MyHealth@Eu Electronic Prescription and Dispense
1.0.0-poc - qa-preview 150

MyHealth@Eu Electronic Prescription and Dispense - Downloaded Version 1.0.0-poc See the Directory of published versions

Resource Profile: MedicationDispenseMyHealthEuEpd - Detailed Descriptions

Draft as of 2026-07-16

Definitions for the MedicationDispense-myhealtheu-epd 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.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 SHALL be taken from The codes SHOULD be taken from eHDSI Languagehttp://hl7.org/fhir/ValueSet/languages|4.0.1
(required to http://terminology.ehdsi.eu/ValueSet/eHDSILanguage)
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()))
6. MedicationDispense.extension
Definition

An Extension


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.

ShortExtensionAdditional 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.

Control10..*
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())
SlicingThis element introduces a set of slices on MedicationDispense.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 8. MedicationDispense.extension:renderedDosageInstruction
    Slice NamerenderedDosageInstruction
    Definition

    R5: MedicationDispense.renderedDosageInstruction (new:markdown)

    ShortFull representation of the dosage instructions
    Comments

    Element MedicationDispense.renderedDosageInstruction has a context of MedicationDispense based on following the parent source element upwards and mapping to MedicationDispense. Element MedicationDispense.renderedDosageInstruction has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). The content of the renderedDosageInstructions must not be different than the dose represented in the dosageInstruction content.

    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(R5: Full representation of the dosage instructions (new)) (Extension Type: markdown)
    Is Modifierfalse
    Obligations
      ObligationsActorSource
      SHOULD:able-to-populateProducerfrom MedicationDispense: MPD
      Summaryfalse
      Requirements

      EHDSDosage

      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())
      ele-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())
      10. MedicationDispense.extension:recorded
      Slice Namerecorded
      Definition

      R5: MedicationDispense.recorded (new:dateTime)

      ShortR5: When the recording of the dispense started (new)
      Comments

      Element MedicationDispense.recorded has a context of MedicationDispense based on following the parent source element upwards and mapping to MedicationDispense. Element MedicationDispense.recorded has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

      Control1..1
      This element is affected by the following invariants: ele-1
      TypeExtension(R5: When the recording of the dispense started (new)) (Extension Type: dateTime)
      Is Modifierfalse
      Obligations
        ObligationsActorSource
        SHALL:able-to-populateProducerfrom MedicationDispense: MPD
        SHALL:able-to-populate & SHALL:handleProducerMyHealth@EU Handlerfrom MedicationDispense: MPD
        Summaryfalse
        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())
        ele-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())
        12. 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())
        14. 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.

        ShortExternal identifier
        Comments

        This is a business identifier, not a resource identifier.

        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..*
        TypeIdentifier
        Is Modifierfalse
        Obligations
          ObligationsActor
          SHALL:handleMyHealth@EU Handler
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          16. MedicationDispense.status
          Definition

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

          Shortpreparation | 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
          Obligations
            ObligationsActorSource
            SHALL:able-to-populateProducerfrom MedicationDispense: MPD
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            18. 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|4.0.1
            (example to http://hl7.org/fhir/ValueSet/medication-codes|4.0.1)

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

            TypeReference(Medication), CodeableConcept
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Obligations
              ObligationsActorSource
              SHALL:able-to-populateProducerfrom MedicationDispense: MPD
              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 Closed, and can be differentiated using the following discriminators:
              • type @ $this
              • 20. 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.

                Control1..1
                TypeReference(Medication (EPD), Medication), CodeableConcept
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Is Modifierfalse
                Obligations
                  ObligationsActor
                  SHALL:handleMyHealth@EU Handler
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  22. 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 (Core), Patient, Group)
                  Is Modifierfalse
                  Obligations
                    ObligationsActorSource
                    SHALL:able-to-populateProducerfrom MedicationDispense: MPD
                    SHALL:able-to-populate & SHALL:handleProducerMyHealth@EU Handlerfrom MedicationDispense: MPD
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    24. MedicationDispense.location
                    Definition

                    The principal physical location where the dispense was performed.

                    ShortWhere the dispense occurred
                    Control0..1
                    TypeReference(Location)
                    Is Modifierfalse
                    Obligations
                      ObligationsActor
                      SHOULD:handleMyHealth@EU Handler
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      26. 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 (EPD), MedicationRequest)
                      Is Modifierfalse
                      Obligations
                        ObligationsActorSource
                        SHALL:able-to-populateProducerfrom MedicationDispense: MPD
                        SHALL:able-to-populate & SHALL:handleProducerMyHealth@EU Handlerfrom MedicationDispense: MPD
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        28. MedicationDispense.quantity
                        Definition

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

                        ShortAmount dispensed
                        Control10..1
                        TypeQuantity(Simple Quantity (MyHealth@EU), SimpleQuantity)
                        Is Modifierfalse
                        Obligations
                          ObligationsActorSource
                          SHALL:able-to-populateProducerfrom MedicationDispense: MPD
                          SHALL:able-to-populate & SHALL:handleProducerMyHealth@EU Handlerfrom MedicationDispense: MPD
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          30. MedicationDispense.daysSupply
                          Definition

                          The amount of medication expressed as a timing amount.

                          ShortAmount of medication expressed as a timing amount
                          Control0..1
                          TypeQuantity(Simple Quantity (MyHealth@EU), SimpleQuantity)
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          32. MedicationDispense.whenHandedOver
                          Definition

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

                          ShortDate and time when the medication was handed over. When not present, the time of dispensation is assumed to be the time of issuing the dispense record.When product was given out
                          Control10..1
                          TypedateTime
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Obligations
                            ObligationsActor
                            SHALL:handleMyHealth@EU Handler
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            34. 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 (Core), Patient, Practitioner)
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            36. MedicationDispense.dosageInstruction
                            Definition

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

                            ShortHow the medication is to be used by the patientHow 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: MPD)
                            Is Modifierfalse
                            Obligations
                              ObligationsActorSource
                              SHOULD:able-to-populateProducerfrom MedicationDispense: MPD
                              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.language
                              BindingThe codes SHALL be taken from eHDSI Language
                              (required to http://terminology.ehdsi.eu/ValueSet/eHDSILanguage)
                              4. MedicationDispense.extension:recorded
                              Slice Namerecorded
                              Obligations
                                ObligationsActorSource
                                SHALL:able-to-populate & SHALL:handleProducerMyHealth@EU Handlerfrom MedicationDispense: MPD
                                6. MedicationDispense.identifier
                                NoteThis is a business identifier, not a resource identifier (see discussion)
                                Obligations
                                  ObligationsActor
                                  SHALL:handleMyHealth@EU Handler
                                  8. MedicationDispense.medication[x]:medicationReference
                                  Slice NamemedicationReference
                                  Control1..?
                                  TypeReference(Medication (EPD))
                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                  Obligations
                                    ObligationsActor
                                    SHALL:handleMyHealth@EU Handler
                                    10. MedicationDispense.subject
                                    TypeReference(Patient (Core))
                                    Obligations
                                      ObligationsActorSource
                                      SHALL:able-to-populate & SHALL:handleProducerMyHealth@EU Handlerfrom MedicationDispense: MPD
                                      12. MedicationDispense.performer
                                      14. MedicationDispense.performer.actor
                                      TypeReference(PractitionerRole (Core), Practitioner (Core), Organization (Core))
                                      Obligations
                                        ObligationsActorSource
                                        SHALL:able-to-populate & SHALL:handleProducerMyHealth@EU Handlerfrom MedicationDispense: MPD
                                        16. MedicationDispense.location
                                        Obligations
                                          ObligationsActor
                                          SHOULD:handleMyHealth@EU Handler
                                          18. MedicationDispense.authorizingPrescription
                                          TypeReference(MedicationRequest (EPD))
                                          Obligations
                                            ObligationsActorSource
                                            SHALL:able-to-populate & SHALL:handleProducerMyHealth@EU Handlerfrom MedicationDispense: MPD
                                            20. MedicationDispense.quantity
                                            TypeQuantity(Simple Quantity (MyHealth@EU))
                                            Obligations
                                              ObligationsActorSource
                                              SHALL:able-to-populate & SHALL:handleProducerMyHealth@EU Handlerfrom MedicationDispense: MPD
                                              22. MedicationDispense.daysSupply
                                              TypeQuantity(Simple Quantity (MyHealth@EU))
                                              24. MedicationDispense.whenHandedOver
                                              Control1..?
                                              Obligations
                                                ObligationsActor
                                                SHALL:handleMyHealth@EU Handler
                                                26. MedicationDispense.receiver
                                                TypeReference(Patient (Core))
                                                28. MedicationDispense.dosageInstruction
                                                ShortHow the medication is to be used by the patient
                                                30. MedicationDispense.substitution
                                                32. MedicationDispense.substitution.wasSubstituted
                                                Obligations
                                                  ObligationsActor
                                                  SHALL:handleMyHealth@EU Handler
                                                  34. MedicationDispense.substitution.type
                                                  BindingUnless not suitable, these codes SHALL be taken from eHDSI Substitution Code
                                                  (extensible to http://terminology.ehdsi.eu/ValueSet/eHDSISubstitutionCode)
                                                  36. MedicationDispense.substitution.responsibleParty
                                                  TypeReference(Practitioner (Core), PractitionerRole (Core))

                                                  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 SHALL be taken from eHDSI Language
                                                  (required to http://terminology.ehdsi.eu/ValueSet/eHDSILanguage)
                                                  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

                                                  An Extension

                                                  ShortExtension
                                                  Control1..*
                                                  TypeExtension
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  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())
                                                  SlicingThis element introduces a set of slices on MedicationDispense.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                  • value @ url
                                                  • 16. MedicationDispense.extension:renderedDosageInstruction
                                                    Slice NamerenderedDosageInstruction
                                                    Definition

                                                    R5: MedicationDispense.renderedDosageInstruction (new:markdown)

                                                    ShortFull representation of the dosage instructions
                                                    Comments

                                                    Element MedicationDispense.renderedDosageInstruction has a context of MedicationDispense based on following the parent source element upwards and mapping to MedicationDispense. Element MedicationDispense.renderedDosageInstruction has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). The content of the renderedDosageInstructions must not be different than the dose represented in the dosageInstruction content.

                                                    Control0..1
                                                    This element is affected by the following invariants: ele-1
                                                    TypeExtension(R5: Full representation of the dosage instructions (new)) (Extension Type: markdown)
                                                    Is Modifierfalse
                                                    Obligations
                                                      ObligationsActorSource
                                                      SHOULD:able-to-populateProducerfrom MedicationDispense: MPD
                                                      Summaryfalse
                                                      Requirements

                                                      EHDSDosage

                                                      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.extension:recorded
                                                      Slice Namerecorded
                                                      Definition

                                                      R5: MedicationDispense.recorded (new:dateTime)

                                                      ShortR5: When the recording of the dispense started (new)
                                                      Comments

                                                      Element MedicationDispense.recorded has a context of MedicationDispense based on following the parent source element upwards and mapping to MedicationDispense. Element MedicationDispense.recorded has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

                                                      Control1..1
                                                      This element is affected by the following invariants: ele-1
                                                      TypeExtension(R5: When the recording of the dispense started (new)) (Extension Type: dateTime)
                                                      Is Modifierfalse
                                                      Obligations
                                                        ObligationsActorSource
                                                        SHALL:able-to-populateProducerfrom MedicationDispense: MPD
                                                        SHALL:able-to-populate & SHALL:handleProducerMyHealth@EU Handlerfrom MedicationDispense: MPD
                                                        Summaryfalse
                                                        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())
                                                        20. 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())
                                                        22. 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.

                                                        ShortExternal identifier
                                                        Comments

                                                        This is a business identifier, not a resource identifier.

                                                        NoteThis is a business identifier, not a resource identifier (see discussion)
                                                        Control0..*
                                                        TypeIdentifier
                                                        Is Modifierfalse
                                                        Obligations
                                                          ObligationsActor
                                                          SHALL:handleMyHealth@EU Handler
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          24. 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()))
                                                          26. MedicationDispense.status
                                                          Definition

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

                                                          Shortpreparation | 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 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
                                                          Obligations
                                                            ObligationsActorSource
                                                            SHALL:able-to-populateProducerfrom MedicationDispense: MPD
                                                            Summarytrue
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            28. 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|4.0.1)

                                                            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()))
                                                            30. 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|4.0.1)

                                                            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()))
                                                            32. 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|4.0.1)

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

                                                            TypeReference(Medication)
                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                            Is Modifierfalse
                                                            Obligations
                                                              ObligationsActorSource
                                                              SHALL:able-to-populateProducerfrom MedicationDispense: MPD
                                                              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 Closed, and can be differentiated using the following discriminators:
                                                              • type @ $this
                                                              • 34. 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.

