AU Core Implementation Guide
0.2.2-preview - Preview Australia flag

This page is part of the Australian Core IG (v0.2.2-preview: AU Core) based on FHIR R4. For a full list of available versions, see the Directory of published versions

Resource Profile: AU Core MedicationDispense

Official URL: http://hl7.org.au/fhir/core/StructureDefinition/au-core-medicationdispense Version: 0.2.2-preview
Standards status: Draft Maturity Level: 0 Computable Name: AUCoreMedicationDispense

Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License. HL7 Australia© 2022+; Licensed Under Creative Commons No Rights Reserved.

This profile sets minimum expectations for a MedicationDispense resource to record, search, and fetch medication dispense history associated with a patient. It is based on the AU Base Medication Dispense profile and identifies the additional mandatory core elements, extensions, vocabularies and value sets that SHALL be present in the MedicationDispense when conforming to this profile. It provides the floor for standards development for specific uses cases in an Australian context.

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:

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?

Usage:

Formal Views of Profile Content

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

This structure is derived from AUBaseMedicationDispense

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationDispense C0..*AUBaseMedicationDispenseA 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..*ExtensionExtension
Slice: Unordered, Open by value:url
... dispenseNumber S0..1integerNumber of this dispense
URL: http://hl7.org.au/fhir/StructureDefinition/dispense-number
... identifier S0..*Identifier, AULocalDispenseIdentifierExternal identifier
... statusReason[x] S0..1CodeableConcept, Reference(DetectedIssue)Why a dispense was not performed
... category S0..1CodeableConceptType of medication dispense
... Slices for medication[x] S1..1CodeableConcept, Reference(Medication)What medication was supplied
Slice: Unordered, Closed by type:$this
.... medication[x]:medicationCodeableConcept 0..1CodeableConceptCoded Dispensed Medication
..... Slices for coding 0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
...... coding:pbs S0..*CodingPBS Item Code
...... coding:amt S0..*CodingAMT Medicines
.... medication[x]:medicationReference 0..1Reference(AU Core Medication)Dispensed Medication
... subject S1..1Reference(AU Core Patient)Who the dispense is for
... context S0..1Reference(AU Core Encounter)Encounter / Episode associated with event
... performer SC0..*BackboneElementWho performed event
.... function S0..1CodeableConceptWho performed the dispense and what they did
.... actor S1..1Reference(AU Core Practitioner | AU Core PractitionerRole | AU Core Organization | AU Core Patient | AU Core RelatedPerson)Individual who was performing
... location SC0..1Reference(AU Core Location)Where the dispense occurred
... authorizingPrescription S0..*Reference(AU Core MedicationRequest)Medication order that authorizes the dispense
... quantity S0..1SimpleQuantityAmount dispensed
... daysSupply S0..1SimpleQuantityAmount of medication expressed as a timing amount
... whenHandedOver S1..1dateTimeWhen product was given out
... note S0..*AnnotationInformation about the dispense
... dosageInstruction S0..*AUBaseDosageDosage information in an Australian healthcare context
... substitution S0..1BackboneElementWhether a substitution was performed on the dispense
.... wasSubstituted S1..1booleanWhether a substitution was or was not performed on the dispense

doco Documentation for this format

Constraints

IdGradePath(s)DetailsRequirements
au-core-mdd-01errorMedicationDispenseThe location shall at least have a valid identifier or address or type
: performer.exists() or location.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationDispense C0..*AUBaseMedicationDispenseA 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 ?!Σ0..1uriA set of rules under which this content was created
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... subsidisedConcurrentSupply 0..1CodingGrounds 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)
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier S0..*Identifier, AULocalDispenseIdentifierExternal identifier
... status ?!SΣ1..1codepreparation | 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] S0..1Why a dispense was not performed
Binding: MedicationDispense Status Reason Codes (example): A code describing why a dispense was not performed.

.... statusReasonCodeableConceptCodeableConcept
.... statusReasonReferenceReference(DetectedIssue)
... category S0..1CodeableConceptType 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] SΣ1..1What medication was supplied
Slice: Unordered, Closed by type:$this
Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying which substance or product can be dispensed.

