDispense.medication[x]:medicationCodeableConcept	example	SNOMEDCTMedicationCodes
MedicationDispense.medication[x]:medicationCodeableConcept.coding:pbs	preferred	PBSItemCodes
MedicationDispense.medication[x]:medicationCodeableConcept.coding:gtin	preferred	GTIN
MedicationDispense.medication[x]:medicationCodeableConcept.coding:amt	preferred	https://healthterminologies.gov.au/fhir/ValueSet/australian-medication-1
MedicationDispense.medication[x]:medicationCodeableConcept.coding:mimsPackage	preferred	MIMS
MedicationDispense.performer.function	example	MedicationDispense Performer Function Codes
MedicationDispense.substitution.reason	preferred	https://healthterminologies.gov.au/fhir/ValueSet/medicine-substitution-reason-1

Constraints

Id	Grade	Path(s)	Details	Requirements
au-core-mdd-01	error	MedicationDispense	The location shall at least have a valid identifier or address or type : performer.exists() or location.exists()

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	AUBaseMedicationDispense	A dispense record for a medication for a patient in an Australian healthcare context au-core-mdd-01: The location shall at least have a valid identifier or address or type
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
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
subsidisedConcurrentSupply		0..1	Coding	Grounds for concurrent supply of medication URL: http://hl7.org.au/fhir/StructureDefinition/subsidised-concurrent-supply Binding: https://healthterminologies.gov.au/fhir/ValueSet/concurrent-supply-grounds-1 (required)
dispenseNumber	S	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	S	0..*	Identifier, AULocalDispenseIdentifier	External identifier
partOf		0..*	Reference(Procedure)	Event that dispense is part of
status	?!SΣ	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]	S	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	S	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]	SΣ	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): A coded concept identifying which substance or product can be dispensed.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:pbs	SΣ	0..*	Coding	PBS Item Code Binding: PBS Item Codes (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
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://pbs.gov.au/code/item
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
coding:gtin	Σ	0..*	Coding	Medication Package Global Trade Item Number (GTIN) Binding: 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
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://www.gs1.org/gtin
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
coding:amt	SΣ	0..*	Coding	AMT Medicines Binding: https://healthterminologies.gov.au/fhir/ValueSet/australian-medication-1 (preferred)
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
medicationClass		0..1	Coding	Medication type URL: http://hl7.org.au/fhir/StructureDefinition/medication-type Binding: Medication Type (required)
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
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
coding:mimsPackage	Σ	0..1	Coding	MIMS Package Binding: MIMS (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
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://www.mims.com.au/codes
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(AU Core Medication)	Dispensed Medication
subject	SΣ	1..1	Reference(AU Core Patient)	Who the dispense is for
context	S	0..1	Reference(AU Core Encounter)	Encounter / Episode associated with event
supportingInformation		0..*	Reference(Resource)	Information that supports the dispensing of the medication
performer	SC	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	S	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	S	1..1	Reference(AU Core Practitioner | AU Core PractitionerRole | AU Core Organization | AU Core Patient | AU Core RelatedPerson)	Individual who was performing
location	SC	0..1	Reference(AU Core Location)	Where the dispense occurred
authorizingPrescription	S	0..*	Reference(AU Core 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	S	0..1	SimpleQuantity	Amount dispensed
daysSupply	S	0..1	SimpleQuantity	Amount of medication expressed as a timing amount
whenPrepared	Σ	0..1	dateTime	When product was packaged and reviewed
whenHandedOver	S	1..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	S	0..*	Annotation	Information about the dispense
dosageInstruction	S	0..*	AUBaseDosage	Dosage information in an Australian healthcare context
substitution	S	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	S	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: https://healthterminologies.gov.au/fhir/ValueSet/medicine-substitution-reason-1 (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
MedicationDispense.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
MedicationDispense.status	required	MedicationDispense Status Codes
MedicationDispense.statusReason[x]	example	MedicationDispense Status Reason Codes
MedicationDispense.category	preferred	MedicationDispense Category Codes
MedicationDispense.medication[x]	example	SNOMEDCTMedicationCodes
MedicationDispense.medication[x]:medicationCodeableConcept	example	SNOMEDCTMedicationCodes
MedicationDispense.medication[x]:medicationCodeableConcept.coding:pbs	preferred	PBSItemCodes
MedicationDispense.medication[x]:medicationCodeableConcept.coding:gtin	preferred	GTIN
MedicationDispense.medication[x]:medicationCodeableConcept.coding:amt	preferred	https://healthterminologies.gov.au/fhir/ValueSet/australian-medication-1
MedicationDispense.medication[x]:medicationCodeableConcept.coding:mimsPackage	preferred	MIMS
MedicationDispense.performer.function	example	MedicationDispense Performer Function Codes
MedicationDispense.type	example	ActPharmacySupplyType
MedicationDispense.substitution.type	example	ActSubstanceAdminSubstitutionCode
MedicationDispense.substitution.reason	preferred	https://healthterminologies.gov.au/fhir/ValueSet/medicine-substitution-reason-1

