MyHealth@Eu Hospital Discharge Report
0.0.1 - qa-preview 150

MyHealth@Eu Hospital Discharge Report - Local Development build (v0.0.1) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: MedicationDispenseHdrMyHealthEu - Detailed Descriptions

Page standards status: Draft Maturity Level: 1

Definitions for the medicationDispense-hdr-myhealtheu resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. MedicationDispense
Definition

Indicates that a medication product is to be or has been dispensed for a named person/patient. This includes a description of the medication product (supply) provided and the instructions for administering the medication. The medication dispense is the result of a pharmacy system responding to a medication order.

ShortDispensing a medication to a named patient
Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
mdd-1: whenHandedOver cannot be before whenPrepared (whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared)
mdd-1: whenHandedOver cannot be before whenPrepared (whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared)
2. MedicationDispense.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. MedicationDispense.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. MedicationDispense.status
Definition

A code specifying the state of the set of dispense events.

ShortCurrent state of the dispensationpreparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown
Comments

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

Control1..1
BindingThe codes SHALL be taken from MedicationDispense Status Codeshttp://hl7.org/fhir/ValueSet/medicationdispense-status|4.0.1
(required to http://hl7.org/fhir/ValueSet/medicationdispense-status|4.0.1)

A coded concept specifying the state of the dispense event.

Typecode
Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. MedicationDispense.statusReason[x]
Definition

Indicates the reason why a dispense was not performed.

ShortWhy a dispense was not performed
Control0..1
BindingFor example codes, see MedicationDispense Status Reason Codeshttp://hl7.org/fhir/ValueSet/medicationdispense-status-reason
(example to http://hl7.org/fhir/ValueSet/medicationdispense-status-reason)

A code describing why a dispense was not performed.

TypeChoice of: CodeableConcept, Reference(DetectedIssue)
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on MedicationDispense.statusReason[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • type @ $this
  • 10. MedicationDispense.statusReason[x]:statusReasonCodeableConcept
    Slice NamestatusReasonCodeableConcept
    Definition

    Indicates the reason why a dispense was not performed.

    ShortWhy a dispense was not performed
    Control0..1
    BindingThe codes SHALL be taken from For example codes, see eHDSI Medication Status Reason With Exceptionshttp://hl7.org/fhir/ValueSet/medicationdispense-status-reason
    (required to http://fhir.ehdsi.eu/hdr/ValueSet/eHDSIMedicationStatusReasonWithExceptions)
    TypeCodeableConcept, Reference(DetectedIssue)
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    12. MedicationDispense.medication[x]
    Definition

    Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.

    ShortWhat medication was supplied
    Comments

    If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource.

    Control1..1
    BindingFor example codes, see SNOMEDCTMedicationCodeshttp://hl7.org/fhir/ValueSet/medication-codes
    (example to http://hl7.org/fhir/ValueSet/medication-codes)

    A coded concept identifying which substance or product can be dispensed.

    TypeChoice of: CodeableConcept, Reference(Medication: HDR, Medication)
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    SlicingThis element introduces a set of slices on MedicationDispense.medication[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • type @ $this
    • 14. MedicationDispense.medication[x]:medicationReference
      Slice NamemedicationReference
      Definition

      Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.

      ShortWhat medication was supplied
      Comments

      If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource.

      Control01..1
      TypeReference(Medication: HDR, Medication), CodeableConcept
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Obligations
        ObligationsActor
        SHALL:handleHDR Handler
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        16. MedicationDispense.subject
        Definition

        A link to a resource representing the person or the group to whom the medication will be given.

        ShortWho the dispense is for
        Comments

        SubstanceAdministration->subject->Patient.

        Control0..1
        TypeReference(Patient: HDR, Patient, Group)
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        18. MedicationDispense.authorizingPrescription
        Definition

        Indicates the medication order that is being dispensed against.

        ShortMedication order that authorizes the dispense
        Comments

        Maps to basedOn in Event logical model.

        Control0..*
        TypeReference(MedicationRequest: HDR, MedicationRequest)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        20. MedicationDispense.quantity
        Definition

        The amount of medication that has been dispensed. Includes unit of measure.