.... medicationCodeableConceptCodeableConcept
.... medicationReferenceReference(Medication)
.... medication[x]:medicationCodeableConcept Σ0..1CodeableConceptCoded Dispensed Medication
Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying which substance or product can be dispensed.

..... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
...... coding:pbs SΣ0..*CodingPBS Item Code
Binding: PBS Item Codes (preferred)
....... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://pbs.gov.au/code/item
...... coding:gtin Σ0..*CodingMedication Package Global Trade Item Number (GTIN)
Binding: GTIN (preferred)
....... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://www.gs1.org/gtin
...... coding:amt SΣ0..*CodingAMT Medicines
Binding: https://healthterminologies.gov.au/fhir/ValueSet/australian-medication-1 (preferred)
....... medicationClass 0..1CodingMedication type
URL: http://hl7.org.au/fhir/StructureDefinition/medication-type
Binding: Medication Type (required)
....... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
...... coding:mimsPackage Σ0..1CodingMIMS Package
Binding: MIMS (preferred)
....... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://www.mims.com.au/codes
.... medication[x]:medicationReference Σ0..1Reference(AU Core Medication)Dispensed Medication
... subject SΣ1..1Reference(AU Core Patient)Who the dispense is for
... context S0..1Reference(AU Core Encounter)Encounter / Episode associated with event
... performer SC0..*BackboneElementWho performed event
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... function S0..1CodeableConceptWho 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 S1..1Reference(AU Core Practitioner | AU Core PractitionerRole | AU Core Organization | AU Core Patient | AU Core RelatedPerson)Individual who was performing
... location SC0..1Reference(AU Core Location)Where the dispense occurred
... authorizingPrescription S0..*Reference(AU Core MedicationRequest)Medication order that authorizes the dispense
... quantity S0..1SimpleQuantityAmount dispensed
... daysSupply S0..1SimpleQuantityAmount of medication expressed as a timing amount
... whenHandedOver S1..1dateTimeWhen product was given out
... note S0..*AnnotationInformation about the dispense
... dosageInstruction S0..*AUBaseDosageDosage information in an Australian healthcare context
... substitution S0..1BackboneElementWhether a substitution was performed on the dispense
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... wasSubstituted S1..1booleanWhether a substitution was or was not performed on the dispense
.... reason 0..1CodeableConceptWhy was substitution made
Binding: https://healthterminologies.gov.au/fhir/ValueSet/medicine-substitution-reason-1 (preferred)

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
MedicationDispense.statusrequiredMedicationDispense Status Codes
MedicationDispense.statusReason[x]exampleMedicationDispense Status Reason Codes
MedicationDispense.categorypreferredMedicationDispense Category Codes
MedicationDispense.medication[x]exampleSNOMEDCTMedicationCodes
MedicationDispense.medication[x]:medicationCodeableConceptexampleSNOMEDCTMedicationCodes
MedicationDispense.medication[x]:medicationCodeableConcept.coding:pbspreferredPBSItemCodes
MedicationDispense.medication[x]:medicationCodeableConcept.coding:gtinpreferredGTIN
MedicationDispense.medication[x]:medicationCodeableConcept.coding:amtpreferredhttps://healthterminologies.gov.au/fhir/ValueSet/australian-medication-1
MedicationDispense.medication[x]:medicationCodeableConcept.coding:mimsPackagepreferredMIMS
MedicationDispense.performer.functionexampleMedicationDispense Performer Function Codes
MedicationDispense.substitution.reasonpreferredhttps://healthterminologies.gov.au/fhir/ValueSet/medicine-substitution-reason-1

Constraints

IdGradePath(s)DetailsRequirements
au-core-mdd-01errorMedicationDispenseThe location shall at least have a valid identifier or address or type
: performer.exists() or location.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationDispense C0..*AUBaseMedicationDispenseA 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 Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... subsidisedConcurrentSupply 0..1CodingGrounds 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 S0..1integerNumber of this dispense
URL: http://hl7.org.au/fhir/StructureDefinition/dispense-number
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier S0..*Identifier, AULocalDispenseIdentifierExternal identifier
... partOf 0..*Reference(Procedure)Event that dispense is part of
... status ?!SΣ1..1codepreparation | 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] S0..1Why a dispense was not performed
Binding: MedicationDispense Status Reason Codes (example): A code describing why a dispense was not performed.