Differential View

This structure is derived from AUBaseMedicationDispense

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	AUBaseMedicationDispense	A dispense record for a medication for a patient in an Australian healthcare context au-core-mdd-01: The location shall at least have a valid identifier or address or type
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
dispenseNumber	S	0..1	integer	Number of this dispense URL: http://hl7.org.au/fhir/StructureDefinition/dispense-number
identifier	S	0..*	Identifier, AULocalDispenseIdentifier	External identifier
status	S	1..1	code	preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown
statusReason[x]	S	0..1	CodeableConcept, Reference(DetectedIssue)	Why a dispense was not performed
category	S	0..1	CodeableConcept	Type of medication dispense
Slices for medication[x]	S	1..1	CodeableConcept, Reference(Medication)	What medication was supplied Slice: Unordered, Closed by type:$this
medication[x]:medicationCodeableConcept		0..1	CodeableConcept	Coded Dispensed Medication
Slices for coding		0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:pbs	S	0..*	Coding	PBS Item Code
coding:amt	S	0..*	Coding	AMT Medicines
medication[x]:medicationReference		0..1	Reference(AU Core Medication)	Dispensed Medication
subject	S	1..1	Reference(AU Core Patient)	Who the dispense is for
context	S	0..1	Reference(AU Core Encounter)	Encounter / Episode associated with event
performer	SC	0..*	BackboneElement	Who performed event
function	S	0..1	CodeableConcept	Who performed the dispense and what they did
actor	S	1..1	Reference(AU Core Practitioner | AU Core PractitionerRole | AU Core Organization | AU Core Patient | AU Core RelatedPerson)	Individual who was performing
location	SC	0..1	Reference(AU Core Location)	Where the dispense occurred
authorizingPrescription	S	0..*	Reference(AU Core MedicationRequest)	Medication order that authorizes the dispense
quantity	S	0..1	SimpleQuantity	Amount dispensed
daysSupply	S	0..1	SimpleQuantity	Amount of medication expressed as a timing amount
whenHandedOver	S	1..1	dateTime	When product was given out
note	S	0..*	Annotation	Information about the dispense
dosageInstruction	S	0..*	AUBaseDosage	Dosage information in an Australian healthcare context
substitution	S	0..1	BackboneElement	Whether a substitution was performed on the dispense
wasSubstituted	S	1..1	boolean	Whether a substitution was or was not performed on the dispense
Documentation for this format