        ShortAmount dispensed
        Control10..1
        TypeQuantity(SimpleQuantity)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        22. MedicationDispense.daysSupply
        Definition

        The amount of medication expressed as a timing amount.

        ShortDays supplyAmount of medication expressed as a timing amount
        Control0..1
        TypeQuantity(SimpleQuantity)
        Is Modifierfalse
        Obligations
          ObligationsActor
          SHALL:handleHDR Handler
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          24. MedicationDispense.whenHandedOver
          Definition

          The time the dispensed product was provided to the patient or their representative.

          ShortWhen product was given out
          Control10..1
          TypedateTime
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          26. MedicationDispense.dosageInstruction
          Definition

          Indicates how the medication is to be used by the patient.

          ShortHow the medication is to be used by the patient or administered by the caregiver
          Comments

          When the dose or rate is intended to change over the entire administration period (e.g. Tapering dose prescriptions), multiple instances of dosage instructions will need to be supplied to convey the different doses/rates. The pharmacist reviews the medication order prior to dispense and updates the dosageInstruction based on the actual product being dispensed.

          Control0..*
          TypeDosage(Dosage: HDR)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

          Guidance on how to interpret the contents of this table can be foundhere

          0. MedicationDispense
          2. MedicationDispense.statusReason[x]
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          SlicingThis element introduces a set of slices on MedicationDispense.statusReason[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • type @ $this
          • 4. MedicationDispense.statusReason[x]:statusReasonCodeableConcept
            Slice NamestatusReasonCodeableConcept
            Control0..1
            BindingThe codes SHALL be taken from eHDSI Medication Status Reason With Exceptions
            (required to http://fhir.ehdsi.eu/hdr/ValueSet/eHDSIMedicationStatusReasonWithExceptions)
            TypeCodeableConcept
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            6. MedicationDispense.medication[x]
            TypeChoice of: CodeableConcept, Reference(Medication: HDR)
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            SlicingThis element introduces a set of slices on MedicationDispense.medication[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • type @ $this
            • 8. MedicationDispense.medication[x]:medicationReference
              Slice NamemedicationReference
              Control0..1
              TypeReference(Medication: HDR)
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Obligations
                ObligationsActor
                SHALL:handleHDR Handler
                10. MedicationDispense.subject
                TypeReference(Patient: HDR)
                12. MedicationDispense.authorizingPrescription
                TypeReference(MedicationRequest: HDR)
                14. MedicationDispense.daysSupply
                ShortDays supply
                Obligations
                  ObligationsActor
                  SHALL:handleHDR Handler
                  16. MedicationDispense.dosageInstruction
                  TypeDosage(Dosage: HDR)

                  Guidance on how to interpret the contents of this table can be foundhere

                  0. MedicationDispense
                  Definition

                  Indicates that a medication product is to be or has been dispensed for a named person/patient. This includes a description of the medication product (supply) provided and the instructions for administering the medication. The medication dispense is the result of a pharmacy system responding to a medication order.

                  ShortDispensing a medication to a named patient
                  Control0..*
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                  dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                  dom-6: A resource should have narrative for robust management (text.`div`.exists())
                  mdd-1: whenHandedOver cannot be before whenPrepared (whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared)
                  2. MedicationDispense.id
                  Definition

                  The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

                  ShortLogical id of this artifact
                  Comments

                  The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

                  Control0..1
                  Typeid
                  Is Modifierfalse
                  Summarytrue
                  4. MedicationDispense.meta
                  Definition

                  The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

                  ShortMetadata about the resource
                  Control0..1
                  TypeMeta
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  6. MedicationDispense.implicitRules
                  Definition

                  A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

                  ShortA set of rules under which this content was created
                  Comments

                  Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

                  Control0..1
                  Typeuri
                  Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  8. MedicationDispense.language
                  Definition

                  The base language in which the resource is written.

                  ShortLanguage of the resource content
                  Comments

                  Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

                  Control0..1
                  BindingThe codes SHOULD be taken from CommonLanguages
                  (preferred to http://hl7.org/fhir/ValueSet/languages)

                  A human language.