.... statusReasonCodeableConceptCodeableConcept
.... statusReasonReferenceReference(DetectedIssue)
... category S0..1CodeableConceptType 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] SΣ1..1What medication was supplied
Slice: Unordered, Closed by type:$this
Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying which substance or product can be dispensed.

.... medicationCodeableConceptCodeableConcept
.... medicationReferenceReference(Medication)
.... medication[x]:medicationCodeableConcept Σ0..1CodeableConceptCoded Dispensed Medication
Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying which substance or product can be dispensed.

..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
...... coding:pbs SΣ0..*CodingPBS Item Code
Binding: PBS Item Codes (preferred)
....... id 0..1stringUnique id for inter-element referencing
....... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://pbs.gov.au/code/item
....... version Σ0..1stringVersion of the system - if relevant
....... code Σ0..1codeSymbol in syntax defined by the system
....... display Σ0..1stringRepresentation defined by the system
....... userSelected Σ0..1booleanIf this coding was chosen directly by the user
...... coding:gtin Σ0..*CodingMedication Package Global Trade Item Number (GTIN)
Binding: GTIN (preferred)
....... id 0..1stringUnique id for inter-element referencing
....... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://www.gs1.org/gtin
....... version Σ0..1stringVersion of the system - if relevant
....... code Σ0..1codeSymbol in syntax defined by the system
....... display Σ0..1stringRepresentation defined by the system
....... userSelected Σ0..1booleanIf this coding was chosen directly by the user
...... coding:amt SΣ0..*CodingAMT Medicines
Binding: https://healthterminologies.gov.au/fhir/ValueSet/australian-medication-1 (preferred)
....... id 0..1stringUnique id for inter-element referencing
....... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
....... medicationClass 0..1CodingMedication type
URL: http://hl7.org.au/fhir/StructureDefinition/medication-type
Binding: Medication Type (required)
....... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
....... version Σ0..1stringVersion of the system - if relevant
....... code Σ0..1codeSymbol in syntax defined by the system
....... display Σ0..1stringRepresentation defined by the system
....... userSelected Σ0..1booleanIf this coding was chosen directly by the user
...... coding:mimsPackage Σ0..1CodingMIMS Package
Binding: MIMS (preferred)
....... id 0..1stringUnique id for inter-element referencing
....... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://www.mims.com.au/codes
....... version Σ0..1stringVersion of the system - if relevant
....... code Σ0..1codeSymbol in syntax defined by the system
....... display Σ0..1stringRepresentation defined by the system
....... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... text Σ0..1stringMedication primary text
.... medication[x]:medicationReference Σ0..1Reference(AU Core Medication)Dispensed Medication
... subject SΣ1..1Reference(AU Core Patient)Who the dispense is for
... context S0..1Reference(AU Core Encounter)Encounter / Episode associated with event
... supportingInformation 0..*Reference(Resource)Information that supports the dispensing of the medication
... performer SC0..*BackboneElementWho performed event
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... function S0..1CodeableConceptWho 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 S1..1Reference(AU Core Practitioner | AU Core PractitionerRole | AU Core Organization | AU Core Patient | AU Core RelatedPerson)Individual who was performing
... location SC0..1Reference(AU Core Location)Where the dispense occurred
... authorizingPrescription S0..*Reference(AU Core MedicationRequest)Medication order that authorizes the dispense
... type 0..1CodeableConceptTrial 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 S0..1SimpleQuantityAmount dispensed
... daysSupply S0..1SimpleQuantityAmount of medication expressed as a timing amount
... whenPrepared Σ0..1dateTimeWhen product was packaged and reviewed
... whenHandedOver S1..1dateTimeWhen product was given out
... destination 0..1Reference(Location)Where the medication was sent
... receiver 0..*Reference(Patient | Practitioner)Who collected the medication
... note S0..*AnnotationInformation about the dispense
... dosageInstruction S0..*AUBaseDosageDosage information in an Australian healthcare context
... substitution S0..1BackboneElementWhether a substitution was performed on the dispense
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... wasSubstituted S1..1booleanWhether a substitution was or was not performed on the dispense
.... type 0..1CodeableConceptCode 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..1CodeableConceptWhy 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

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
MedicationDispense.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
MedicationDispense.statusrequiredMedicationDispense Status Codes
MedicationDispense.statusReason[x]exampleMedicationDispense Status Reason Codes
MedicationDispense.categorypreferredMedicationDispense Category Codes
MedicationDispense.medication[x]exampleSNOMEDCTMedicationCodes
MedicationDispense.medication[x]:medicationCodeableConceptexampleSNOMEDCTMedicationCodes
MedicationDispense.medication[x]:medicationCodeableConcept.coding:pbspreferredPBSItemCodes
MedicationDispense.medication[x]:medicationCodeableConcept.coding:gtinpreferredGTIN
MedicationDispense.medication[x]:medicationCodeableConcept.coding:amtpreferredhttps://healthterminologies.gov.au/fhir/ValueSet/australian-medication-1
MedicationDispense.medication[x]:medicationCodeableConcept.coding:mimsPackagepreferredMIMS
MedicationDispense.performer.functionexampleMedicationDispense Performer Function Codes
MedicationDispense.typeexampleActPharmacySupplyType
MedicationDispense.substitution.typeexampleActSubstanceAdminSubstitutionCode
MedicationDispense.substitution.reasonpreferredhttps://healthterminologies.gov.au/fhir/ValueSet/medicine-substitution-reason-1

Constraints

IdGradePath(s)DetailsRequirements
au-core-mdd-01errorMedicationDispenseThe location shall at least have a valid identifier or address or type
: performer.exists() or location.exists()

Differential View

This structure is derived from AUBaseMedicationDispense

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationDispense C0..*AUBaseMedicationDispenseA 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..*ExtensionExtension
Slice: Unordered, Open by value:url
... dispenseNumber S0..1integerNumber of this dispense
URL: http://hl7.org.au/fhir/StructureDefinition/dispense-number
... identifier S0..*Identifier, AULocalDispenseIdentifierExternal identifier
... statusReason[x] S0..1CodeableConcept, Reference(DetectedIssue)Why a dispense was not performed
... category S0..1CodeableConceptType of medication dispense
... Slices for medication[x] S1..1CodeableConcept, Reference(Medication)What medication was supplied
Slice: Unordered, Closed by type:$this
.... medication[x]:medicationCodeableConcept 0..1CodeableConceptCoded Dispensed Medication
..... Slices for coding 0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
...... coding:pbs S0..*CodingPBS Item Code
...... coding:amt S0..*CodingAMT Medicines
.... medication[x]:medicationReference 0..1Reference(AU Core Medication)Dispensed Medication
... subject S1..1Reference(AU Core Patient)Who the dispense is for
... context S0..1Reference(AU Core Encounter)Encounter / Episode associated with event
... performer SC0..*BackboneElementWho performed event
.... function S0..1CodeableConceptWho performed the dispense and what they did
.... actor S1..1Reference(AU Core Practitioner | AU Core PractitionerRole | AU Core Organization | AU Core Patient | AU Core RelatedPerson)Individual who was performing
... location SC0..1Reference(AU Core Location)Where the dispense occurred
... authorizingPrescription S0..*Reference(AU Core MedicationRequest)Medication order that authorizes the dispense
... quantity S0..1SimpleQuantityAmount dispensed
... daysSupply S0..1SimpleQuantityAmount of medication expressed as a timing amount
... whenHandedOver S1..1dateTimeWhen product was given out
... note S0..*AnnotationInformation about the dispense
... dosageInstruction S0..*AUBaseDosageDosage information in an Australian healthcare context
... substitution S0..1BackboneElementWhether a substitution was performed on the dispense
.... wasSubstituted S1..1booleanWhether a substitution was or was not performed on the dispense

doco Documentation for this format

Constraints

IdGradePath(s)DetailsRequirements
au-core-mdd-01errorMedicationDispenseThe location shall at least have a valid identifier or address or type
: performer.exists() or location.exists()