Constraints

Id	Grade	Path(s)	Details	Requirements
au-core-mdd-01	error	MedicationDispense	The location shall at least have a valid identifier or address or type : performer.exists() or location.exists()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	AUBaseMedicationDispense	A dispense record for a medication for a patient in an Australian healthcare context au-core-mdd-01: The location shall at least have a valid identifier or address or type
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
subsidisedConcurrentSupply		0..1	Coding	Grounds for concurrent supply of medication URL: http://hl7.org.au/fhir/StructureDefinition/subsidised-concurrent-supply Binding: https://healthterminologies.gov.au/fhir/ValueSet/concurrent-supply-grounds-1 (required)
dispenseNumber	S	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	S	0..*	Identifier, AULocalDispenseIdentifier	External identifier
status	?!SΣ	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]	S	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	S	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]	SΣ	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): A coded concept identifying which substance or product can be dispensed.
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:pbs	SΣ	0..*	Coding	PBS Item Code Binding: PBS Item Codes (preferred)
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://pbs.gov.au/code/item
coding:gtin	Σ	0..*	Coding	Medication Package Global Trade Item Number (GTIN) Binding: GTIN (preferred)
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://www.gs1.org/gtin
coding:amt	SΣ	0..*	Coding	AMT Medicines Binding: https://healthterminologies.gov.au/fhir/ValueSet/australian-medication-1 (preferred)
medicationClass		0..1	Coding	Medication type URL: http://hl7.org.au/fhir/StructureDefinition/medication-type Binding: Medication Type (required)
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
coding:mimsPackage	Σ	0..1	Coding	MIMS Package Binding: MIMS (preferred)
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://www.mims.com.au/codes
medication[x]:medicationReference	Σ	0..1	Reference(AU Core Medication)	Dispensed Medication
subject	SΣ	1..1	Reference(AU Core Patient)	Who the dispense is for
context	S	0..1	Reference(AU Core Encounter)	Encounter / Episode associated with event
performer	SC	0..*	BackboneElement	Who performed event
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function	S	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	S	1..1	Reference(AU Core Practitioner | AU Core PractitionerRole | AU Core Organization | AU Core Patient | AU Core RelatedPerson)	Individual who was performing
location	SC	0..1	Reference(AU Core Location)	Where the dispense occurred
authorizingPrescription	S	0..*	Reference(AU Core MedicationRequest)	Medication order that authorizes the dispense
quantity	S	0..1	SimpleQuantity	Amount dispensed
daysSupply	S	0..1	SimpleQuantity	Amount of medication expressed as a timing amount
whenHandedOver	S	1..1	dateTime	When product was given out
note	S	0..*	Annotation	Information about the dispense
dosageInstruction	S	0..*	AUBaseDosage	Dosage information in an Australian healthcare context
substitution	S	0..1	BackboneElement	Whether a substitution was performed on the dispense
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
wasSubstituted	S	1..1	boolean	Whether a substitution was or was not performed on the dispense
reason		0..1	CodeableConcept	Why was substitution made Binding: https://healthterminologies.gov.au/fhir/ValueSet/medicine-substitution-reason-1 (preferred)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
MedicationDispense.status	required	MedicationDispense Status Codes
MedicationDispense.statusReason[x]	example	MedicationDispense Status Reason Codes
MedicationDispense.category	preferred	MedicationDispense Category Codes
MedicationDispense.medication[x]	example	SNOMEDCTMedicationCodes
MedicationDispense.medication[x]:medicationCodeableConcept	example	SNOMEDCTMedicationCodes
MedicationDispense.medication[x]:medicationCodeableConcept.coding:pbs	preferred	PBSItemCodes
MedicationDispense.medication[x]:medicationCodeableConcept.coding:gtin	preferred	GTIN
MedicationDispense.medication[x]:medicationCodeableConcept.coding:amt	preferred	https://healthterminologies.gov.au/fhir/ValueSet/australian-medication-1
MedicationDispense.medication[x]:medicationCodeableConcept.coding:mimsPackage	preferred	MIMS
MedicationDispense.performer.function	example	MedicationDispense Performer Function Codes
MedicationDispense.substitution.reason	preferred	https://healthterminologies.gov.au/fhir/ValueSet/medicine-substitution-reason-1