                  Additional BindingsPurpose
                  AllLanguagesMax Binding
                  Typecode
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  10. MedicationDispense.text
                  Definition

                  A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

                  ShortText summary of the resource, for human interpretation
                  Comments

                  Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

                  Control0..1
                  TypeNarrative
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesnarrative, html, xhtml, display
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  12. MedicationDispense.contained
                  Definition

                  These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

                  ShortContained, inline Resources
                  Comments

                  This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

                  Control0..*
                  TypeResource
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesinline resources, anonymous resources, contained resources
                  14. MedicationDispense.extension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                  ShortAdditional content defined by implementations
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  16. MedicationDispense.modifierExtension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                  ShortExtensions that cannot be ignored
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                  Summaryfalse
                  Requirements

                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  18. MedicationDispense.identifier
                  Definition

                  Identifiers associated with this Medication Dispense that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.

                  ShortDispensation/dispensed item ID
                  Comments

                  It is the dispensation ID if the presciption includes only one prescribed item

                  NoteThis is a business identifier, not a resource identifier (see discussion)
                  Control0..*
                  TypeIdentifier
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  20. MedicationDispense.partOf
                  Definition

                  The procedure that trigger the dispense.

                  ShortEvent that dispense is part of
                  Control0..*
                  TypeReference(Procedure)
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  22. MedicationDispense.status
                  Definition

                  A code specifying the state of the set of dispense events.

                  ShortCurrent state of the dispensation
                  Comments

                  This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

                  Control1..1
                  BindingThe codes SHALL be taken from MedicationDispense Status Codes
                  (required to http://hl7.org/fhir/ValueSet/medicationdispense-status|4.0.1)

                  A coded concept specifying the state of the dispense event.

                  Typecode
                  Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  24. MedicationDispense.statusReason[x]
                  Definition

                  Indicates the reason why a dispense was not performed.

                  ShortWhy a dispense was not performed
                  Control0..1
                  BindingFor example codes, see MedicationDispense Status Reason Codes
                  (example to http://hl7.org/fhir/ValueSet/medicationdispense-status-reason)

                  A code describing why a dispense was not performed.

                  TypeChoice of: CodeableConcept, Reference(DetectedIssue)
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  SlicingThis element introduces a set of slices on MedicationDispense.statusReason[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • type @ $this
                  • 26. MedicationDispense.statusReason[x]:statusReasonCodeableConcept
                    Slice NamestatusReasonCodeableConcept
                    Definition

                    Indicates the reason why a dispense was not performed.

                    ShortWhy a dispense was not performed
                    Control0..1
                    BindingThe codes SHALL be taken from eHDSI Medication Status Reason With Exceptions
                    (required to http://fhir.ehdsi.eu/hdr/ValueSet/eHDSIMedicationStatusReasonWithExceptions)
                    TypeCodeableConcept
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    28. MedicationDispense.category
                    Definition

                    Indicates the type of medication dispense (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)).

                    ShortType of medication dispense
                    Comments

                    The category can be used to include where the medication is expected to be consumed or other types of dispenses. Invariants can be used to bind to different value sets when profiling to bind.

                    Control0..1
                    BindingThe codes SHOULD be taken from MedicationDispense Category Codes
                    (preferred to http://hl7.org/fhir/ValueSet/medicationdispense-category)

                    A code describing where the dispensed medication is expected to be consumed or administered.

                    TypeCodeableConcept
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    30. MedicationDispense.medication[x]
                    Definition

                    Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.

                    ShortWhat medication was supplied
                    Comments

                    If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource.

                    Control1..1
                    BindingFor example codes, see SNOMEDCTMedicationCodes
                    (example to http://hl7.org/fhir/ValueSet/medication-codes)

                    A coded concept identifying which substance or product can be dispensed.

                    TypeChoice of: CodeableConcept, Reference(Medication: HDR)
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    SlicingThis element introduces a set of slices on MedicationDispense.medication[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • type @ $this
                    • 32. MedicationDispense.medication[x]:medicationReference
                      Slice NamemedicationReference
                      Definition

                      Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.

                      ShortWhat medication was supplied
                      Comments

                      If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource.

                      Control0..1
                      TypeReference(Medication: HDR)
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      Is Modifierfalse
                      Obligations
                        ObligationsActor
                        SHALL:handleHDR Handler
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        34. MedicationDispense.subject
                        Definition

                        A link to a resource representing the person or the group to whom the medication will be given.