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationDispense C0..*AUBaseMedicationDispenseA 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 ?!Σ0..1uriA set of rules under which this content was created
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... subsidisedConcurrentSupply 0..1CodingGrounds 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)
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier S0..*Identifier, AULocalDispenseIdentifierExternal identifier
... status ?!SΣ1..1codepreparation | 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] S0..1Why a dispense was not performed
Binding: MedicationDispense Status Reason Codes (example): A code describing why a dispense was not performed.

.... statusReasonCodeableConceptCodeableConcept
.... statusReasonReferenceReference(DetectedIssue)
... category S0..1CodeableConceptType 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] SΣ1..1What medication was supplied
Slice: Unordered, Closed by type:$this
Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying which substance or product can be dispensed.

.... medicationCodeableConceptCodeableConcept
.... medicationReferenceReference(Medication)
.... medication[x]:medicationCodeableConcept Σ0..1CodeableConceptCoded Dispensed Medication
Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying which substance or product can be dispensed.

..... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
...... coding:pbs SΣ0..*CodingPBS Item Code
Binding: PBS Item Codes (preferred)
....... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://pbs.gov.au/code/item
...... coding:gtin Σ0..*CodingMedication Package Global Trade Item Number (GTIN)
Binding: GTIN (preferred)
....... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://www.gs1.org/gtin
...... coding:amt SΣ0..*CodingAMT Medicines
Binding: https://healthterminologies.gov.au/fhir/ValueSet/australian-medication-1 (preferred)
....... medicationClass 0..1CodingMedication type
URL: http://hl7.org.au/fhir/StructureDefinition/medication-type
Binding: Medication Type (required)
....... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
...... coding:mimsPackage Σ0..1CodingMIMS Package
Binding: MIMS (preferred)
....... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://www.mims.com.au/codes
.... medication[x]:medicationReference Σ0..1Reference(AU Core Medication)Dispensed Medication
... subject SΣ1..1Reference(AU Core Patient)Who the dispense is for
... context S0..1Reference(AU Core Encounter)Encounter / Episode associated with event
... performer SC0..*BackboneElementWho performed event
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... function S0..1CodeableConceptWho 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 S1..1Reference(AU Core Practitioner | AU Core PractitionerRole | AU Core Organization | AU Core Patient | AU Core RelatedPerson)Individual who was performing
... location SC0..1Reference(AU Core Location)Where the dispense occurred
... authorizingPrescription S0..*Reference(AU Core MedicationRequest)Medication order that authorizes the dispense
... quantity S0..1SimpleQuantityAmount dispensed
... daysSupply S0..1SimpleQuantityAmount of medication expressed as a timing amount
... whenHandedOver S1..1dateTimeWhen product was given out
... note S0..*AnnotationInformation about the dispense
... dosageInstruction S0..*AUBaseDosageDosage information in an Australian healthcare context
... substitution S0..1BackboneElementWhether a substitution was performed on the dispense
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... wasSubstituted S1..1booleanWhether a substitution was or was not performed on the dispense
.... reason 0..1CodeableConceptWhy was substitution made
Binding: https://healthterminologies.gov.au/fhir/ValueSet/medicine-substitution-reason-1 (preferred)