Constraints

Id	Grade	Path(s)	Details	Requirements
au-core-mdd-01	error	MedicationDispense	The location shall at least have a valid identifier or address or type : performer.exists() or location.exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	AUBaseMedicationDispense	A dispense record for a medication for a patient in an Australian healthcare context au-core-mdd-01: The location shall at least have a valid identifier or address or type
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
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
subsidisedConcurrentSupply		0..1	Coding	Grounds for concurrent supply of medication URL: http://hl7.org.au/fhir/StructureDefinition/subsidised-concurrent-supply Binding: https://healthterminologies.gov.au/fhir/ValueSet/concurrent-supply-grounds-1 (required)
dispenseNumber	S	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	S	0..*	Identifier, AULocalDispenseIdentifier	External identifier
partOf		0..*	Reference(Procedure)	Event that dispense is part of
status	?!SΣ	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]	S	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	S	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]	SΣ	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): A coded concept identifying which substance or product can be dispensed.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:pbs	SΣ	0..*	Coding	PBS Item Code Binding: PBS Item Codes (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
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://pbs.gov.au/code/item
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
coding:gtin	Σ	0..*	Coding	Medication Package Global Trade Item Number (GTIN) Binding: 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
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://www.gs1.org/gtin
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
coding:amt	SΣ	0..*	Coding	AMT Medicines Binding: https://healthterminologies.gov.au/fhir/ValueSet/australian-medication-1 (preferred)
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
medicationClass		0..1	Coding	Medication type URL: http://hl7.org.au/fhir/StructureDefinition/medication-type Binding: Medication Type (required)
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
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
coding:mimsPackage	Σ	0..1	Coding	MIMS Package Binding: MIMS (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
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://www.mims.com.au/codes
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(AU Core Medication)	Dispensed Medication
subject	SΣ	1..1	Reference(AU Core Patient)	Who the dispense is for
context	S	0..1	Reference(AU Core Encounter)	Encounter / Episode associated with event
supportingInformation		0..*	Reference(Resource)	Information that supports the dispensing of the medication
performer	SC	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	S	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	S	1..1	Reference(AU Core Practitioner | AU Core PractitionerRole | AU Core Organization | AU Core Patient | AU Core RelatedPerson)	Individual who was performing
location	SC	0..1	Reference(AU Core Location)	Where the dispense occurred
authorizingPrescription	S	0..*	Reference(AU Core 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	S	0..1	SimpleQuantity	Amount dispensed
daysSupply	S	0..1	SimpleQuantity	Amount of medication expressed as a timing amount
whenPrepared	Σ	0..1	dateTime	When product was packaged and reviewed
whenHandedOver	S	1..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	S	0..*	Annotation	Information about the dispense
dosageInstruction	S	0..*	AUBaseDosage	Dosage information in an Australian healthcare context
substitution	S	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	S	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: https://healthterminologies.gov.au/fhir/ValueSet/medicine-substitution-reason-1 (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
MedicationDispense.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
MedicationDispense.status	required	MedicationDispense Status Codes
MedicationDispense.statusReason[x]	example	MedicationDispense Status Reason Codes
MedicationDispense.category	preferred	MedicationDispense Category Codes
MedicationDispense.medication[x]	example	SNOMEDCTMedicationCodes
MedicationDispense.medication[x]:medicationCodeableConcept	example	SNOMEDCTMedicationCodes
MedicationDispense.medication[x]:medicationCodeableConcept.coding:pbs	preferred	PBSItemCodes
MedicationDispense.medication[x]:medicationCodeableConcept.coding:gtin	preferred	GTIN
MedicationDispense.medication[x]:medicationCodeableConcept.coding:amt	preferred	https://healthterminologies.gov.au/fhir/ValueSet/australian-medication-1
MedicationDispense.medication[x]:medicationCodeableConcept.coding:mimsPackage	preferred	MIMS
MedicationDispense.performer.function	example	MedicationDispense Performer Function Codes
MedicationDispense.type	example	ActPharmacySupplyType
MedicationDispense.substitution.type	example	ActSubstanceAdminSubstitutionCode
MedicationDispense.substitution.reason	preferred	https://healthterminologies.gov.au/fhir/ValueSet/medicine-substitution-reason-1

This structure is derived from AUBaseMedicationDispense

Summary

Mandatory: 2 elements
Must-Support: 22 elements

Structures

This structure refers to these other structures:

• AU Core Medication (http://hl7.org.au/fhir/core/StructureDefinition/au-core-medication)
• AU Core Patient (http://hl7.org.au/fhir/core/StructureDefinition/au-core-patient)
• AU Core Encounter (http://hl7.org.au/fhir/core/StructureDefinition/au-core-encounter)
• AU Core Practitioner (http://hl7.org.au/fhir/core/StructureDefinition/au-core-practitioner)
• AU Core PractitionerRole (http://hl7.org.au/fhir/core/StructureDefinition/au-core-practitionerrole)
• AU Core Organization (http://hl7.org.au/fhir/core/StructureDefinition/au-core-organization)
• AU Core RelatedPerson (http://hl7.org.au/fhir/core/StructureDefinition/au-core-relatedperson)
• AU Core Location (http://hl7.org.au/fhir/core/StructureDefinition/au-core-location)
• AU Core MedicationRequest (http://hl7.org.au/fhir/core/StructureDefinition/au-core-medicationrequest)