                        ShortWho the dispense is for
                        Comments

                        SubstanceAdministration->subject->Patient.

                        Control0..1
                        TypeReference(Patient: HDR)
                        Is Modifierfalse
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        36. MedicationDispense.context
                        Definition

                        The encounter or episode of care that establishes the context for this event.

                        ShortEncounter / Episode associated with event
                        Control0..1
                        TypeReference(Encounter, EpisodeOfCare)
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        38. MedicationDispense.supportingInformation
                        Definition

                        Additional information that supports the medication being dispensed.

                        ShortInformation that supports the dispensing of the medication
                        Control0..*
                        TypeReference(Resource)
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        40. MedicationDispense.performer
                        Definition

                        Indicates who or what performed the event.

                        ShortWho performed event
                        Control0..*
                        TypeBackboneElement
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        42. MedicationDispense.performer.id
                        Definition

                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                        ShortUnique id for inter-element referencing
                        Control0..1
                        Typestring
                        Is Modifierfalse
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Summaryfalse
                        44. MedicationDispense.performer.extension
                        Definition

                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                        ShortAdditional content defined by implementations
                        Comments

                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                        Control0..*
                        TypeExtension
                        Is Modifierfalse
                        Summaryfalse
                        Alternate Namesextensions, user content
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        46. MedicationDispense.performer.modifierExtension
                        Definition

                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                        ShortExtensions that cannot be ignored even if unrecognized
                        Comments

                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                        Control0..*
                        TypeExtension
                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                        Summarytrue
                        Requirements

                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                        Alternate Namesextensions, user content, modifiers
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        48. MedicationDispense.performer.function
                        Definition

                        Distinguishes the type of performer in the dispense. For example, date enterer, packager, final checker.

                        ShortWho performed the dispense and what they did
                        Control0..1
                        BindingFor example codes, see MedicationDispense Performer Function Codes
                        (example to http://hl7.org/fhir/ValueSet/medicationdispense-performer-function)

                        A code describing the role an individual played in dispensing a medication.

                        TypeCodeableConcept
                        Is Modifierfalse
                        Summaryfalse
                        Requirements

                        Allows disambiguation of the types of involvement of different performers.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        50. MedicationDispense.performer.actor
                        Definition

                        The device, practitioner, etc. who performed the action. It should be assumed that the actor is the dispenser of the medication.

                        ShortIndividual who was performing
                        Control1..1
                        TypeReference(Practitioner, PractitionerRole, Organization, Patient, Device, RelatedPerson)
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        52. MedicationDispense.location
                        Definition

                        The principal physical location where the dispense was performed.

                        ShortWhere the dispense occurred
                        Control0..1
                        TypeReference(Location)
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        54. MedicationDispense.authorizingPrescription
                        Definition

                        Indicates the medication order that is being dispensed against.

                        ShortMedication order that authorizes the dispense
                        Comments

                        Maps to basedOn in Event logical model.

                        Control0..*
                        TypeReference(MedicationRequest: HDR)
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        56. MedicationDispense.type
                        Definition

                        Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.

                        ShortTrial fill, partial fill, emergency fill, etc.
                        Control0..1
                        BindingFor example codes, see ActPharmacySupplyType
                        (example to http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType)

                        Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.

                        TypeCodeableConcept
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        58. MedicationDispense.quantity
                        Definition

                        The amount of medication that has been dispensed. Includes unit of measure.

                        ShortAmount dispensed
                        Control1..1
                        TypeQuantity(SimpleQuantity)
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        60. MedicationDispense.daysSupply
                        Definition

                        The amount of medication expressed as a timing amount.

                        ShortDays supply
                        Control0..1
                        TypeQuantity(SimpleQuantity)
                        Is Modifierfalse
                        Obligations
                          ObligationsActor
                          SHALL:handleHDR Handler
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          62. MedicationDispense.whenPrepared
                          Definition

                          The time when the dispensed product was packaged and reviewed.

                          ShortWhen product was packaged and reviewed
                          Control0..1
                          TypedateTime
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          64. MedicationDispense.whenHandedOver
                          Definition

                          The time the dispensed product was provided to the patient or their representative.

                          ShortWhen product was given out
                          Control1..1
                          TypedateTime
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          66. MedicationDispense.destination
                          Definition

                          Identification of the facility/location where the medication was shipped to, as part of the dispense event.

                          ShortWhere the medication was sent
                          Control0..1
                          TypeReference(Location)
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          68. MedicationDispense.receiver
                          Definition

                          Identifies the person who picked up the medication. This will usually be a patient or their caregiver, but some cases exist where it can be a healthcare professional.

                          ShortWho collected the medication
                          Control0..*
                          TypeReference(Patient, Practitioner)
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          70. MedicationDispense.note
                          Definition

                          Extra information about the dispense that could not be conveyed in the other attributes.

                          ShortInformation about the dispense
                          Control0..*
                          TypeAnnotation
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          72. MedicationDispense.dosageInstruction
                          Definition

                          Indicates how the medication is to be used by the patient.

                          ShortHow the medication is to be used by the patient or administered by the caregiver
                          Comments

                          When the dose or rate is intended to change over the entire administration period (e.g. Tapering dose prescriptions), multiple instances of dosage instructions will need to be supplied to convey the different doses/rates. The pharmacist reviews the medication order prior to dispense and updates the dosageInstruction based on the actual product being dispensed.

                          Control0..*
                          TypeDosage(Dosage: HDR)
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          74. MedicationDispense.substitution
                          Definition

                          Indicates whether or not substitution was made as part of the dispense. In some cases, substitution will be expected but does not happen, in other cases substitution is not expected but does happen. This block explains what substitution did or did not happen and why. If nothing is specified, substitution was not done.

                          ShortWhether a substitution was performed on the dispense
                          Control0..1
                          TypeBackboneElement
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          76. MedicationDispense.substitution.id
                          Definition

                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                          ShortUnique id for inter-element referencing
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          78. MedicationDispense.substitution.extension
                          Definition

                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                          ShortAdditional content defined by implementations
                          Comments

                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                          Control0..*
                          TypeExtension
                          Is Modifierfalse
                          Summaryfalse
                          Alternate Namesextensions, user content
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          80. MedicationDispense.substitution.modifierExtension
                          Definition

                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                          ShortExtensions that cannot be ignored even if unrecognized
                          Comments

                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                          Control0..*
                          TypeExtension
                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                          Summarytrue
                          Requirements

                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                          Alternate Namesextensions, user content, modifiers
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          82. MedicationDispense.substitution.wasSubstituted
                          Definition

                          True if the dispenser dispensed a different drug or product from what was prescribed.

                          ShortWhether a substitution was or was not performed on the dispense
                          Control1..1
                          Typeboolean
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          84. MedicationDispense.substitution.type
                          Definition

                          A code signifying whether a different drug was dispensed from what was prescribed.

                          ShortCode signifying whether a different drug was dispensed from what was prescribed
                          Control0..1
                          BindingFor example codes, see ActSubstanceAdminSubstitutionCode
                          (example to http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode)

                          A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          86. MedicationDispense.substitution.reason
                          Definition

                          Indicates the reason for the substitution (or lack of substitution) from what was prescribed.

                          ShortWhy was substitution made
                          Control0..*
                          BindingFor example codes, see SubstanceAdminSubstitutionReason
                          (example to http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason)

                          A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          88. MedicationDispense.substitution.responsibleParty
                          Definition

                          The person or organization that has primary responsibility for the substitution.

                          ShortWho is responsible for the substitution
                          Control0..*
                          TypeReference(Practitioner, PractitionerRole)
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          90. MedicationDispense.detectedIssue
                          Definition

                          Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. drug-drug interaction, duplicate therapy, dosage alert etc.

                          ShortClinical issue with action
                          Comments

                          This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue.

                          Control0..*
                          TypeReference(DetectedIssue)
                          Is Modifierfalse
                          Summaryfalse
                          Alternate NamesContraindication, Drug Utilization Review (DUR), Alert
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          92. MedicationDispense.eventHistory
                          Definition

                          A summary of the events of interest that have occurred, such as when the dispense was verified.

                          ShortA list of relevant lifecycle events
                          Comments

                          This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).

                          Control0..*
                          TypeReference(Provenance)
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))