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
MedicationDispense.statusrequiredMedicationDispense Status Codes
MedicationDispense.statusReason[x]exampleMedicationDispense Status Reason Codes
MedicationDispense.categorypreferredMedicationDispense Category Codes
MedicationDispense.medication[x]exampleSNOMEDCTMedicationCodes
MedicationDispense.medication[x]:medicationCodeableConceptexampleSNOMEDCTMedicationCodes
MedicationDispense.medication[x]:medicationCodeableConcept.coding:pbspreferredPBSItemCodes
MedicationDispense.medication[x]:medicationCodeableConcept.coding:gtinpreferredGTIN
MedicationDispense.medication[x]:medicationCodeableConcept.coding:amtpreferredhttps://healthterminologies.gov.au/fhir/ValueSet/australian-medication-1
MedicationDispense.medication[x]:medicationCodeableConcept.coding:mimsPackagepreferredMIMS
MedicationDispense.performer.functionexampleMedicationDispense Performer Function Codes
MedicationDispense.substitution.reasonpreferredhttps://healthterminologies.gov.au/fhir/ValueSet/medicine-substitution-reason-1

Constraints

IdGradePath(s)DetailsRequirements
au-core-mdd-01errorMedicationDispenseThe location shall at least have a valid identifier or address or type
: performer.exists() or location.exists()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationDispense C0..*AUBaseMedicationDispenseA 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 Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... subsidisedConcurrentSupply 0..1CodingGrounds 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 S0..1integerNumber of this dispense
URL: http://hl7.org.au/fhir/StructureDefinition/dispense-number
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier S0..*Identifier, AULocalDispenseIdentifierExternal identifier
... partOf 0..*Reference(Procedure)Event that dispense is part of
... status ?!SΣ1..1codepreparation | 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] S0..1Why a dispense was not performed
Binding: MedicationDispense Status Reason Codes (example): A code describing why a dispense was not performed.

.... statusReasonCodeableConceptCodeableConcept
.... statusReasonReferenceReference(DetectedIssue)
... category S0..1CodeableConceptType 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] SΣ1..1What medication was supplied
Slice: Unordered, Closed by type:$this
Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying which substance or product can be dispensed.

.... medicationCodeableConceptCodeableConcept
.... medicationReferenceReference(Medication)
.... medication[x]:medicationCodeableConcept Σ0..1CodeableConceptCoded Dispensed Medication
Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying which substance or product can be dispensed.

..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
...... coding:pbs SΣ0..*CodingPBS Item Code
Binding: PBS Item Codes (preferred)
....... id 0..1stringUnique id for inter-element referencing
....... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://pbs.gov.au/code/item
....... version Σ0..1stringVersion of the system - if relevant
....... code Σ0..1codeSymbol in syntax defined by the system
....... display Σ0..1stringRepresentation defined by the system
....... userSelected Σ0..1booleanIf this coding was chosen directly by the user
...... coding:gtin Σ0..*CodingMedication Package Global Trade Item Number (GTIN)
Binding: GTIN (preferred)
....... id 0..1stringUnique id for inter-element referencing
....... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://www.gs1.org/gtin
....... version Σ0..1stringVersion of the system - if relevant
....... code Σ0..1codeSymbol in syntax defined by the system
....... display Σ0..1stringRepresentation defined by the system
....... userSelected Σ0..1booleanIf this coding was chosen directly by the user
...... coding:amt SΣ0..*CodingAMT Medicines
Binding: https://healthterminologies.gov.au/fhir/ValueSet/australian-medication-1 (preferred)
....... id 0..1stringUnique id for inter-element referencing
....... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
....... medicationClass 0..1CodingMedication type
URL: http://hl7.org.au/fhir/StructureDefinition/medication-type
Binding: Medication Type (required)
....... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
....... version Σ0..1stringVersion of the system - if relevant
....... code Σ0..1codeSymbol in syntax defined by the system
....... display Σ0..1stringRepresentation defined by the system
....... userSelected Σ0..1booleanIf this coding was chosen directly by the user
...... coding:mimsPackage Σ0..1CodingMIMS Package
Binding: MIMS (preferred)
....... id 0..1stringUnique id for inter-element referencing
....... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://www.mims.com.au/codes
....... version Σ0..1stringVersion of the system - if relevant
....... code Σ0..1codeSymbol in syntax defined by the system
....... display Σ0..1stringRepresentation defined by the system
....... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... text Σ0..1stringMedication primary text
.... medication[x]:medicationReference Σ0..1Reference(AU Core Medication)Dispensed Medication
... subject SΣ1..1Reference(AU Core Patient)Who the dispense is for
... context S0..1Reference(AU Core Encounter)Encounter / Episode associated with event
... supportingInformation 0..*Reference(Resource)Information that supports the dispensing of the medication
... performer SC0..*BackboneElementWho performed event
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... function S0..1CodeableConceptWho 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 S1..1Reference(AU Core Practitioner | AU Core PractitionerRole | AU Core Organization | AU Core Patient | AU Core RelatedPerson)Individual who was performing
... location SC0..1Reference(AU Core Location)Where the dispense occurred
... authorizingPrescription S0..*Reference(AU Core MedicationRequest)Medication order that authorizes the dispense
... type 0..1CodeableConceptTrial 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 S0..1SimpleQuantityAmount dispensed
... daysSupply S0..1SimpleQuantityAmount of medication expressed as a timing amount
... whenPrepared Σ0..1dateTimeWhen product was packaged and reviewed
... whenHandedOver S1..1dateTimeWhen product was given out
... destination 0..1Reference(Location)Where the medication was sent
... receiver 0..*Reference(Patient | Practitioner)Who collected the medication
... note S0..*AnnotationInformation about the dispense
... dosageInstruction S0..*AUBaseDosageDosage information in an Australian healthcare context
... substitution S0..1BackboneElementWhether a substitution was performed on the dispense
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... wasSubstituted S1..1booleanWhether a substitution was or was not performed on the dispense
.... type 0..1CodeableConceptCode 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..1CodeableConceptWhy 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