Extensions

This structure refers to these extensions:

• http://hl7.org.au/fhir/StructureDefinition/dispense-number

Slices

This structure defines the following Slices:

• The element MedicationDispense.medication[x] is sliced based on the value of type:$this (Closed)
• The element MedicationDispense.medication[x].coding is sliced based on the value of value:system

Maturity: 0

Below is an overview of the mandatory and optional search parameters and combined search parameters. FHIR search operations and the syntax used to describe the interactions is described here.

Any search parameter defined in FHIR may be ‘allowed’ by the system unless explicitly marked as “SHALL NOT”. A few items are marked as MAY in this implementation guide to highlight their potential relevance.

Mandatory Search Parameters

The following search parameters and search parameter combinations SHALL be supported:

1. SHALL support searching using the patient search parameter:
   • SHOULD support these _include parameters: MedicationDispense:medication
   • SHALL support these _revinclude parameters: Provenance:target
   • SHOULD support chained searching of patient canonical identifier patient.identifier (e.g. patient.identifier=[system|][code])

   GET [base]/MedicationDispense?patient={Type/}[id] or optionallyGET [base]/MedicationDispense?patient.identifier=[system|][code]

   Example:

   1. GET [base]/MedicationDispense?patient=5678
   2. GET [base]/MedicationDispense?patient.identifier=http://ns.electronichealth.net.au/id/medicare-number|32788511952
   3. GET [base]/MedicationDispense?patient.identifier=http://ns.electronichealth.net.au/id/hi/ihi/1.0|8003608833357361

   Implementation Notes: Fetches a bundle of all MedicationDispense resources for the specified patient (how to search by reference and how to search by token)

2. SHALL support searching using the combination of the patient and status search parameters:
   • SHOULD support these _include parameters: MedicationDispense:medication
   • SHALL support these _revinclude parameters: Provenance:target
   • SHOULD support chained searching of patient canonical identifier patient.identifier (e.g. patient.identifier=[system|][code])
   • SHALL support multipleOr search on status (e.g.status={system|}[code],{system|}[code],...)

   GET [base]/MedicationDispense?patient={Type/}[id]&status={system|}[code]{,{system|}[code],...}

   Example:

   1. GET [base]/MedicationDispense?patient=5678&status=active
   2. GET [base]/MedicationDispense?patient=5678&status=active&_include=MedicationDispense:medication

   Implementation Notes: Fetches a bundle of all MedicationDispense resources for the specified patient and status (how to search by reference and how to search by token)

Optional Search Parameters

The following search parameters and search parameter combinations SHOULD be supported:

1. SHOULD support searching using the combination of the patient and whenhandedover search parameters:
   • SHOULD support these _include parameters: MedicationDispense:medication
   • SHALL support these _revinclude parameters: Provenance:target
   • SHOULD support chained searching of patient canonical identifier patient.identifier (e.g. patient.identifier=[system|][code])
   • SHALL support these whenhandedover comparators: gt,lt,ge,le
   • SHOULD support multipleAnd search on whenhandedover (e.g.whenhandedover=[date]&whenhandedover=[date]]&...)

   GET [base]/MedicationDispense?patient={Type/}[id]&whenhandedover={gt|lt|ge|le}[date]{&whenhandedover={gt|lt|ge|le}[date]&...}

   Example:

   1. GET [base]/MedicationDispense?patient=5678&whenhandedover=ge2020-01-01T00:00:00Z
   2. GET [base]/MedicationDispense?patient.identifier=http://example.org/fhir/mrn|12345&whenhandedover=ge2020-01-01T00:00:00Z
   3. GET [base]/MedicationDispense?patient.identifier=http://example.org/fhir/mrn|12345&whenhandedover=ge2020-01-01T00:00:00Z&_include=MedicationDispense:medication

   Implementation Notes: Fetches a bundle of all MedicationDispense resources for the specified patient and date. (how to search by reference and how to search by date)