                                                                Control1..1
                                                                TypeReference(Medication (EPD))
                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                Is Modifierfalse
                                                                Obligations
                                                                  ObligationsActor
                                                                  SHALL:handleMyHealth@EU Handler
                                                                  Summarytrue
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  36. 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 (Core))
                                                                  Is Modifierfalse
                                                                  Obligations
                                                                    ObligationsActorSource
                                                                    SHALL:able-to-populateProducerfrom MedicationDispense: MPD
                                                                    SHALL:able-to-populate & SHALL:handleProducerMyHealth@EU Handlerfrom MedicationDispense: MPD
                                                                    Summarytrue
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    38. 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()))
                                                                    40. 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()))
                                                                    42. 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()))
                                                                    44. 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
                                                                    46. 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())
                                                                    48. 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())
                                                                    50. 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|4.0.1)

                                                                    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()))
                                                                    52. 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(PractitionerRole (Core), Practitioner (Core), Organization (Core))
                                                                    Is Modifierfalse
                                                                    Obligations
                                                                      ObligationsActorSource
                                                                      SHALL:able-to-populateProducerfrom MedicationDispense: MPD
                                                                      SHALL:able-to-populate & SHALL:handleProducerMyHealth@EU Handlerfrom MedicationDispense: MPD
                                                                      Summaryfalse
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      54. MedicationDispense.location
                                                                      Definition

                                                                      The principal physical location where the dispense was performed.

                                                                      ShortWhere the dispense occurred
                                                                      Control0..1
                                                                      TypeReference(Location)
                                                                      Is Modifierfalse
                                                                      Obligations
                                                                        ObligationsActor
                                                                        SHOULD:handleMyHealth@EU Handler
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        56. 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 (EPD))
                                                                        Is Modifierfalse
                                                                        Obligations
                                                                          ObligationsActorSource
                                                                          SHALL:able-to-populateProducerfrom MedicationDispense: MPD
                                                                          SHALL:able-to-populate & SHALL:handleProducerMyHealth@EU Handlerfrom MedicationDispense: MPD
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          58. 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()))
                                                                          60. MedicationDispense.quantity
                                                                          Definition

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

                                                                          ShortAmount dispensed
                                                                          Control1..1
                                                                          TypeQuantity(Simple Quantity (MyHealth@EU))
                                                                          Is Modifierfalse
                                                                          Obligations
                                                                            ObligationsActorSource
                                                                            SHALL:able-to-populateProducerfrom MedicationDispense: MPD
                                                                            SHALL:able-to-populate & SHALL:handleProducerMyHealth@EU Handlerfrom MedicationDispense: MPD
                                                                            Summaryfalse
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            62. MedicationDispense.daysSupply
                                                                            Definition

                                                                            The amount of medication expressed as a timing amount.

                                                                            ShortAmount of medication expressed as a timing amount
                                                                            Control0..1
                                                                            TypeQuantity(Simple Quantity (MyHealth@EU))
                                                                            Is Modifierfalse
                                                                            Summaryfalse
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            64. 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()))
                                                                            66. MedicationDispense.whenHandedOver
                                                                            Definition

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

                                                                            ShortDate and time when the medication was handed over. When not present, the time of dispensation is assumed to be the time of issuing the dispense record.
                                                                            Control1..1
                                                                            TypedateTime
                                                                            Is Modifierfalse
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Obligations
                                                                              ObligationsActor
                                                                              SHALL:handleMyHealth@EU Handler
                                                                              Summaryfalse
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              68. 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()))
                                                                              70. 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 (Core))
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              72. 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()))
                                                                              74. MedicationDispense.dosageInstruction
                                                                              Definition

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

                                                                              ShortHow the medication is to be used by the patient
                                                                              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: MPD)
                                                                              Is Modifierfalse
                                                                              Obligations
                                                                                ObligationsActorSource
                                                                                SHOULD:able-to-populateProducerfrom MedicationDispense: MPD
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                76. 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()))
                                                                                78. 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
                                                                                80. 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())
                                                                                82. 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())
                                                                                84. 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
                                                                                Obligations
                                                                                  ObligationsActor
                                                                                  SHALL:handleMyHealth@EU Handler
                                                                                  Summaryfalse
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  86. 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
                                                                                  BindingUnless not suitable, these codes SHALL be taken from eHDSI Substitution Code
                                                                                  (extensible to http://terminology.ehdsi.eu/ValueSet/eHDSISubstitutionCode)
                                                                                  TypeCodeableConcept
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  88. 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()))
                                                                                  90. MedicationDispense.substitution.responsibleParty
                                                                                  Definition

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

                                                                                  ShortWho is responsible for the substitution
                                                                                  Control0..*
                                                                                  TypeReference(Practitioner (Core), PractitionerRole (Core))
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  92. 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()))
                                                                                  94. 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()))