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
MedicationDispense.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
MedicationDispense.statusrequiredMedicationDispense Status Codes
MedicationDispense.statusReason[x]exampleMedicationDispense Status Reason Codes
MedicationDispense.categorypreferredMedicationDispense Category Codes
MedicationDispense.medication[x]exampleSNOMEDCTMedicationCodes
MedicationDispense.medication[x]:medicationCodeableConceptexampleSNOMEDCTMedicationCodes
MedicationDispense.medication[x]:medicationCodeableConcept.coding:pbspreferredPBSItemCodes
MedicationDispense.medication[x]:medicationCodeableConcept.coding:gtinpreferredGTIN
MedicationDispense.medication[x]:medicationCodeableConcept.coding:amtpreferredhttps://healthterminologies.gov.au/fhir/ValueSet/australian-medication-1
MedicationDispense.medication[x]:medicationCodeableConcept.coding:mimsPackagepreferredMIMS
MedicationDispense.performer.functionexampleMedicationDispense Performer Function Codes
MedicationDispense.typeexampleActPharmacySupplyType
MedicationDispense.substitution.typeexampleActSubstanceAdminSubstitutionCode
MedicationDispense.substitution.reasonpreferredhttps://healthterminologies.gov.au/fhir/ValueSet/medicine-substitution-reason-1

Constraints

IdGradePath(s)DetailsRequirements
au-core-mdd-01errorMedicationDispenseThe location shall at least have a valid identifier or address or type
: performer.exists() or location.exists()

 

Other representations of profile: CSV, Excel, Schematron

Notes:

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.

Parameter(s) Conformance Type(s) Requirements (when used alone or in combination)
patient SHALL reference The client SHALL provide at least an id value and MAY provide both the Type and id values. The server SHALL support both.
patient+status SHALL reference+token
patient.identifier SHOULD reference.token The client SHALL provide both the system and code values. The server SHALL support both.

The client SHOULD support search using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile. The server SHOULD support search using the using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile.
patient+whenhandedover SHOULD reference+date
status MAY token The client SHALL provide at least a code value and MAY provide both the system and code values. The server SHALL support both.
whenhandedover MAY date A client SHALL provide a value precise to the second + time offset. A server SHALL support a value precise to the second + time offset.

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)