Pharmacist Services and Summaries - FHIR (PhCP)
1.0.0 - STU Release 1.0.0 for FHIR R4

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## Resource Profile: PhCP-MedicationDispense

Defining URL: | http://hl7.org/fhir/us/phcp/StructureDefinition/PhCP-MedicationDispense
Version: | 1.0.0
Name: | PhCPMedicationDispense
Title: | PhCP MedicationDispense
Status: | Draft as of 2017-07-20T15:29:09.2599666-04:00
Definition: | This profile records the act of supplying medications (i.e., dispensing).
Publisher: | HL7 Structured Documents Work Group
Source Resource: | XML / JSON / Turtle

The official URL for this profile is:

    http://hl7.org/fhir/us/phcp/StructureDefinition/PhCP-MedicationDispense

### Formal Views of Profile Content

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

- Text Summary
- Differential Table
- Snapshot Table
- Snapshot Table (Must Support)
- All

This structure is derived from MedicationDispense

Summary

Must-Support: 7 elements

Structures

This structure refers to these other structures:

- http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication
- http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner
- http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole
- http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest

This structure is derived from MedicationDispense

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
MedicationDispense |  | 1..* | MedicationDispense | Dispensing a medication to a named patient
medication[x] | S | 1..1 |  | What medication was supplied Binding: US Core Medication Codes (RxNorm) (preferred)
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(US Core Medication Profile) |
performer | S | 0..* | BackboneElement | Who performed event
actor | S | 1..1 | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile) | Individual who was performing
authorizingPrescription | S | 0..* | Reference(US Core MedicationRequest Profile) | 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 | 0..1 | dateTime | When product was given out
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
MedicationDispense | I | 1..* | MedicationDispense | Dispensing a medication to a named patient
id | Σ | 0..1 | string | 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) Max Binding: AllLanguages: A human language.
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier |  | 0..* | Identifier | 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.
medication[x] | S Σ | 1..1 |  | What medication was supplied Binding: US Core Medication Codes (RxNorm) (preferred)
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(US Core Medication Profile) |
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 | S | 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 | S | 1..1 | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile) | Individual who was performing
location |  | 0..1 | Reference(Location) | Where the dispense occurred
authorizingPrescription | S | 0..* | Reference(US Core MedicationRequest Profile) | 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 | 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..* | Dosage | 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..* | CodeableConcept | Why was substitution made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
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

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
MedicationDispense | I | 1..* | MedicationDispense | Dispensing a medication to a named patient
medication[x] | Σ | 1..1 |  | What medication was supplied Binding: US Core Medication Codes (RxNorm) (preferred)
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(US Core Medication Profile) |
performer |  | 0..* | BackboneElement | Who performed event
actor |  | 1..1 | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile) | Individual who was performing
authorizingPrescription |  | 0..* | Reference(US Core MedicationRequest Profile) | Medication order that authorizes the dispense
quantity |  | 0..1 | SimpleQuantity | Amount dispensed
daysSupply |  | 0..1 | SimpleQuantity | Amount of medication expressed as a timing amount
whenHandedOver |  | 0..1 | dateTime | When product was given out
Documentation for this format

This structure is derived from MedicationDispense

Summary

Must-Support: 7 elements

Structures

This structure refers to these other structures:

- http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication
- http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner
- http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole
- http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest

Differential View

This structure is derived from MedicationDispense

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
MedicationDispense |  | 1..* | MedicationDispense | Dispensing a medication to a named patient
medication[x] | S | 1..1 |  | What medication was supplied Binding: US Core Medication Codes (RxNorm) (preferred)
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(US Core Medication Profile) |
performer | S | 0..* | BackboneElement | Who performed event
actor | S | 1..1 | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile) | Individual who was performing
authorizingPrescription | S | 0..* | Reference(US Core MedicationRequest Profile) | 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 | 0..1 | dateTime | When product was given out
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
MedicationDispense | I | 1..* | MedicationDispense | Dispensing a medication to a named patient
id | Σ | 0..1 | string | 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) Max Binding: AllLanguages: A human language.
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier |  | 0..* | Identifier | 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.
medication[x] | S Σ | 1..1 |  | What medication was supplied Binding: US Core Medication Codes (RxNorm) (preferred)
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(US Core Medication Profile) |
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 | S | 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 | S | 1..1 | Reference(US Core Practitioner Profile | US Core PractitionerRole Profile) | Individual who was performing
location |  | 0..1 | Reference(Location) | Where the dispense occurred
authorizingPrescription | S | 0..* | Reference(US Core MedicationRequest Profile) | 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 | 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..* | Dosage | 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..* | CodeableConcept | Why was substitution made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
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

Other representations of profile: Schematron

#### Terminology Bindings

Path | Conformance | ValueSet
MedicationDispense.language | preferred | CommonLanguages Max Binding: AllLanguages
MedicationDispense.status | required | MedicationDispense Status Codes
MedicationDispense.statusReason[x] | example | MedicationDispense Status Reason Codes
MedicationDispense.category | preferred | MedicationDispense Category Codes
MedicationDispense.medication[x] | preferred | USCoreMedicationCodes
MedicationDispense.performer.function | example | MedicationDispense Performer Function Codes
MedicationDispense.type | example | ActPharmacySupplyType
MedicationDispense.substitution.type | example | ActSubstanceAdminSubstitutionCode
MedicationDispense.substitution.reason | example | SubstanceAdminSubstitutionReason

#### Constraints

Id | Path | Details | Requirements
dom-2 | MedicationDispense | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | 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 | 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 | MedicationDispense | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | MedicationDispense | A resource should have narrative for robust management : text.`div`.exists() |
mdd-1 | MedicationDispense | whenHandedOver cannot be before whenPrepared : whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared |
ele-1 | MedicationDispense.meta | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | MedicationDispense.implicitRules | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | MedicationDispense.language | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | MedicationDispense.text | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | MedicationDispense.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | MedicationDispense.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | MedicationDispense.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | MedicationDispense.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | MedicationDispense.identifier | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | MedicationDispense.partOf | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | MedicationDispense.status | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | MedicationDispense.statusReason[x] | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | MedicationDispense.category | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | MedicationDispense.medication[x] | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | MedicationDispense.subject | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | MedicationDispense.context | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | MedicationDispense.supportingInformation | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | MedicationDispense.performer | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | MedicationDispense.performer.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | MedicationDispense.performer.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | MedicationDispense.performer.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | MedicationDispense.performer.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | MedicationDispense.performer.function | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | MedicationDispense.performer.actor | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | MedicationDispense.location | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | MedicationDispense.authorizingPrescription | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | MedicationDispense.type | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | MedicationDispense.quantity | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | MedicationDispense.daysSupply | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | MedicationDispense.whenPrepared | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | MedicationDispense.whenHandedOver | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | MedicationDispense.destination | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | MedicationDispense.receiver | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | MedicationDispense.note | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | MedicationDispense.dosageInstruction | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | MedicationDispense.substitution | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | MedicationDispense.substitution.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | MedicationDispense.substitution.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | MedicationDispense.substitution.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | MedicationDispense.substitution.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | MedicationDispense.substitution.wasSubstituted | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | MedicationDispense.substitution.type | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | MedicationDispense.substitution.reason | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | MedicationDispense.substitution.responsibleParty | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | MedicationDispense.detectedIssue | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | MedicationDispense.eventHistory | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |