NHS Digital FHIR Medicines

There are no (further) constraints on this element

Element id

MedicationDispense.id

Short description

Logical id of this artifact

Definition

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

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.

Data type

There are no (further) constraints on this element

Element id

MedicationDispense.meta

Short description

Metadata about the resource

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.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

implicitRules

Σ ?!

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.implicitRules

Short description

A set of rules under which this content was created

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.

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.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

language

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationDispense.language

Short description

Language of the resource content

Definition

The base language in which the resource is written.

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).

Data type

Binding

A human language.

CommonLanguages (preferred)

Binding extensions

maxValueSet	AllLanguages

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

text

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.text

Short description

Text summary of the resource, for human interpretation

Alternate names

narrative, html, xhtml, display

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.

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.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: Act.text?

contained

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.contained

Short description

Contained, inline Resources

Alternate names

inline resources, anonymous resources, contained resources

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.

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.

Data type

Mappings

rim: N/A

extension

1..*

Element id

MedicationDispense.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

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

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.

Data type

Slicing

Unordered, Open, by url(Value)

Constraints

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()

Mappings

rim: N/A

prescriptionStatus

S C

1..1

Element id

MedicationDispense.extension:prescriptionStatus

Short description

This is the overall status of the `prescription-order`

Alternate names

extensions, user content

Definition

This is the overall status of the prescription-order, it is not the status of the individual prescription item. This is a code from {{pagelink:DM-Task-Status-Reason-duplicate-2}}, all prescription status reasons in a dispense-notification FHIR Message Bundle must be the same.

"extension": [
    {
        "url": "https://fhir.nhs.uk/StructureDefinition/Extension-EPS-TaskBusinessStatus",
        "valueCoding": {
            "system": "https://fhir.nhs.uk/CodeSystem/EPS-task-business-status",
            "code": "0003",
            "display": "With Dispenser - Active"
        }
    }
]

Comments

Data type

https://fhir.nhs.uk/StructureDefinition/Extension-EPS-TaskBusinessStatus

Extension URL

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

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()

Mappings

rim: N/A
rim: n/a

prescriptionNonDispensingReason

S C

0..1

Element id

MedicationDispense.extension:prescriptionNonDispensingReason

Short description

This is the non dispensing reason for the overall prescription

Alternate names

extensions, user content

Definition

This is the reason a complete prescription was not dispensed, it is not the status of the individual line items, which is contained in MedicationDispense.statusReason.

"extension": [
    {
        "url": "https://fhir.nhs.uk/StructureDefinition/Extension-DM-PrescriptionNonDispensingReason",
        "valueCoding": {
            "system": "https://fhir.nhs.uk/CodeSystem/medicationdispense-status-reason",
            "code": "0002",
            "display": "Clinically unsuitable"
        }
    }
]

Comments

Data type

https://fhir.nhs.uk/StructureDefinition/Extension-DM-PrescriptionNonDispensingReason

Extension URL

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

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()

Mappings

rim: N/A
rim: n/a

repeatInformation

S C

0..1

Extension(Complex)

Element id

MedicationDispense.extension:repeatInformation

Short description

Repeat Prescribing and Dispensing

Alternate names

extensions, user content

Definition

The extension is mandatory for continuous and continuous-repeat-dispensing. The following elements MUST be populated

numberofRepeatsAllowed
numberOfRepeatsIssued

"extension": [
    {
        "url": "https://fhir.nhs.uk/StructureDefinition/Extension-EPS-RepeatInformation",
        "extension": [
            {
                "url" : "numberOfRepeatsAllowed",
                "valueInteger" : 3
            },
            {
                "url" : "numberOfRepeatsIssued",
                "valueInteger" : 2
            }
        ]
    }
]

Comments

Data type

Extension(Complex)

Extension URL

https://fhir.nhs.uk/StructureDefinition/Extension-EPS-RepeatInformation

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

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()

Mappings

rim: N/A
rim: n/a

supplyHeaderIdentifier

S C

0..1

Element id

MedicationDispense.extension:supplyHeaderIdentifier

Short description

Identifier for the SupplyHeader

Alternate names

extensions, user content

Definition

Identifier of the SupplyHeader (v3) object. The prescription in the context of a Dispense Notification or Claim. Mandatory for EPS interactions.

Comments

Data type

https://fhir.nhs.uk/StructureDefinition/Extension-EPS-SupplyHeaderIdentifier

Extension URL

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

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()

Mappings

rim: N/A
rim: n/a

modifierExtension

?! C

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.modifierExtension

Short description

Extensions that cannot be ignored

Alternate names

extensions, user content

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).

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.

Comments

Data type

Constraints

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()

Mappings

rim: N/A

identifier

0..*

Element id

MedicationDispense.identifier

Short description

External identifier

Definition

Each MedicationDispense MUST be identified by an Universal Unique Identifiers (UUIDs) with a system of https://fhir.nhs.uk/Id/prescription-dispense-item-number

UUID example (for illustration purposes only);

4509B70D-D8B8-EA03-1105-64557CB54A29

 "identifier":  [
    {
        "system": "https://fhir.nhs.uk/Id/prescription-dispense-item-number",
        "value": "4509B70D-D8B8-EA03-1105-64557CB54A29"
    }
]

Comments

This is a business identifier, not a resource identifier.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

workflow: Event.identifier
w5: FiveWs.identifier
rim: .id
rx-dispense-rmim: CombinedMedicationDispense.id

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.identifier.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.identifier.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

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.

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationDispense.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Data type

Binding

Identifies the purpose for this identifier, if known .

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationDispense.identifier.type

Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Data type

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.5
rim: Role.code or implied by context

system

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

http://www.acme.com/identifiers/patient

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

value

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

period

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

assigner

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

partOf

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.partOf

Short description

Event that dispense is part of

Definition

The procedure that trigger the dispense.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

workflow: Event.partOf
rim: .outboundRelationship[typeCode=COMP]/target[classCode=PROC,moodCode=EVN]

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.partOf.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.partOf.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

reference

Σ C

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.partOf.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ref-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element id

MedicationDispense.partOf.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

Comments

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

Data type

Binding

Aa resource (or, for logical models, the URI of the logical model).

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.partOf.identifier

Short description

Logical reference, when literal reference is not known

Definition

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

Comments

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.partOf.identifier.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.partOf.identifier.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationDispense.partOf.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Data type

Binding

Identifies the purpose for this identifier, if known .

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationDispense.partOf.identifier.type

Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Data type

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.5
rim: Role.code or implied by context

system

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.partOf.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

http://www.acme.com/identifiers/patient

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

value

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.partOf.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

period

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.partOf.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

assigner

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.partOf.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

display

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.partOf.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

status

S Σ ?!

1..1

codeBinding

Element id

MedicationDispense.status

Short description

Definition

The status of the individual medication item, this will normally indicate whether the medication has been picked up or not.

Code	Display	Definition
completed	Completed	The dispensed product has been picked up.
in-progress	In Progress	The dispensed product is ready for pickup.

Comments

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

Data type

MedicationDispense Status Codes (required)

Binding

A coded concept specifying the state of the dispense event.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

workflow: Event.status
w5: FiveWs.status
rim: .statusCode
rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.statusCode

statusReason[x]

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x]

Short description

Why a dispense was not performed

Definition

Indicates the reason why a dispense was not performed.

Binding

A code describing why a dispense was not performed.

MedicationDispense Status Reason Codes (example)

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

workflow: Event.statusReason
rim: .outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code="not done reason"].value

statusReasonCodeableConcept

Data type

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

coding

1..*

Element id

MedicationDispense.statusReason[x].coding

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Data type

Slicing

Unordered, Open, by system(Value)

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

(All Slices)

The requirements in this element apply to all slices

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].coding.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].coding.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

system

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].coding.system

Short description

Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].coding.version

Short description

Version of the system - if relevant

Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].coding.code

Short description

Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Requirements

Need to refer to a particular code in the system.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

display

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].coding.display

Short description

Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].coding.userSelected

Short description

If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

notDispensedStatusReason

S Σ

0..*

CodingBinding

Element id

MedicationDispense.statusReason[x].coding:notDispensedStatusReason

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Data type

MedicationDispenseStatusReason (required)

Binding

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].coding:notDispensedStatusReason.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].coding:notDispensedStatusReason.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

system

1..1

uriAuto Value

Element id

MedicationDispense.statusReason[x].coding:notDispensedStatusReason.system

Short description

Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Auto value

https://fhir.nhs.uk/CodeSystem/medicationdispense-status-reason

Mappings

v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].coding:notDispensedStatusReason.version

Short description

Version of the system - if relevant

Definition

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].coding:notDispensedStatusReason.code

Short description

Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Requirements

Need to refer to a particular code in the system.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

display

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].coding:notDispensedStatusReason.display

Short description

Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].coding:notDispensedStatusReason.userSelected

Short description

If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

amendmentStatusReason

S Σ

0..*

CodingBinding

Element id

MedicationDispense.statusReason[x].coding:amendmentStatusReason

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Data type

Binding

TaskReasonCode (required)

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].coding:amendmentStatusReason.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].coding:amendmentStatusReason.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

system

1..1

uriAuto Value

Element id

MedicationDispense.statusReason[x].coding:amendmentStatusReason.system

Short description

Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Auto value

https://fhir.nhs.uk/CodeSystem/EPS-task-dispense-withdraw-reason

Mappings

v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].coding:amendmentStatusReason.version

Short description

Version of the system - if relevant

Definition

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].coding:amendmentStatusReason.code

Short description

Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Requirements

Need to refer to a particular code in the system.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

display

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].coding:amendmentStatusReason.display

Short description

Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].coding:amendmentStatusReason.userSelected

Short description

If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

text

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].text

Short description

Plain text representation of the concept

Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

category

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationDispense.category

Short description

Type of medication dispense

Definition

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

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.

Data type

MedicationDispense Category Codes (preferred)

Binding

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

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication dispense"].value

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.category.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.category.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

coding

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.category.coding

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.category.coding.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.category.coding.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

system

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.category.coding.system

Short description

Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.category.coding.version

Short description

Version of the system - if relevant

Definition

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.category.coding.code

Short description

Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Requirements

Need to refer to a particular code in the system.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

display

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.category.coding.display

Short description

Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.category.coding.userSelected

Short description

If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

text

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.category.text

Short description

Plain text representation of the concept

Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Requirements

Comments

Very often the text is the same as a displayName of one of the codings.

Data type

NHS Digital Medication Code (extensible)

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

medication[x]

S Σ

1..1

Binding

Element id

MedicationDispense.medication[x]

Short description

What medication was supplied

Definition

Actual Medical Product Packs (AMPP) SHOULD be used. It is valid to include a FHIR Medication resource within the FHIR Message, this practice is discouraged to simplify handling of the event messages.

<table> <thead> <th data-no-sort width="25%"> dm+d Category </th> <th data-no-sort width="50%"> dm+d Description </th> <th data-no-sort width="25%"> UK SNOMED Members Of </th>

</thead> <tr> <td> VMPP </td> <td> Virtual Medical Product Pack </td> <td> <a href="https://termbrowser.nhs.uk/?perspective=full&conceptId1=999000571000001104" target="_blank">999000571000001104</a> </td>

</tr> <tr> <td> AMPP </td> <td> Actual Medical Product Pack </td> <td> <a href="https://termbrowser.nhs.uk/?perspective=full&conceptId1=999000551000001106" target="_blank">999000551000001106</a> </td> </tr> <tr> <td> VMP </td> <td> Virtual Medical Product </td> <td> <a href="https://termbrowser.nhs.uk/?perspective=full&conceptId1=999000561000001109" target="_blank">999000561000001109</a> </td> </tr> <tr> <td> AMP </td> <td> Actual Medical Product </td> <td> <a href="https://termbrowser.nhs.uk/?perspective=full&conceptId1=999000541000001108" target="_blank">999000541000001108</a> </td> </tr> </table>

<br>

"medicationCodeableConcept": {
        "coding":  [
        {
            "system": "http://snomed.info/sct",
            "code": "10460811000001109",
            "display": "Amoxil 500mg capsules (Dowelhurst Ltd) 12 capsule"
        }
    ]
}

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.

Binding

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

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

workflow: Event.code
w5: FiveWs.what[x]
v2: RXD-2-Dispense/Give Code
rim: .participation[typeCode=PRD].role
rx-dispense-rmim: CombinedMedicationRequest.component1.AdministrationRequest.consumable

medicationCodeableConcept

Data type

medicationReference

Data type

Allowed aggregation:bundled

subject

S Σ C

1..1

Element id

MedicationDispense.subject

Short description

Who the dispense is for

Definition

A reference to the patient via a traced NHS Number is required, an untraced NHS Number MUST NOT be used. This can be sent in two ways, first option is via a identifier reference. Only the NHS Number:

"subject": {
    "type": "Patient",
    "identifier": {
        "system": "https://fhir.nhs.uk/Id/nhs-number",
        "value": "2300992742"
    }
}

Second option uses a FHIR Patient resource to convey the NHS Number.

The reference in the MedicationDispesnse is now a resource reference.

 "subject": {
                    "type": "Patient",
                    "reference": "urn:uuid:bde9eba6-079f-4210-8108-6ea8db58de8c",
                    "display": "Miss Bernie Kanfeld"
                }

The NHS Number has moved to the Patient resource alongside other patient identifiers such as MRN. E.g.

"fullUrl": "urn:uuid:bde9eba6-079f-4210-8108-6ea8db58de8c",
"resource": {
                "resourceType": "Patient",
                "identifier": [
                    {
                        "extension": [
                            {
                                "url": "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberVerificationStatus",
                                "valueCodeableConcept": {
                                    "coding": [
                                        {
                                            "system": "https://fhir.hl7.org.uk/CodeSystem/UKCore-NHSNumberVerificationStatus",
                                            "code": "01",
                                            "display": "Number present and verified"
                                        }
                                    ]
                                }
                            }
                        ],
                        "system": "https://fhir.nhs.uk/Id/nhs-number",
                        "value": "9876543210"
                    },
                    {
                        "system": "https://fhir.leedsth.nhs.uk/Id/pas-number",
                        "value": "ABC8650149"
                    },
                    {
                        "system": "https://fhir.leedsth.nhs.uk/Id/PPMIdentifier",
                        "value": "1"
                    }
                ],
               ... other elements removed from example.
            }

It is anticipated that hospital pharmacies will prefer the later option for compatibility with other systems. Community pharmacies are anticipated to prefer the former option.

Comments

SubstanceAdministration->subject->Patient.

Data type

Allowed aggregation:referenced, bundled

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
eps-2: subject - An identifier reference or resource reference must be provided
(reference.exists() or (identifier.exists()))
patient-nhs: Length of the supplied NHS Number is wrong.
identifier.where(system='https://fhir.nhs.uk/Id/nhs-number').exists().not() or (identifier.where(system='https://fhir.nhs.uk/Id/nhs-number').exists() and identifier.where(system='https://fhir.nhs.uk/Id/nhs-number').value.matches('^([0-9]{10})$'))

Mappings

workflow: Event.subject
w5: FiveWs.subject[x]
v2: PID-3-Patient ID List
rim: .participation[typeCode=SBJ].role[classCode=PAT]
w5: FiveWs.subject

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.subject.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.subject.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

reference

Σ C

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.subject.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ref-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element id

MedicationDispense.subject.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Comments

Data type

Binding

Aa resource (or, for logical models, the URI of the logical model).

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.subject.identifier

Short description

Logical reference, when literal reference is not known

Definition

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.subject.identifier.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.subject.identifier.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationDispense.subject.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Data type

Binding

Identifies the purpose for this identifier, if known .

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationDispense.subject.identifier.type

Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Data type

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.5
rim: Role.code or implied by context

system

1..1

uriAuto Value

Element id

MedicationDispense.subject.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Auto value

https://fhir.nhs.uk/Id/nhs-number

Examples
General

http://www.acme.com/identifiers/patient

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

value

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.subject.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

period

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.subject.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

assigner

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.subject.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

display

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.subject.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

context

0..1

Element id

MedicationDispense.context

Short description

Encounter / Episode associated with event

Definition

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

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

workflow: Event.context
rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.context.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.context.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

reference

Σ C

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.context.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ref-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element id

MedicationDispense.context.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Comments

Data type

Binding

Aa resource (or, for logical models, the URI of the logical model).

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.context.identifier

Short description

Logical reference, when literal reference is not known

Definition

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.context.identifier.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.context.identifier.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationDispense.context.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Data type

Binding

Identifies the purpose for this identifier, if known .

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationDispense.context.identifier.type

Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Data type

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.5
rim: Role.code or implied by context

system

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.context.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

http://www.acme.com/identifiers/patient

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

value

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.context.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

period

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.context.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

assigner

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.context.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

display

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.context.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

supportingInformation

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.supportingInformation

Short description

Information that supports the dispensing of the medication

Definition

Additional information that supports the medication being dispensed.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

w5: FiveWs.context
rim: .outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.supportingInformation.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.supportingInformation.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

reference

Σ C

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.supportingInformation.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ref-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element id

MedicationDispense.supportingInformation.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Comments

Data type

Binding

Aa resource (or, for logical models, the URI of the logical model).

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.supportingInformation.identifier

Short description

Logical reference, when literal reference is not known

Definition

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.supportingInformation.identifier.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.supportingInformation.identifier.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationDispense.supportingInformation.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Data type

Binding

Identifies the purpose for this identifier, if known .

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationDispense.supportingInformation.identifier.type

Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Data type

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.5
rim: Role.code or implied by context

system

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.supportingInformation.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

http://www.acme.com/identifiers/patient

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

value

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.supportingInformation.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

period

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.supportingInformation.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

assigner

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.supportingInformation.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

display

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.supportingInformation.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

performer

1..*

Element id

MedicationDispense.performer

Short description

Who performed event

Definition

The pharmacist and pharmacy MUST be present and MUST use identifier references. This means FHIR Practitioner, Organization and PractitionerRole resource are not included in the FHIR Message. Professional codes and ODS codes should be used instead. sds-user-role-id is permitted to identify a Practitioner(& Role) but professional codes are preferred to support wider NHS interoperability.

 "performer": [
    {
        "actor": {
            "reference" : "#performer"
        }
    }
],

The contained PractitionerRole:

{
    "resourceType": "MedicationDispense",
    "id": "06167339-9337-d030-0366-514a6a46da17",
    "contained": [
        {
                        "resourceType": "PractitionerRole",
                        "id": "performer",
                        "identifier": [
                            {
                                "system": "https://fhir.nhs.uk/Id/sds-role-profile-id",
                                "value": "741555508105"
                            }
                        ],
                        "code": [
                            {
                                "coding": [
                                    {
                                        "system": "https://fhir.nhs.uk/CodeSystem/NHSDigital-SDS-JobRoleCode",
                                        "code": "S0030:G0100:R0620"
                                    }
                                ]
                            }
                        ],
                        "practitioner": {
                            "identifier": {
                                "system": "https://fhir.nhs.uk/Id/sds-user-id",
                                "value": "7654321"
                            },
                            "display": "Mr Peter Potion"
                        },
                        "organization": {
                            "reference": "urn:uuid:2bf9f37c-d88b-4f86-ad5f-373c1416e04b"
                        },
                        "telecom": [
                            {
                                "system": "phone",
                                "use": "work",
                                "value": "0532567890"
                            }
                        ]
                   }
    ],

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

workflow: Event.performer
rim: .participation[typeCode=PRF]

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.performer.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.performer.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Constraints

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()

Mappings

rim: n/a

modifierExtension

Σ ?! C

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.performer.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

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).

Requirements

Comments

Data type

Constraints

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()

Mappings

rim: N/A

function

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.performer.function

Short description

Who performed the dispense and what they did

Definition

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

Requirements

Allows disambiguation of the types of involvement of different performers.

Data type

MedicationDispense Performer Function Codes (example)

Binding

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

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: participation[typeCode=PRF].functionCode

actor

1..1

Element id

MedicationDispense.performer.actor

Short description

A reference from one resource to another

Definition

A reference from one resource to another.

Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Data type

Allowed aggregation:contained

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
performer: An identifier reference or resource reference must be provided
(reference.exists() or identifier.exists())

Mappings

workflow: Event.performer.actor
rim: .role
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.performer.actor.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.performer.actor.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

reference

Σ C

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.performer.actor.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ref-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element id

MedicationDispense.performer.actor.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Comments

Data type

Binding

Aa resource (or, for logical models, the URI of the logical model).

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

identifier

0..1

Element id

MedicationDispense.performer.actor.identifier

Short description

An identifier intended for computation

Definition

An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .identifier
rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd: Identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.performer.actor.identifier.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.performer.actor.identifier.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationDispense.performer.actor.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Data type

Binding

Identifies the purpose for this identifier, if known .

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationDispense.performer.actor.identifier.type

Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Data type

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.5
rim: Role.code or implied by context

system

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.performer.actor.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

http://www.acme.com/identifiers/patient

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

value

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.performer.actor.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

period

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.performer.actor.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

assigner

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.performer.actor.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

display

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.performer.actor.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

location

0..1

Element id

MedicationDispense.location

Short description

Where the dispense occurred

Definition

The principal physical location where the dispense was performed.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .participation[typeCode=LOC].role

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.location.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.location.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

reference

Σ C

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.location.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ref-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element id

MedicationDispense.location.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Comments

Data type

Binding

Aa resource (or, for logical models, the URI of the logical model).

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.location.identifier

Short description

Logical reference, when literal reference is not known

Definition

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.location.identifier.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.location.identifier.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationDispense.location.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Data type

Binding

Identifies the purpose for this identifier, if known .

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationDispense.location.identifier.type

Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Data type

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.5
rim: Role.code or implied by context

system

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.location.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

http://www.acme.com/identifiers/patient

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

value

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.location.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

period

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.location.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

assigner

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.location.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

display

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.location.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

authorizingPrescription

1..*

Element id

MedicationDispense.authorizingPrescription

Short description

Medication order that authorizes the dispense

Definition

A reference to the MedicationRequest.

"authorizingPrescription": [
    {
        "reference": "#m1"
    }
]

When a MedicationDispesne is sent in a FHIR Message bundle, which is the case with EPS NextGen dispense-notifications, a contained MedicationRequest is required.

This MedicationRequest MUST follow the rules in NHSDigital-MedicationRequest and it is strongly recommended to reuse the MedicationRequest received when the prescription was downloaded.

For example:

{
                "resourceType": "MedicationDispense",
                "contained":  [
                    {
                        "resourceType": "MedicationRequest",
                        "id": "m1",
                        "identifier":  [
                            {
                                "system": "https://fhir.nhs.uk/Id/prescription-order-item-number",
                                "value": "299c610b-f4f1-4eac-a7d7-4fb6b0556e11"
                            }
                        ],
                        "status": "active",
                        "intent": "order",
                        "medicationCodeableConcept": {
                            "coding":  [
                                {
                                    "system": "http://snomed.info/sct",
                                    "code": "39720311000001101",
                                    "display": "Paracetamol 500mg soluble tablets"
                                }
                            ]
                        },
                        "subject": {
                            "identifier": {
                                "system": "https://fhir.nhs.uk/Id/nhs-number",
                                "value": "9876543210"
                            }
                        },
                        "groupIdentifier": {
                            "extension":  [
                                {
                                    "url": "https://fhir.nhs.uk/StructureDefinition/Extension-DM-PrescriptionId",
                                    "valueIdentifier": {
                                        "system": "https://fhir.nhs.uk/Id/prescription",
                                        "value": "b2fc79f0-2793-4736-9b2d-0976c21e73a5"
                                    }
                                }
                            ],
                            "system": "https://fhir.nhs.uk/Id/prescription-order-number",
                            "value": "82D996-C81010-11DB12"
                        },
                        "dispenseRequest": {
                            "quantity": {
                                "value": 100,
                                "unit": "tablet",
                                "system": "http://snomed.info/sct",
                                "code": "732936001"
                            }
                        },
                        "substitution": {
                            "allowedBoolean": false
                        }
                    }
                ],
                "authorizingPrescription":  [
                    {
                        "reference": "#m1"
                    }
                ],

This is based on a MedicationRequest in this implementation guide. The uuid resource references are not permitted and must be replaced with identifier references. E.g. in this section from the $release

        "subject": {
            "reference": "urn:uuid:78d3c2eb-009e-4ec8-a358-b042954aa9b2"
        },
        "authoredOn": "2020-12-21T18:15:29+00:00",
        "requester": {
            "reference": "urn:uuid:56166769-c1c4-4d07-afa8-132b5dfca666"
        },

The requester reference can be removed and the subject reference changed to use the Patient's NHSNumber e.g.

        "subject": {
            "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9876543210"
        }
    },

Comments

Maps to basedOn in Event logical model.

Data type

Allowed aggregation:contained, referenced

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

workflow: Event.basedOn
v2: ORC-2 Placer Order Number
rim: .outboundRelationship[typeCode=FLFS].target[moodCode=RQO]
rx-dispense-rmim: CombinedMedicationDispense.inFulfillmentOf

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.authorizingPrescription.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.authorizingPrescription.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

reference

Σ C

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.authorizingPrescription.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ref-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element id

MedicationDispense.authorizingPrescription.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Comments

Data type

Binding

Aa resource (or, for logical models, the URI of the logical model).

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.authorizingPrescription.identifier

Short description

Logical reference, when literal reference is not known

Definition

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.authorizingPrescription.identifier.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.authorizingPrescription.identifier.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationDispense.authorizingPrescription.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Data type

Binding

Identifies the purpose for this identifier, if known .

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationDispense.authorizingPrescription.identifier.type

Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Data type

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.5
rim: Role.code or implied by context

system

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.authorizingPrescription.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

http://www.acme.com/identifiers/patient

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

value

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.authorizingPrescription.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

period

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.authorizingPrescription.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

assigner

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.authorizingPrescription.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

display

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.authorizingPrescription.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

type

0..1

CodeableConceptBinding

Element id

MedicationDispense.type

Short description

Trial fill, partial fill, emergency fill, etc.

Definition

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

"type": {
    "coding": [
        {
            "system": "https://fhir.nhs.uk/CodeSystem/medicationdispense-type",
            "code": "0001",
            "display": "Item fully dispensed"
        }
    ]
}

Data type

MedicationDispenseType (required)

Binding

A ValueSet to identify the type of medication item status.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXD-33-Dispense Type
rim: .code
rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.code

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.type.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.type.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

coding

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.type.coding

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.type.coding.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.type.coding.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

system

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.type.coding.system

Short description

Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.type.coding.version

Short description

Version of the system - if relevant

Definition

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.type.coding.code

Short description

Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Requirements

Need to refer to a particular code in the system.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

display

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.type.coding.display

Short description

Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.type.coding.userSelected

Short description

If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

text

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.type.text

Short description

Plain text representation of the concept

Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Requirements

Comments

Very often the text is the same as a displayName of one of the codings.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

quantity

1..1

Element id

MedicationDispense.quantity

Short description

Amount dispensed

Definition

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

"quantity": {
    "value": 28,
    "unit": "capsule",
    "system": "http://snomed.info/sct",
    "code": "3316911000001105"
}

If no actual quantity has been dispensed then use a value of zero.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense Units.name of coding system
rim: .quantity
rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.quantity

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.quantity.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

Element id

MedicationDispense.quantity.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

runningTotal

0..1

Element id

MedicationDispense.quantity.extension:runningTotal

Short description

Optional Extensions Element

Alternate names

extensions, user content

Definition

Optional Extension Element - found in all resources.

Comments

Data type

https://fhir.nhs.uk/StructureDefinition/Extension-DM-RunningTotal

Extension URL

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

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()

Mappings

rim: n/a
rim: N/A

value

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.quantity.value

Short description

Numerical value (with implicit precision)

Definition

The value of the measured amount. The value includes an implicit precision in the presentation of the value.

Requirements

Precision is handled implicitly in almost all cases of measurement.

Comments

The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: SN.2 / CQ - N/A
rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value

comparator

Σ ?!

0..0

codeBinding

There are no (further) constraints on this element

Element id

MedicationDispense.quantity.comparator

Short description

< | <= | >= | > - how to understand the value

Definition

Not allowed to be used in this context

Requirements

Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

Meaning when missing

If there is no comparator, then there is no modification of the value

Data type

Binding

How the Quantity should be understood and represented.

QuantityComparator (required)

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: SN.1 / CQ.1
rim: IVL properties

unit

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.quantity.unit

Short description

Unit representation

Definition

A human-readable form of the unit.

Requirements

There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.unit

system

Σ C

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.quantity.system

Short description

System that defines coded unit form

Definition

The identification of the system that provides the coded form of the unit.

Requirements

Need to know the system that defines the coded form of the unit.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: qty-3

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: CO.codeSystem, PQ.translation.codeSystem

code

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.quantity.code

Short description

Coded form of the unit

Definition

A computer processable form of the unit in some unit representation system.

Requirements

Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

Comments

The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.code, MO.currency, PQ.translation.code

daysSupply

0..1

Element id

MedicationDispense.daysSupply

Short description

Amount of medication expressed as a timing amount

Definition

The amount of medication expressed as a timing amount.

"daysSupply": {
    "value": 7,
    "unit": "Day",
    "system": "http://unitsofmeasure.org",
    "code": "d"
}

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: TQ1.6 Timing/Quantity Segment Service Duration. Prior to v2.5, ORC.7.3 Common Order Segment / Quantity/Timing / Duration component. This is a formatted string, first character for the time unit (e.g., D=days), followed by the value. For example, “D14” represents “14 days supply” From v2.5 on, TQ1.6 Timing/Quantity Segment / Service Duration. This is a CQ data type (<Quantity (NM)> ^ <Units (CWE)>), thus for days supply, assuming the unit of measure is “days”, the numeric value is TQ1.6.1 (…|14^ For backwards compatibility, ORC.7 was permitted through v2.6. Both forms (field and segment) may be present in v2.5, v2.5.1, and v2.6
rim: effectiveUseTime

whenPrepared

S Σ

0..1

Element id

MedicationDispense.whenPrepared

Short description

When product was packaged and reviewed

Definition

The time when the dispensed product was packaged and reviewed.

"whenPrepared": "2004-09-16T16:30:00+00:00"

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXD-3-Date/Time Dispensed
rim: .effectiveTime[xmi:type=IVL_TS].low
rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.effectiveTime

whenHandedOver

0..1

Element id

MedicationDispense.whenHandedOver

Short description

When product was given out

Definition

The time the dispensed product was provided to the patient or their representative. In HL7 v3 this is: The date and local time that the medication is issued by the dispenser.

"whenHandedOver": "2004-09-16T16:30:00+00:00"

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

workflow: Event.occurrence[x]
v2: RXD-3-Date/Time Dispensed
rim: .effectiveTime[xmi:type=IVL_TS].high
rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.effectiveTime

destination

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.destination

Short description

Where the medication was sent

Definition

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

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXD-13 Dispense-to Location; RXD-30 Dispense to Pharmacy; RXD-31 Dispense to Pharmacy Address
rim: .participation[typeCode=DST].role
rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.destination

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.destination.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.destination.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

reference

Σ C

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.destination.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ref-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element id

MedicationDispense.destination.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Comments

Data type

Binding

Aa resource (or, for logical models, the URI of the logical model).

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.destination.identifier

Short description

Logical reference, when literal reference is not known

Definition

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.destination.identifier.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.destination.identifier.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationDispense.destination.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Data type

Binding

Identifies the purpose for this identifier, if known .

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationDispense.destination.identifier.type

Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Data type

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.5
rim: Role.code or implied by context

system

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.destination.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

http://www.acme.com/identifiers/patient

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

value

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.destination.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

period

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.destination.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

assigner

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.destination.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

display

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.destination.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

receiver

0..1

Reference( | )

There are no (further) constraints on this element

Element id

MedicationDispense.receiver

Short description

Who collected the medication

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.

Data type

Reference( | )

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .participation[typeCode=RCV].role
rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.receiver

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.receiver.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.receiver.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

reference

Σ C

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.receiver.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ref-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element id

MedicationDispense.receiver.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Comments

Data type

Binding

Aa resource (or, for logical models, the URI of the logical model).

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.receiver.identifier

Short description

Logical reference, when literal reference is not known

Definition

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.receiver.identifier.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.receiver.identifier.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationDispense.receiver.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Data type

Binding

Identifies the purpose for this identifier, if known .

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationDispense.receiver.identifier.type

Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Data type

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.5
rim: Role.code or implied by context

system

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.receiver.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

http://www.acme.com/identifiers/patient

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

value

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.receiver.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

period

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.receiver.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

assigner

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.receiver.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

display

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.receiver.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

note

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.note

Short description

Information about the dispense

Definition

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

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

workflow: Event.note
v2: RXD-9 Dispense Notes
rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=ACT,moodCode=EVN]

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.note.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.note.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

author[x]

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.note.author[x]

Short description

Individual responsible for the annotation

Definition

The individual responsible for making the annotation.

Comments

Organization is used when there's no need for specific attribution as to who made the comment.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Act.participant[typeCode=AUT].role

authorString

There are no (further) constraints on this element

Data type

authorReference

Reference( | | | )

There are no (further) constraints on this element

Data type

Reference( | | | )

time

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.note.time

Short description

When the annotation was made

Definition

Indicates when this particular annotation was made.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Act.effectiveTime

text

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.note.text

Short description

The annotation - text content (as markdown)

Definition

The text of the annotation in markdown format.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Act.text

dosageInstruction

0..*

Element id

MedicationDispense.dosageInstruction

Short description

How the medication is/was taken or should be taken

Definition

At present only the text element MUST be provided. It is recommended the guidance in FHIR Dose Syntax Implementation Guidance is followed.

Note the structure of this section is similar as the NHSDigital-MedicationRequest from the prescription-order.

"dosageInstruction": [
    {
        "text": "4 times a day for 7 days",
        "timing": {
            "repeat": {
                "boundsDuration": {
                    "value": 7,
                    "unit": "d"
                },
                "frequency": 4,
                "period": 1,
                "periodUnit": "d"
            }
        },
        "doseAndRate": [
            {
                "doseQuantity": {
                    "value": 1,
                    "unit": "capsule",
                    "system": "http://snomed.info/sct",
                    "code": "3316911000001105"
                }
            }
        ]
    }
]

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.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]
rim: n/a

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

modifierExtension

Σ ?! C

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

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

Requirements

Comments

Data type

Constraints

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()

Mappings

rim: N/A

sequence

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.sequence

Short description

The order of the dosage instructions

Definition

Indicates the order in which the dosage instructions should be applied or interpreted.

Requirements

If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: TQ1-1
rim: .text

text

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.text

Short description

Free text dosage instructions e.g. SIG

Definition

Free text dosage instructions e.g. SIG.

Requirements

Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXO-6; RXE-21
rim: .text

additionalInstruction

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.additionalInstruction

Short description

Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"

Definition

Supplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps").

Requirements

Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded.

Comments

Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text.

Data type

SNOMEDCTAdditionalDosageInstructions (example)

Binding

A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXO-7
rim: .text

patientInstruction

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.patientInstruction

Short description

Patient or consumer oriented instructions

Definition

Instructions in terms that are understood by the patient or consumer.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXO-7
rim: .text

timing

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.timing

Short description

When medication should be administered

Definition

When medication should be administered.

Requirements

The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

Comments

This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .effectiveTime

asNeeded[x]

0..1

Binding

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.asNeeded[x]

Short description

Take "as needed" (for x)

Definition

Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).

Comments

Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed".

Binding

A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: TQ1-9
rim: .outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept

asNeededBoolean

There are no (further) constraints on this element

Data type

asNeededCodeableConcept

There are no (further) constraints on this element

Data type

site

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.site

Short description

Body site to administer to

Definition

Body site to administer to.

Requirements

A coded specification of the anatomic site where the medication first enters the body.

Comments

If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.

Data type

Binding

A coded concept describing the site location the medicine enters into or onto the body.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXR-2
rim: .approachSiteCode

route

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.route

Short description

How drug should enter body

Definition

How drug should enter body.

Requirements

A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.

Data type

Binding

A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXR-1
rim: .routeCode

method

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.method

Short description

Technique for administering medication

Definition

Technique for administering medication.

Requirements

A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV.

Comments

Terminologies used often pre-coordinate this term with the route and or form of administration.

Data type

Binding

A coded concept describing the technique by which the medicine is administered.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXR-4
rim: .doseQuantity

doseAndRate

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.doseAndRate

Short description

Amount of medication administered

Definition

The amount of medication administered.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: TQ1-2

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.doseAndRate.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.doseAndRate.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

type

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.doseAndRate.type

Short description

The kind of dose or rate specified

Definition

The kind of dose or rate specified, for example, ordered or calculated.

Requirements

If the type is not populated, assume to be "ordered".

Data type

Binding

The kind of dose or rate specified.

DoseAndRateType (example)

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXO-21; RXE-23

dose[x]

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.doseAndRate.dose[x]

Short description

Amount of medication per dose

Definition

Amount of medication per dose.

Requirements

The amount of therapeutic or other substance given at one administration event.

Comments

Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXO-2, RXE-3
rim: .doseQuantity

doseRange

There are no (further) constraints on this element

Data type

doseQuantity

There are no (further) constraints on this element

Data type

rate[x]

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.doseAndRate.rate[x]

Short description

Amount of medication per unit of time

Definition

Amount of medication per unit of time.

Requirements

Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.

Comments

It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.

It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXE22, RXE23, RXE-24
rim: .rateQuantity

rateRatio

There are no (further) constraints on this element

Data type

rateRange

There are no (further) constraints on this element

Data type

rateQuantity

There are no (further) constraints on this element

Data type

maxDosePerPeriod

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.maxDosePerPeriod

Short description

Upper limit on medication per unit of time

Definition

Upper limit on medication per unit of time.

Requirements

The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours.

Comments

This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day".

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXO-23, RXE-19
rim: .maxDoseQuantity

maxDosePerAdministration

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.maxDosePerAdministration

Short description

Upper limit on medication per administration

Definition

Upper limit on medication per administration.

Requirements

The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.

Comments

This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: not supported

maxDosePerLifetime

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.maxDosePerLifetime

Short description

Upper limit on medication per lifetime of the patient

Definition

Upper limit on medication per lifetime of the patient.

Requirements

The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: not supported

substitution

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.substitution

Short description

Whether a substitution was performed on the dispense

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.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .outboundRelationship[typeCode=COMP].target[classCode=SUBST, moodCode=EVN]
rx-dispense-rmim: CombinedMedicationDispense.substitutionMade

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Constraints

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()

Mappings

rim: n/a

modifierExtension

Σ ?! C

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

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

Requirements

Comments

Data type

Constraints

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()

Mappings

rim: N/A

wasSubstituted

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.wasSubstituted

Short description

Whether a substitution was or was not performed on the dispense

Definition

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

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .actionNegationInd

type

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.type

Short description

Code signifying whether a different drug was dispensed from what was prescribed

Definition

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

Data type

v3.ActSubstanceAdminSubstitutionCode (example)

Binding

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

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXO-9-Allow Substitutions / RXE-9-Substitution Status
rim: .code
rx-dispense-rmim: CombinedMedicationDispense.substitutionMade.code

reason

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.reason

Short description

Why was substitution made

Definition

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

Data type

v3.SubstanceAdminSubstitutionReason (example)

Binding

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

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .reasonCode
rx-dispense-rmim: CombinedMedicationDispense.substitutionMade.reasonCode

responsibleParty

0..*

Reference( | )

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.responsibleParty

Short description

Who is responsible for the substitution

Definition

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

Data type

Reference( | )

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .participation[typeCode=PFM].role[classCode=ASSIGN]
rx-dispense-rmim: CombinedMedicationDispense.substitutionMade.ResponsibleParty

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.responsibleParty.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.responsibleParty.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

reference

Σ C

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.responsibleParty.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ref-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.responsibleParty.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Comments

Data type

Binding

Aa resource (or, for logical models, the URI of the logical model).

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.responsibleParty.identifier

Short description

Logical reference, when literal reference is not known

Definition

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.responsibleParty.identifier.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.responsibleParty.identifier.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.responsibleParty.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Data type

Binding

Identifies the purpose for this identifier, if known .

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.responsibleParty.identifier.type

Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Data type

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.5
rim: Role.code or implied by context

system

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.responsibleParty.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

http://www.acme.com/identifiers/patient

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

value

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.responsibleParty.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

period

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.responsibleParty.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

assigner

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.responsibleParty.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

display

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.responsibleParty.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

detectedIssue

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.detectedIssue

Short description

Clinical issue with action

Alternate names

Contraindication, Drug Utilization Review (DUR), Alert

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.

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.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.detectedIssue.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.detectedIssue.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

reference

Σ C

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.detectedIssue.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ref-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element id

MedicationDispense.detectedIssue.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Comments

Data type

Binding

Aa resource (or, for logical models, the URI of the logical model).

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.detectedIssue.identifier

Short description

Logical reference, when literal reference is not known

Definition

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.detectedIssue.identifier.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.detectedIssue.identifier.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationDispense.detectedIssue.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Data type

Binding

Identifies the purpose for this identifier, if known .

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationDispense.detectedIssue.identifier.type

Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Data type

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.5
rim: Role.code or implied by context

system

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.detectedIssue.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

http://www.acme.com/identifiers/patient

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

value

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.detectedIssue.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

period

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.detectedIssue.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

assigner

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.detectedIssue.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

display

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.detectedIssue.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

eventHistory

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.eventHistory

Short description

A list of relevant lifecycle events

Definition

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

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.).

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.eventHistory.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.eventHistory.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

reference

Σ C

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.eventHistory.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ref-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element id

MedicationDispense.eventHistory.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Comments

Data type

Binding

Aa resource (or, for logical models, the URI of the logical model).

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.eventHistory.identifier

Short description

Logical reference, when literal reference is not known

Definition

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.eventHistory.identifier.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.eventHistory.identifier.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationDispense.eventHistory.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Data type

Binding

Identifies the purpose for this identifier, if known .

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationDispense.eventHistory.identifier.type

Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Data type

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.5
rim: Role.code or implied by context

system

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.eventHistory.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

http://www.acme.com/identifiers/patient

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

value

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.eventHistory.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

period

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.eventHistory.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

assigner

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.eventHistory.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

display

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.eventHistory.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

NHSDigitalMedicationDispense (MedicationDispense)

There are no (further) constraints on this element

Element id

MedicationDispense

Short description

Dispensing a medication to a named patient

Definition

Data type

Constraints

dom-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

Mappings

rim: Entity. Role, or Act
workflow: Event
rim: Supply[moodCode=EVN]

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.id

Short description

Logical id of this artifact

Definition

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

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.

Data type

There are no (further) constraints on this element

Element id

MedicationDispense.meta

Short description

Metadata about the resource

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.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

implicitRules

Σ ?!

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.implicitRules

Short description

A set of rules under which this content was created

Definition

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

language

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationDispense.language

Short description

Language of the resource content

Definition

The base language in which the resource is written.

Comments

Data type

Binding

A human language.

CommonLanguages (preferred)

Binding extensions

maxValueSet	AllLanguages

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

text

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.text

Short description

Text summary of the resource, for human interpretation

Alternate names

narrative, html, xhtml, display

Definition

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: Act.text?

contained

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.contained

Short description

Contained, inline Resources

Alternate names

inline resources, anonymous resources, contained resources

Definition

Comments

Data type

Mappings

rim: N/A

extension

1..*

Element id

MedicationDispense.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Constraints

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()

Mappings

rim: N/A

prescriptionStatus

S C

1..1

Element id

MedicationDispense.extension:prescriptionStatus

Short description

This is the overall status of the `prescription-order`

Alternate names

extensions, user content

Definition

"extension": [
    {
        "url": "https://fhir.nhs.uk/StructureDefinition/Extension-EPS-TaskBusinessStatus",
        "valueCoding": {
            "system": "https://fhir.nhs.uk/CodeSystem/EPS-task-business-status",
            "code": "0003",
            "display": "With Dispenser - Active"
        }
    }
]

Comments

Data type

https://fhir.nhs.uk/StructureDefinition/Extension-EPS-TaskBusinessStatus

Extension URL

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

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()

Mappings

rim: N/A
rim: n/a

prescriptionNonDispensingReason

S C

0..1

Element id

MedicationDispense.extension:prescriptionNonDispensingReason

Short description

This is the non dispensing reason for the overall prescription

Alternate names

extensions, user content

Definition

This is the reason a complete prescription was not dispensed, it is not the status of the individual line items, which is contained in MedicationDispense.statusReason.

"extension": [
    {
        "url": "https://fhir.nhs.uk/StructureDefinition/Extension-DM-PrescriptionNonDispensingReason",
        "valueCoding": {
            "system": "https://fhir.nhs.uk/CodeSystem/medicationdispense-status-reason",
            "code": "0002",
            "display": "Clinically unsuitable"
        }
    }
]

Comments

Data type

https://fhir.nhs.uk/StructureDefinition/Extension-DM-PrescriptionNonDispensingReason

Extension URL

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

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()

Mappings

rim: N/A
rim: n/a

repeatInformation

S C

0..1

Extension(Complex)

Element id

MedicationDispense.extension:repeatInformation

Short description

Repeat Prescribing and Dispensing

Alternate names

extensions, user content

Definition

The extension is mandatory for continuous and continuous-repeat-dispensing. The following elements MUST be populated

numberofRepeatsAllowed
numberOfRepeatsIssued

"extension": [
    {
        "url": "https://fhir.nhs.uk/StructureDefinition/Extension-EPS-RepeatInformation",
        "extension": [
            {
                "url" : "numberOfRepeatsAllowed",
                "valueInteger" : 3
            },
            {
                "url" : "numberOfRepeatsIssued",
                "valueInteger" : 2
            }
        ]
    }
]

Comments

Data type

Extension(Complex)

Extension URL

https://fhir.nhs.uk/StructureDefinition/Extension-EPS-RepeatInformation

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

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()

Mappings

rim: N/A
rim: n/a

supplyHeaderIdentifier

S C

0..1

Element id

MedicationDispense.extension:supplyHeaderIdentifier

Short description

Identifier for the SupplyHeader

Alternate names

extensions, user content

Definition

Identifier of the SupplyHeader (v3) object. The prescription in the context of a Dispense Notification or Claim. Mandatory for EPS interactions.

Comments

Data type

https://fhir.nhs.uk/StructureDefinition/Extension-EPS-SupplyHeaderIdentifier

Extension URL

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

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()

Mappings

rim: N/A
rim: n/a

modifierExtension

?! C

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.modifierExtension

Short description

Extensions that cannot be ignored

Alternate names

extensions, user content

Definition

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

Requirements

Comments

Data type

Constraints

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()

Mappings

rim: N/A

identifier

0..*

Element id

MedicationDispense.identifier

Short description

External identifier

Definition

Each MedicationDispense MUST be identified by an Universal Unique Identifiers (UUIDs) with a system of https://fhir.nhs.uk/Id/prescription-dispense-item-number

UUID example (for illustration purposes only);

4509B70D-D8B8-EA03-1105-64557CB54A29

 "identifier":  [
    {
        "system": "https://fhir.nhs.uk/Id/prescription-dispense-item-number",
        "value": "4509B70D-D8B8-EA03-1105-64557CB54A29"
    }
]

Comments

This is a business identifier, not a resource identifier.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

workflow: Event.identifier
w5: FiveWs.identifier
rim: .id
rx-dispense-rmim: CombinedMedicationDispense.id

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.identifier.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.identifier.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationDispense.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Data type

Binding

Identifies the purpose for this identifier, if known .

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationDispense.identifier.type

Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Data type

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.5
rim: Role.code or implied by context

system

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

http://www.acme.com/identifiers/patient

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

value

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

period

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

assigner

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

partOf

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.partOf

Short description

Event that dispense is part of

Definition

The procedure that trigger the dispense.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

workflow: Event.partOf
rim: .outboundRelationship[typeCode=COMP]/target[classCode=PROC,moodCode=EVN]

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.partOf.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.partOf.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

reference

Σ C

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.partOf.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ref-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element id

MedicationDispense.partOf.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Comments

Data type

Binding

Aa resource (or, for logical models, the URI of the logical model).

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.partOf.identifier

Short description

Logical reference, when literal reference is not known

Definition

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.partOf.identifier.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.partOf.identifier.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationDispense.partOf.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Data type

Binding

Identifies the purpose for this identifier, if known .

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationDispense.partOf.identifier.type

Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Data type

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.5
rim: Role.code or implied by context

system

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.partOf.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

http://www.acme.com/identifiers/patient

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

value

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.partOf.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

period

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.partOf.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

assigner

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.partOf.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

display

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.partOf.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

status

S Σ ?!

1..1

codeBinding

Element id

MedicationDispense.status

Short description

Definition

The status of the individual medication item, this will normally indicate whether the medication has been picked up or not.

Code	Display	Definition
completed	Completed	The dispensed product has been picked up.
in-progress	In Progress	The dispensed product is ready for pickup.

Comments

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

Data type

MedicationDispense Status Codes (required)

Binding

A coded concept specifying the state of the dispense event.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

workflow: Event.status
w5: FiveWs.status
rim: .statusCode
rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.statusCode

statusReason[x]

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x]

Short description

Why a dispense was not performed

Definition

Indicates the reason why a dispense was not performed.

Binding

A code describing why a dispense was not performed.

MedicationDispense Status Reason Codes (example)

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

workflow: Event.statusReason
rim: .outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code="not done reason"].value

statusReasonCodeableConcept

Data type

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

coding

1..*

Element id

MedicationDispense.statusReason[x].coding

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Data type

Slicing

Unordered, Open, by system(Value)

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

(All Slices)

The requirements in this element apply to all slices

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].coding.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].coding.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

system

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].coding.system

Short description

Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].coding.version

Short description

Version of the system - if relevant

Definition

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].coding.code

Short description

Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Requirements

Need to refer to a particular code in the system.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

display

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].coding.display

Short description

Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].coding.userSelected

Short description

If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

notDispensedStatusReason

S Σ

0..*

CodingBinding

Element id

MedicationDispense.statusReason[x].coding:notDispensedStatusReason

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Data type

MedicationDispenseStatusReason (required)

Binding

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].coding:notDispensedStatusReason.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].coding:notDispensedStatusReason.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

system

1..1

uriAuto Value

Element id

MedicationDispense.statusReason[x].coding:notDispensedStatusReason.system

Short description

Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Auto value

https://fhir.nhs.uk/CodeSystem/medicationdispense-status-reason

Mappings

v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].coding:notDispensedStatusReason.version

Short description

Version of the system - if relevant

Definition

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].coding:notDispensedStatusReason.code

Short description

Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Requirements

Need to refer to a particular code in the system.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

display

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].coding:notDispensedStatusReason.display

Short description

Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].coding:notDispensedStatusReason.userSelected

Short description

If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

amendmentStatusReason

S Σ

0..*

CodingBinding

Element id

MedicationDispense.statusReason[x].coding:amendmentStatusReason

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Data type

Binding

TaskReasonCode (required)

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].coding:amendmentStatusReason.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].coding:amendmentStatusReason.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

system

1..1

uriAuto Value

Element id

MedicationDispense.statusReason[x].coding:amendmentStatusReason.system

Short description

Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Auto value

https://fhir.nhs.uk/CodeSystem/EPS-task-dispense-withdraw-reason

Mappings

v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].coding:amendmentStatusReason.version

Short description

Version of the system - if relevant

Definition

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].coding:amendmentStatusReason.code

Short description

Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Requirements

Need to refer to a particular code in the system.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

display

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].coding:amendmentStatusReason.display

Short description

Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].coding:amendmentStatusReason.userSelected

Short description

If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

text

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.statusReason[x].text

Short description

Plain text representation of the concept

Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Requirements

Comments

Very often the text is the same as a displayName of one of the codings.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

category

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationDispense.category

Short description

Type of medication dispense

Definition

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

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.

Data type

MedicationDispense Category Codes (preferred)

Binding

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

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication dispense"].value

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.category.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.category.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

coding

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.category.coding

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.category.coding.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.category.coding.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

system

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.category.coding.system

Short description

Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.category.coding.version

Short description

Version of the system - if relevant

Definition

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.category.coding.code

Short description

Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Requirements

Need to refer to a particular code in the system.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

display

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.category.coding.display

Short description

Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.category.coding.userSelected

Short description

If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

text

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.category.text

Short description

Plain text representation of the concept

Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Requirements

Comments

Very often the text is the same as a displayName of one of the codings.

Data type

NHS Digital Medication Code (extensible)

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

medication[x]

S Σ

1..1

Binding

Element id

MedicationDispense.medication[x]

Short description

What medication was supplied

Definition

Actual Medical Product Packs (AMPP) SHOULD be used. It is valid to include a FHIR Medication resource within the FHIR Message, this practice is discouraged to simplify handling of the event messages.

<table> <thead> <th data-no-sort width="25%"> dm+d Category </th> <th data-no-sort width="50%"> dm+d Description </th> <th data-no-sort width="25%"> UK SNOMED Members Of </th>

<br>

"medicationCodeableConcept": {
        "coding":  [
        {
            "system": "http://snomed.info/sct",
            "code": "10460811000001109",
            "display": "Amoxil 500mg capsules (Dowelhurst Ltd) 12 capsule"
        }
    ]
}

Comments

Binding

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

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

workflow: Event.code
w5: FiveWs.what[x]
v2: RXD-2-Dispense/Give Code
rim: .participation[typeCode=PRD].role
rx-dispense-rmim: CombinedMedicationRequest.component1.AdministrationRequest.consumable

medicationCodeableConcept

Data type

medicationReference

Data type

Allowed aggregation:bundled

subject

S Σ C

1..1

Element id

MedicationDispense.subject

Short description

Who the dispense is for

Definition

"subject": {
    "type": "Patient",
    "identifier": {
        "system": "https://fhir.nhs.uk/Id/nhs-number",
        "value": "2300992742"
    }
}

Second option uses a FHIR Patient resource to convey the NHS Number.

The reference in the MedicationDispesnse is now a resource reference.

 "subject": {
                    "type": "Patient",
                    "reference": "urn:uuid:bde9eba6-079f-4210-8108-6ea8db58de8c",
                    "display": "Miss Bernie Kanfeld"
                }

The NHS Number has moved to the Patient resource alongside other patient identifiers such as MRN. E.g.

"fullUrl": "urn:uuid:bde9eba6-079f-4210-8108-6ea8db58de8c",
"resource": {
                "resourceType": "Patient",
                "identifier": [
                    {
                        "extension": [
                            {
                                "url": "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberVerificationStatus",
                                "valueCodeableConcept": {
                                    "coding": [
                                        {
                                            "system": "https://fhir.hl7.org.uk/CodeSystem/UKCore-NHSNumberVerificationStatus",
                                            "code": "01",
                                            "display": "Number present and verified"
                                        }
                                    ]
                                }
                            }
                        ],
                        "system": "https://fhir.nhs.uk/Id/nhs-number",
                        "value": "9876543210"
                    },
                    {
                        "system": "https://fhir.leedsth.nhs.uk/Id/pas-number",
                        "value": "ABC8650149"
                    },
                    {
                        "system": "https://fhir.leedsth.nhs.uk/Id/PPMIdentifier",
                        "value": "1"
                    }
                ],
               ... other elements removed from example.
            }

It is anticipated that hospital pharmacies will prefer the later option for compatibility with other systems. Community pharmacies are anticipated to prefer the former option.

Comments

SubstanceAdministration->subject->Patient.

Data type

Allowed aggregation:referenced, bundled

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
eps-2: subject - An identifier reference or resource reference must be provided
(reference.exists() or (identifier.exists()))
patient-nhs: Length of the supplied NHS Number is wrong.
identifier.where(system='https://fhir.nhs.uk/Id/nhs-number').exists().not() or (identifier.where(system='https://fhir.nhs.uk/Id/nhs-number').exists() and identifier.where(system='https://fhir.nhs.uk/Id/nhs-number').value.matches('^([0-9]{10})$'))

Mappings

workflow: Event.subject
w5: FiveWs.subject[x]
v2: PID-3-Patient ID List
rim: .participation[typeCode=SBJ].role[classCode=PAT]
w5: FiveWs.subject

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.subject.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.subject.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

reference

Σ C

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.subject.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ref-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element id

MedicationDispense.subject.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Comments

Data type

Binding

Aa resource (or, for logical models, the URI of the logical model).

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.subject.identifier

Short description

Logical reference, when literal reference is not known

Definition

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.subject.identifier.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.subject.identifier.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationDispense.subject.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Data type

Binding

Identifies the purpose for this identifier, if known .

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationDispense.subject.identifier.type

Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Data type

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.5
rim: Role.code or implied by context

system

1..1

uriAuto Value

Element id

MedicationDispense.subject.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Auto value

https://fhir.nhs.uk/Id/nhs-number

Examples
General

http://www.acme.com/identifiers/patient

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

value

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.subject.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

period

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.subject.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

assigner

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.subject.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

display

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.subject.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

context

0..1

Element id

MedicationDispense.context

Short description

Encounter / Episode associated with event

Definition

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

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

workflow: Event.context
rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.context.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.context.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

reference

Σ C

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.context.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ref-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element id

MedicationDispense.context.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Comments

Data type

Binding

Aa resource (or, for logical models, the URI of the logical model).

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.context.identifier

Short description

Logical reference, when literal reference is not known

Definition

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.context.identifier.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.context.identifier.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationDispense.context.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Data type

Binding

Identifies the purpose for this identifier, if known .

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationDispense.context.identifier.type

Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Data type

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.5
rim: Role.code or implied by context

system

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.context.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

http://www.acme.com/identifiers/patient

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

value

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.context.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

period

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.context.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

assigner

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.context.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

display

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.context.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

supportingInformation

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.supportingInformation

Short description

Information that supports the dispensing of the medication

Definition

Additional information that supports the medication being dispensed.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

w5: FiveWs.context
rim: .outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.supportingInformation.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.supportingInformation.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

reference

Σ C

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.supportingInformation.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ref-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element id

MedicationDispense.supportingInformation.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Comments

Data type

Binding

Aa resource (or, for logical models, the URI of the logical model).

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.supportingInformation.identifier

Short description

Logical reference, when literal reference is not known

Definition

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.supportingInformation.identifier.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.supportingInformation.identifier.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationDispense.supportingInformation.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Data type

Binding

Identifies the purpose for this identifier, if known .

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationDispense.supportingInformation.identifier.type

Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Data type

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.5
rim: Role.code or implied by context

system

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.supportingInformation.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

http://www.acme.com/identifiers/patient

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

value

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.supportingInformation.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

period

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.supportingInformation.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

assigner

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.supportingInformation.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

display

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.supportingInformation.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

performer

1..*

Element id

MedicationDispense.performer

Short description

Who performed event

Definition

 "performer": [
    {
        "actor": {
            "reference" : "#performer"
        }
    }
],

The contained PractitionerRole:

{
    "resourceType": "MedicationDispense",
    "id": "06167339-9337-d030-0366-514a6a46da17",
    "contained": [
        {
                        "resourceType": "PractitionerRole",
                        "id": "performer",
                        "identifier": [
                            {
                                "system": "https://fhir.nhs.uk/Id/sds-role-profile-id",
                                "value": "741555508105"
                            }
                        ],
                        "code": [
                            {
                                "coding": [
                                    {
                                        "system": "https://fhir.nhs.uk/CodeSystem/NHSDigital-SDS-JobRoleCode",
                                        "code": "S0030:G0100:R0620"
                                    }
                                ]
                            }
                        ],
                        "practitioner": {
                            "identifier": {
                                "system": "https://fhir.nhs.uk/Id/sds-user-id",
                                "value": "7654321"
                            },
                            "display": "Mr Peter Potion"
                        },
                        "organization": {
                            "reference": "urn:uuid:2bf9f37c-d88b-4f86-ad5f-373c1416e04b"
                        },
                        "telecom": [
                            {
                                "system": "phone",
                                "use": "work",
                                "value": "0532567890"
                            }
                        ]
                   }
    ],

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

workflow: Event.performer
rim: .participation[typeCode=PRF]

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.performer.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.performer.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Constraints

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()

Mappings

rim: n/a

modifierExtension

Σ ?! C

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.performer.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

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

Requirements

Comments

Data type

Constraints

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()

Mappings

rim: N/A

function

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.performer.function

Short description

Who performed the dispense and what they did

Definition

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

Requirements

Allows disambiguation of the types of involvement of different performers.

Data type

MedicationDispense Performer Function Codes (example)

Binding

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

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: participation[typeCode=PRF].functionCode

actor

1..1

Element id

MedicationDispense.performer.actor

Short description

A reference from one resource to another

Definition

A reference from one resource to another.

Comments

Data type

Allowed aggregation:contained

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
performer: An identifier reference or resource reference must be provided
(reference.exists() or identifier.exists())

Mappings

workflow: Event.performer.actor
rim: .role
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.performer.actor.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.performer.actor.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

reference

Σ C

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.performer.actor.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ref-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element id

MedicationDispense.performer.actor.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Comments

Data type

Binding

Aa resource (or, for logical models, the URI of the logical model).

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

identifier

0..1

Element id

MedicationDispense.performer.actor.identifier

Short description

An identifier intended for computation

Definition

An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .identifier
rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd: Identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.performer.actor.identifier.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.performer.actor.identifier.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationDispense.performer.actor.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Data type

Binding

Identifies the purpose for this identifier, if known .

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationDispense.performer.actor.identifier.type

Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Data type

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.5
rim: Role.code or implied by context

system

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.performer.actor.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

http://www.acme.com/identifiers/patient

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

value

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.performer.actor.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

period

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.performer.actor.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

assigner

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.performer.actor.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

display

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.performer.actor.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

location

0..1

Element id

MedicationDispense.location

Short description

Where the dispense occurred

Definition

The principal physical location where the dispense was performed.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .participation[typeCode=LOC].role

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.location.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.location.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

reference

Σ C

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.location.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ref-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element id

MedicationDispense.location.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Comments

Data type

Binding

Aa resource (or, for logical models, the URI of the logical model).

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.location.identifier

Short description

Logical reference, when literal reference is not known

Definition

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.location.identifier.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.location.identifier.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationDispense.location.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Data type

Binding

Identifies the purpose for this identifier, if known .

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationDispense.location.identifier.type

Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Data type

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.5
rim: Role.code or implied by context

system

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.location.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

http://www.acme.com/identifiers/patient

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

value

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.location.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

period

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.location.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

assigner

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.location.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

display

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.location.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

authorizingPrescription

1..*

Element id

MedicationDispense.authorizingPrescription

Short description

Medication order that authorizes the dispense

Definition

A reference to the MedicationRequest.

"authorizingPrescription": [
    {
        "reference": "#m1"
    }
]

When a MedicationDispesne is sent in a FHIR Message bundle, which is the case with EPS NextGen dispense-notifications, a contained MedicationRequest is required.

This MedicationRequest MUST follow the rules in NHSDigital-MedicationRequest and it is strongly recommended to reuse the MedicationRequest received when the prescription was downloaded.

For example:

{
                "resourceType": "MedicationDispense",
                "contained":  [
                    {
                        "resourceType": "MedicationRequest",
                        "id": "m1",
                        "identifier":  [
                            {
                                "system": "https://fhir.nhs.uk/Id/prescription-order-item-number",
                                "value": "299c610b-f4f1-4eac-a7d7-4fb6b0556e11"
                            }
                        ],
                        "status": "active",
                        "intent": "order",
                        "medicationCodeableConcept": {
                            "coding":  [
                                {
                                    "system": "http://snomed.info/sct",
                                    "code": "39720311000001101",
                                    "display": "Paracetamol 500mg soluble tablets"
                                }
                            ]
                        },
                        "subject": {
                            "identifier": {
                                "system": "https://fhir.nhs.uk/Id/nhs-number",
                                "value": "9876543210"
                            }
                        },
                        "groupIdentifier": {
                            "extension":  [
                                {
                                    "url": "https://fhir.nhs.uk/StructureDefinition/Extension-DM-PrescriptionId",
                                    "valueIdentifier": {
                                        "system": "https://fhir.nhs.uk/Id/prescription",
                                        "value": "b2fc79f0-2793-4736-9b2d-0976c21e73a5"
                                    }
                                }
                            ],
                            "system": "https://fhir.nhs.uk/Id/prescription-order-number",
                            "value": "82D996-C81010-11DB12"
                        },
                        "dispenseRequest": {
                            "quantity": {
                                "value": 100,
                                "unit": "tablet",
                                "system": "http://snomed.info/sct",
                                "code": "732936001"
                            }
                        },
                        "substitution": {
                            "allowedBoolean": false
                        }
                    }
                ],
                "authorizingPrescription":  [
                    {
                        "reference": "#m1"
                    }
                ],

        "subject": {
            "reference": "urn:uuid:78d3c2eb-009e-4ec8-a358-b042954aa9b2"
        },
        "authoredOn": "2020-12-21T18:15:29+00:00",
        "requester": {
            "reference": "urn:uuid:56166769-c1c4-4d07-afa8-132b5dfca666"
        },

The requester reference can be removed and the subject reference changed to use the Patient's NHSNumber e.g.

        "subject": {
            "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9876543210"
        }
    },

Comments

Maps to basedOn in Event logical model.

Data type

Allowed aggregation:contained, referenced

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

workflow: Event.basedOn
v2: ORC-2 Placer Order Number
rim: .outboundRelationship[typeCode=FLFS].target[moodCode=RQO]
rx-dispense-rmim: CombinedMedicationDispense.inFulfillmentOf

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.authorizingPrescription.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.authorizingPrescription.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

reference

Σ C

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.authorizingPrescription.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ref-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element id

MedicationDispense.authorizingPrescription.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Comments

Data type

Binding

Aa resource (or, for logical models, the URI of the logical model).

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.authorizingPrescription.identifier

Short description

Logical reference, when literal reference is not known

Definition

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.authorizingPrescription.identifier.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.authorizingPrescription.identifier.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationDispense.authorizingPrescription.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Data type

Binding

Identifies the purpose for this identifier, if known .

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationDispense.authorizingPrescription.identifier.type

Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Data type

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.5
rim: Role.code or implied by context

system

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.authorizingPrescription.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

http://www.acme.com/identifiers/patient

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

value

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.authorizingPrescription.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

period

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.authorizingPrescription.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

assigner

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.authorizingPrescription.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

display

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.authorizingPrescription.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

type

0..1

CodeableConceptBinding

Element id

MedicationDispense.type

Short description

Trial fill, partial fill, emergency fill, etc.

Definition

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

"type": {
    "coding": [
        {
            "system": "https://fhir.nhs.uk/CodeSystem/medicationdispense-type",
            "code": "0001",
            "display": "Item fully dispensed"
        }
    ]
}

Data type

MedicationDispenseType (required)

Binding

A ValueSet to identify the type of medication item status.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXD-33-Dispense Type
rim: .code
rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.code

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.type.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.type.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

coding

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.type.coding

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.type.coding.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.type.coding.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

system

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.type.coding.system

Short description

Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.type.coding.version

Short description

Version of the system - if relevant

Definition

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.type.coding.code

Short description

Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Requirements

Need to refer to a particular code in the system.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

display

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.type.coding.display

Short description

Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.type.coding.userSelected

Short description

If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

text

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.type.text

Short description

Plain text representation of the concept

Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Requirements

Comments

Very often the text is the same as a displayName of one of the codings.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

quantity

1..1

Element id

MedicationDispense.quantity

Short description

Amount dispensed

Definition

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

"quantity": {
    "value": 28,
    "unit": "capsule",
    "system": "http://snomed.info/sct",
    "code": "3316911000001105"
}

If no actual quantity has been dispensed then use a value of zero.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense Units.name of coding system
rim: .quantity
rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.quantity

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.quantity.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

Element id

MedicationDispense.quantity.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

runningTotal

0..1

Element id

MedicationDispense.quantity.extension:runningTotal

Short description

Optional Extensions Element

Alternate names

extensions, user content

Definition

Optional Extension Element - found in all resources.

Comments

Data type

https://fhir.nhs.uk/StructureDefinition/Extension-DM-RunningTotal

Extension URL

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

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()

Mappings

rim: n/a
rim: N/A

value

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.quantity.value

Short description

Numerical value (with implicit precision)

Definition

The value of the measured amount. The value includes an implicit precision in the presentation of the value.

Requirements

Precision is handled implicitly in almost all cases of measurement.

Comments

The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: SN.2 / CQ - N/A
rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value

comparator

Σ ?!

0..0

codeBinding

There are no (further) constraints on this element

Element id

MedicationDispense.quantity.comparator

Short description

< | <= | >= | > - how to understand the value

Definition

Not allowed to be used in this context

Requirements

Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

Meaning when missing

If there is no comparator, then there is no modification of the value

Data type

Binding

How the Quantity should be understood and represented.

QuantityComparator (required)

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: SN.1 / CQ.1
rim: IVL properties

unit

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.quantity.unit

Short description

Unit representation

Definition

A human-readable form of the unit.

Requirements

There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.unit

system

Σ C

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.quantity.system

Short description

System that defines coded unit form

Definition

The identification of the system that provides the coded form of the unit.

Requirements

Need to know the system that defines the coded form of the unit.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: qty-3

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: CO.codeSystem, PQ.translation.codeSystem

code

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.quantity.code

Short description

Coded form of the unit

Definition

A computer processable form of the unit in some unit representation system.

Requirements

Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

Comments

The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.code, MO.currency, PQ.translation.code

daysSupply

0..1

Element id

MedicationDispense.daysSupply

Short description

Amount of medication expressed as a timing amount

Definition

The amount of medication expressed as a timing amount.

"daysSupply": {
    "value": 7,
    "unit": "Day",
    "system": "http://unitsofmeasure.org",
    "code": "d"
}

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: TQ1.6 Timing/Quantity Segment Service Duration. Prior to v2.5, ORC.7.3 Common Order Segment / Quantity/Timing / Duration component. This is a formatted string, first character for the time unit (e.g., D=days), followed by the value. For example, “D14” represents “14 days supply” From v2.5 on, TQ1.6 Timing/Quantity Segment / Service Duration. This is a CQ data type (<Quantity (NM)> ^ <Units (CWE)>), thus for days supply, assuming the unit of measure is “days”, the numeric value is TQ1.6.1 (…|14^ For backwards compatibility, ORC.7 was permitted through v2.6. Both forms (field and segment) may be present in v2.5, v2.5.1, and v2.6
rim: effectiveUseTime

whenPrepared

S Σ

0..1

Element id

MedicationDispense.whenPrepared

Short description

When product was packaged and reviewed

Definition

The time when the dispensed product was packaged and reviewed.

"whenPrepared": "2004-09-16T16:30:00+00:00"

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXD-3-Date/Time Dispensed
rim: .effectiveTime[xmi:type=IVL_TS].low
rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.effectiveTime

whenHandedOver

0..1

Element id

MedicationDispense.whenHandedOver

Short description

When product was given out

Definition

The time the dispensed product was provided to the patient or their representative. In HL7 v3 this is: The date and local time that the medication is issued by the dispenser.

"whenHandedOver": "2004-09-16T16:30:00+00:00"

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

workflow: Event.occurrence[x]
v2: RXD-3-Date/Time Dispensed
rim: .effectiveTime[xmi:type=IVL_TS].high
rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.effectiveTime

destination

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.destination

Short description

Where the medication was sent

Definition

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

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXD-13 Dispense-to Location; RXD-30 Dispense to Pharmacy; RXD-31 Dispense to Pharmacy Address
rim: .participation[typeCode=DST].role
rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.destination

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.destination.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.destination.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

reference

Σ C

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.destination.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ref-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element id

MedicationDispense.destination.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Comments

Data type

Binding

Aa resource (or, for logical models, the URI of the logical model).

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.destination.identifier

Short description

Logical reference, when literal reference is not known

Definition

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.destination.identifier.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.destination.identifier.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationDispense.destination.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Data type

Binding

Identifies the purpose for this identifier, if known .

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationDispense.destination.identifier.type

Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Data type

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.5
rim: Role.code or implied by context

system

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.destination.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

http://www.acme.com/identifiers/patient

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

value

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.destination.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

period

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.destination.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

assigner

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.destination.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

display

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.destination.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

receiver

0..1

Reference( | )

There are no (further) constraints on this element

Element id

MedicationDispense.receiver

Short description

Who collected the medication

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.

Data type

Reference( | )

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .participation[typeCode=RCV].role
rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.receiver

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.receiver.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.receiver.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

reference

Σ C

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.receiver.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ref-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element id

MedicationDispense.receiver.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Comments

Data type

Binding

Aa resource (or, for logical models, the URI of the logical model).

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.receiver.identifier

Short description

Logical reference, when literal reference is not known

Definition

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.receiver.identifier.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.receiver.identifier.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationDispense.receiver.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Data type

Binding

Identifies the purpose for this identifier, if known .

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationDispense.receiver.identifier.type

Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Data type

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.5
rim: Role.code or implied by context

system

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.receiver.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

http://www.acme.com/identifiers/patient

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

value

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.receiver.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

period

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.receiver.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

assigner

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.receiver.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

display

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.receiver.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

note

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.note

Short description

Information about the dispense

Definition

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

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

workflow: Event.note
v2: RXD-9 Dispense Notes
rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=ACT,moodCode=EVN]

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.note.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.note.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

author[x]

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.note.author[x]

Short description

Individual responsible for the annotation

Definition

The individual responsible for making the annotation.

Comments

Organization is used when there's no need for specific attribution as to who made the comment.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Act.participant[typeCode=AUT].role

authorString

There are no (further) constraints on this element

Data type

authorReference

Reference( | | | )

There are no (further) constraints on this element

Data type

Reference( | | | )

time

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.note.time

Short description

When the annotation was made

Definition

Indicates when this particular annotation was made.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Act.effectiveTime

text

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.note.text

Short description

The annotation - text content (as markdown)

Definition

The text of the annotation in markdown format.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Act.text

dosageInstruction

0..*

Element id

MedicationDispense.dosageInstruction

Short description

How the medication is/was taken or should be taken

Definition

At present only the text element MUST be provided. It is recommended the guidance in FHIR Dose Syntax Implementation Guidance is followed.

Note the structure of this section is similar as the NHSDigital-MedicationRequest from the prescription-order.

"dosageInstruction": [
    {
        "text": "4 times a day for 7 days",
        "timing": {
            "repeat": {
                "boundsDuration": {
                    "value": 7,
                    "unit": "d"
                },
                "frequency": 4,
                "period": 1,
                "periodUnit": "d"
            }
        },
        "doseAndRate": [
            {
                "doseQuantity": {
                    "value": 1,
                    "unit": "capsule",
                    "system": "http://snomed.info/sct",
                    "code": "3316911000001105"
                }
            }
        ]
    }
]

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]
rim: n/a

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

modifierExtension

Σ ?! C

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

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

Requirements

Comments

Data type

Constraints

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()

Mappings

rim: N/A

sequence

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.sequence

Short description

The order of the dosage instructions

Definition

Indicates the order in which the dosage instructions should be applied or interpreted.

Requirements

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: TQ1-1
rim: .text

text

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.text

Short description

Free text dosage instructions e.g. SIG

Definition

Free text dosage instructions e.g. SIG.

Requirements

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXO-6; RXE-21
rim: .text

additionalInstruction

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.additionalInstruction

Short description

Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"

Definition

Requirements

Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded.

Comments

Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text.

Data type

SNOMEDCTAdditionalDosageInstructions (example)

Binding

A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXO-7
rim: .text

patientInstruction

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.patientInstruction

Short description

Patient or consumer oriented instructions

Definition

Instructions in terms that are understood by the patient or consumer.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXO-7
rim: .text

timing

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.timing

Short description

When medication should be administered

Definition

When medication should be administered.

Requirements

Comments

This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .effectiveTime

asNeeded[x]

0..1

Binding

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.asNeeded[x]

Short description

Take "as needed" (for x)

Definition

Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).

Comments

Binding

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: TQ1-9
rim: .outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept

asNeededBoolean

There are no (further) constraints on this element

Data type

asNeededCodeableConcept

There are no (further) constraints on this element

Data type

site

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.site

Short description

Body site to administer to

Definition

Body site to administer to.

Requirements

A coded specification of the anatomic site where the medication first enters the body.

Comments

Data type

Binding

A coded concept describing the site location the medicine enters into or onto the body.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXR-2
rim: .approachSiteCode

route

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.route

Short description

How drug should enter body

Definition

How drug should enter body.

Requirements

A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.

Data type

Binding

A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXR-1
rim: .routeCode

method

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.method

Short description

Technique for administering medication

Definition

Technique for administering medication.

Requirements

A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV.

Comments

Terminologies used often pre-coordinate this term with the route and or form of administration.

Data type

Binding

A coded concept describing the technique by which the medicine is administered.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXR-4
rim: .doseQuantity

doseAndRate

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.doseAndRate

Short description

Amount of medication administered

Definition

The amount of medication administered.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: TQ1-2

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.doseAndRate.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.doseAndRate.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

type

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.doseAndRate.type

Short description

The kind of dose or rate specified

Definition

The kind of dose or rate specified, for example, ordered or calculated.

Requirements

If the type is not populated, assume to be "ordered".

Data type

Binding

The kind of dose or rate specified.

DoseAndRateType (example)

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXO-21; RXE-23

dose[x]

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.doseAndRate.dose[x]

Short description

Amount of medication per dose

Definition

Amount of medication per dose.

Requirements

The amount of therapeutic or other substance given at one administration event.

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXO-2, RXE-3
rim: .doseQuantity

doseRange

There are no (further) constraints on this element

Data type

doseQuantity

There are no (further) constraints on this element

Data type

rate[x]

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.doseAndRate.rate[x]

Short description

Amount of medication per unit of time

Definition

Amount of medication per unit of time.

Requirements

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXE22, RXE23, RXE-24
rim: .rateQuantity

rateRatio

There are no (further) constraints on this element

Data type

rateRange

There are no (further) constraints on this element

Data type

rateQuantity

There are no (further) constraints on this element

Data type

maxDosePerPeriod

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.maxDosePerPeriod

Short description

Upper limit on medication per unit of time

Definition

Upper limit on medication per unit of time.

Requirements

The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours.

Comments

This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day".

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXO-23, RXE-19
rim: .maxDoseQuantity

maxDosePerAdministration

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.maxDosePerAdministration

Short description

Upper limit on medication per administration

Definition

Upper limit on medication per administration.

Requirements

The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: not supported

maxDosePerLifetime

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.dosageInstruction.maxDosePerLifetime

Short description

Upper limit on medication per lifetime of the patient

Definition

Upper limit on medication per lifetime of the patient.

Requirements

The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: not supported

substitution

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.substitution

Short description

Whether a substitution was performed on the dispense

Definition

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .outboundRelationship[typeCode=COMP].target[classCode=SUBST, moodCode=EVN]
rx-dispense-rmim: CombinedMedicationDispense.substitutionMade

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Constraints

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()

Mappings

rim: n/a

modifierExtension

Σ ?! C

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

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

Requirements

Comments

Data type

Constraints

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()

Mappings

rim: N/A

wasSubstituted

1..1

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.wasSubstituted

Short description

Whether a substitution was or was not performed on the dispense

Definition

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

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .actionNegationInd

type

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.type

Short description

Code signifying whether a different drug was dispensed from what was prescribed

Definition

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

Data type

v3.ActSubstanceAdminSubstitutionCode (example)

Binding

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

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXO-9-Allow Substitutions / RXE-9-Substitution Status
rim: .code
rx-dispense-rmim: CombinedMedicationDispense.substitutionMade.code

reason

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.reason

Short description

Why was substitution made

Definition

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

Data type

v3.SubstanceAdminSubstitutionReason (example)

Binding

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

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .reasonCode
rx-dispense-rmim: CombinedMedicationDispense.substitutionMade.reasonCode

responsibleParty

0..*

Reference( | )

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.responsibleParty

Short description

Who is responsible for the substitution

Definition

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

Data type

Reference( | )

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .participation[typeCode=PFM].role[classCode=ASSIGN]
rx-dispense-rmim: CombinedMedicationDispense.substitutionMade.ResponsibleParty

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.responsibleParty.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.responsibleParty.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

reference

Σ C

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.responsibleParty.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ref-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.responsibleParty.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Comments

Data type

Binding

Aa resource (or, for logical models, the URI of the logical model).

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.responsibleParty.identifier

Short description

Logical reference, when literal reference is not known

Definition

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.responsibleParty.identifier.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.responsibleParty.identifier.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.responsibleParty.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Data type

Binding

Identifies the purpose for this identifier, if known .

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.responsibleParty.identifier.type

Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Data type

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.5
rim: Role.code or implied by context

system

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.responsibleParty.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

http://www.acme.com/identifiers/patient

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

value

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.responsibleParty.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

period

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.responsibleParty.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

assigner

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.responsibleParty.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

display

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.substitution.responsibleParty.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

detectedIssue

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.detectedIssue

Short description

Clinical issue with action

Alternate names

Contraindication, Drug Utilization Review (DUR), Alert

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.

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.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.detectedIssue.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.detectedIssue.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

reference

Σ C

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.detectedIssue.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ref-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element id

MedicationDispense.detectedIssue.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Comments

Data type

Binding

Aa resource (or, for logical models, the URI of the logical model).

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.detectedIssue.identifier

Short description

Logical reference, when literal reference is not known

Definition

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.detectedIssue.identifier.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.detectedIssue.identifier.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationDispense.detectedIssue.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Data type

Binding

Identifies the purpose for this identifier, if known .

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationDispense.detectedIssue.identifier.type

Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Data type

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.5
rim: Role.code or implied by context

system

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.detectedIssue.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

http://www.acme.com/identifiers/patient

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

value

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.detectedIssue.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

period

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.detectedIssue.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

assigner

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.detectedIssue.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

display

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.detectedIssue.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

eventHistory

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.eventHistory

Short description

A list of relevant lifecycle events

Definition

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

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.eventHistory.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.eventHistory.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

reference

Σ C

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.eventHistory.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ref-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element id

MedicationDispense.eventHistory.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Comments

Data type

Binding

Aa resource (or, for logical models, the URI of the logical model).

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.eventHistory.identifier

Short description

Logical reference, when literal reference is not known

Definition

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .identifier

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.eventHistory.identifier.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

MedicationDispense.eventHistory.identifier.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

MedicationDispense.eventHistory.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Data type

Binding

Identifies the purpose for this identifier, if known .

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

MedicationDispense.eventHistory.identifier.type

Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Data type

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.5
rim: Role.code or implied by context

system

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.eventHistory.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

http://www.acme.com/identifiers/patient

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

value

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.eventHistory.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

period

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.eventHistory.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

assigner

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.eventHistory.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

display

0..1

There are no (further) constraints on this element

Element id

MedicationDispense.eventHistory.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

MedicationDispense

Short Dispensing a medication to a named patient

Definition

Cardinality 0..*

Constraints

dom-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

Mappings

rim: Entity. Role, or Act
workflow: Event
rim: Supply[moodCode=EVN]

MedicationDispense.id

Short Logical id of this artifact

Definition

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

Cardinality 0..1

Summary True

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.

MedicationDispense.meta

Short Metadata about the resource

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.

Cardinality 0..1

Summary True

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

MedicationDispense.implicitRules

Short A set of rules under which this content was created

Definition

Cardinality 0..1

Modifier True

Summary True

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

MedicationDispense.language

Short Language of the resource content

Definition

The base language in which the resource is written.

Cardinality 0..1

A human language.

CommonLanguages (preferred)

Binding extensions

maxValueSet	AllLanguages

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

MedicationDispense.text

Short Text summary of the resource, for human interpretation

Definition

Cardinality 0..1

Alias narrative, html, xhtml, display

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: Act.text?

MedicationDispense.contained

Short Contained, inline Resources

Definition

Cardinality 0..*

Alias inline resources, anonymous resources, contained resources

Comments

Mappings

rim: N/A

MedicationDispense.extension

Short Additional content defined by implementations

Definition

Cardinality 1..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Constraints

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()

Mappings

rim: N/A

MedicationDispense.extension:prescriptionStatus

Short This is the overall status of the `prescription-order`

Definition

"extension": [
    {
        "url": "https://fhir.nhs.uk/StructureDefinition/Extension-EPS-TaskBusinessStatus",
        "valueCoding": {
            "system": "https://fhir.nhs.uk/CodeSystem/EPS-task-business-status",
            "code": "0003",
            "display": "With Dispenser - Active"
        }
    }
]

Cardinality 1..1

Type Extension(Coding)

Must Support True

Alias extensions, user content

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

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()

Mappings

rim: N/A
rim: n/a

MedicationDispense.extension:prescriptionNonDispensingReason

Short This is the non dispensing reason for the overall prescription

Definition

This is the reason a complete prescription was not dispensed, it is not the status of the individual line items, which is contained in MedicationDispense.statusReason.

"extension": [
    {
        "url": "https://fhir.nhs.uk/StructureDefinition/Extension-DM-PrescriptionNonDispensingReason",
        "valueCoding": {
            "system": "https://fhir.nhs.uk/CodeSystem/medicationdispense-status-reason",
            "code": "0002",
            "display": "Clinically unsuitable"
        }
    }
]

Cardinality 0..1

Type Extension(Coding)

Must Support True

Alias extensions, user content

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

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()

Mappings

rim: N/A
rim: n/a

MedicationDispense.extension:repeatInformation

Short Repeat Prescribing and Dispensing

Definition

The extension is mandatory for continuous and continuous-repeat-dispensing. The following elements MUST be populated

numberofRepeatsAllowed
numberOfRepeatsIssued

"extension": [
    {
        "url": "https://fhir.nhs.uk/StructureDefinition/Extension-EPS-RepeatInformation",
        "extension": [
            {
                "url" : "numberOfRepeatsAllowed",
                "valueInteger" : 3
            },
            {
                "url" : "numberOfRepeatsIssued",
                "valueInteger" : 2
            }
        ]
    }
]

Cardinality 0..1

Type Extension(Complex)

Must Support True

Alias extensions, user content

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

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()

Mappings

rim: N/A
rim: n/a

MedicationDispense.extension:supplyHeaderIdentifier

Short Identifier for the SupplyHeader

Definition

Identifier of the SupplyHeader (v3) object. The prescription in the context of a Dispense Notification or Claim. Mandatory for EPS interactions.

Cardinality 0..1

Type Extension(Identifier)

Must Support True

Alias extensions, user content

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

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()

Mappings

rim: N/A
rim: n/a

MedicationDispense.modifierExtension

Short Extensions that cannot be ignored

Definition

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

Cardinality 0..*

Modifier True

Alias extensions, user content

Requirements

Comments

Constraints

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()

Mappings

rim: N/A

MedicationDispense.identifier

Short External identifier

Definition

Each MedicationDispense MUST be identified by an Universal Unique Identifiers (UUIDs) with a system of https://fhir.nhs.uk/Id/prescription-dispense-item-number

UUID example (for illustration purposes only);

4509B70D-D8B8-EA03-1105-64557CB54A29

 "identifier":  [
    {
        "system": "https://fhir.nhs.uk/Id/prescription-dispense-item-number",
        "value": "4509B70D-D8B8-EA03-1105-64557CB54A29"
    }
]

Cardinality 0..*

Must Support True

Comments

This is a business identifier, not a resource identifier.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

workflow: Event.identifier
w5: FiveWs.identifier
rim: .id
rx-dispense-rmim: CombinedMedicationDispense.id

MedicationDispense.identifier.id

Short Unique id for inter-element referencing

Definition

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

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.identifier.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

MedicationDispense.identifier.use

Short usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Cardinality 0..1

Identifies the purpose for this identifier, if known .

Modifier True

Summary True

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Role.code or implied by context

MedicationDispense.identifier.type

Short Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Cardinality 0..1

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Summary True

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.5
rim: Role.code or implied by context

MedicationDispense.identifier.system

Short The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Cardinality 1..1

Summary True

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples

General

http://www.acme.com/identifiers/patient

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

MedicationDispense.identifier.value

Short The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Cardinality 1..1

Summary True

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples

General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

MedicationDispense.identifier.period

Short Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Cardinality 0..1

Summary True

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

MedicationDispense.identifier.assigner

Short Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Cardinality 0..1

Type Reference()

Summary True

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

MedicationDispense.partOf

Short Event that dispense is part of

Definition

The procedure that trigger the dispense.

Cardinality 0..*

Type Reference()

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

workflow: Event.partOf
rim: .outboundRelationship[typeCode=COMP]/target[classCode=PROC,moodCode=EVN]

MedicationDispense.partOf.id

Short Unique id for inter-element referencing

Definition

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

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.partOf.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

MedicationDispense.partOf.reference

Short Literal reference, Relative, internal or absolute URL

Definition

Cardinality 0..1

Summary True

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ref-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

MedicationDispense.partOf.type

Short Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Cardinality 0..1

Aa resource (or, for logical models, the URI of the logical model).

Summary True

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

MedicationDispense.partOf.identifier

Short Logical reference, when literal reference is not known

Definition

Cardinality 0..1

Summary True

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .identifier

MedicationDispense.partOf.identifier.id

Short Unique id for inter-element referencing

Definition

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

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.partOf.identifier.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

MedicationDispense.partOf.identifier.use

Short usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Cardinality 0..1

Identifies the purpose for this identifier, if known .

Modifier True

Summary True

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Role.code or implied by context

MedicationDispense.partOf.identifier.type

Short Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Cardinality 0..1

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Summary True

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.5
rim: Role.code or implied by context

MedicationDispense.partOf.identifier.system

Short The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Cardinality 0..1

Summary True

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples

General

http://www.acme.com/identifiers/patient

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

MedicationDispense.partOf.identifier.value

Short The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Cardinality 0..1

Summary True

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples

General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

MedicationDispense.partOf.identifier.period

Short Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Cardinality 0..1

Summary True

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

MedicationDispense.partOf.identifier.assigner

Short Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Cardinality 0..1

Type Reference()

Summary True

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

MedicationDispense.partOf.display

Short Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Cardinality 0..1

Summary True

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

MedicationDispense.status

Definition

The status of the individual medication item, this will normally indicate whether the medication has been picked up or not.

Code	Display	Definition
completed	Completed	The dispensed product has been picked up.
in-progress	In Progress	The dispensed product is ready for pickup.

Cardinality 1..1

MedicationDispense Status Codes (required)

A coded concept specifying the state of the dispense event.

Must Support True

Modifier True

Summary True

Comments

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

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

workflow: Event.status
w5: FiveWs.status
rim: .statusCode
rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.statusCode

MedicationDispense.statusReason[x]

Short Why a dispense was not performed

Definition

Indicates the reason why a dispense was not performed.

Cardinality 0..1

MedicationDispense Status Reason Codes (example)

A code describing why a dispense was not performed.

Must Support True

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

workflow: Event.statusReason
rim: .outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code="not done reason"].value

MedicationDispense.statusReason[x].id

Short Unique id for inter-element referencing

Definition

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

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.statusReason[x].extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

MedicationDispense.statusReason[x].coding

Short Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Cardinality 1..*

Summary True

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Unordered, Open, by system(Value)

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

MedicationDispense.statusReason[x].coding.id

Short Unique id for inter-element referencing

Definition

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

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.statusReason[x].coding.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

MedicationDispense.statusReason[x].coding.system

Short Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Cardinality 1..1

Summary True

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

MedicationDispense.statusReason[x].coding.version

Short Version of the system - if relevant

Definition

Cardinality 0..1

Summary True

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

MedicationDispense.statusReason[x].coding.code

Short Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Cardinality 1..1

Summary True

Requirements

Need to refer to a particular code in the system.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

MedicationDispense.statusReason[x].coding.display

Short Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Cardinality 0..1

Summary True

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

MedicationDispense.statusReason[x].coding.userSelected

Short If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Cardinality 0..1

Summary True

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

MedicationDispense.statusReason[x].coding:notDispensedStatusReason

Short Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Cardinality 0..*

MedicationDispenseStatusReason (required)

Must Support True

Summary True

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

MedicationDispense.statusReason[x].coding:notDispensedStatusReason.id

Short Unique id for inter-element referencing

Definition

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

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.statusReason[x].coding:notDispensedStatusReason.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

MedicationDispense.statusReason[x].coding:notDispensedStatusReason.system

Short Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Cardinality 1..1

Summary True

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Auto Value

https://fhir.nhs.uk/CodeSystem/medicationdispense-status-reason

Mappings

v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

MedicationDispense.statusReason[x].coding:notDispensedStatusReason.version

Short Version of the system - if relevant

Definition

Cardinality 0..1

Summary True

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

MedicationDispense.statusReason[x].coding:notDispensedStatusReason.code

Short Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Cardinality 1..1

Summary True

Requirements

Need to refer to a particular code in the system.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

MedicationDispense.statusReason[x].coding:notDispensedStatusReason.display

Short Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Cardinality 0..1

Summary True

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

MedicationDispense.statusReason[x].coding:notDispensedStatusReason.userSelected

Short If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Cardinality 0..1

Summary True

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

MedicationDispense.statusReason[x].coding:amendmentStatusReason

Short Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Cardinality 0..*

TaskReasonCode (required)

Must Support True

Summary True

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

MedicationDispense.statusReason[x].coding:amendmentStatusReason.id

Short Unique id for inter-element referencing

Definition

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

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.statusReason[x].coding:amendmentStatusReason.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

MedicationDispense.statusReason[x].coding:amendmentStatusReason.system

Short Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Cardinality 1..1

Summary True

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Auto Value

https://fhir.nhs.uk/CodeSystem/EPS-task-dispense-withdraw-reason

Mappings

v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

MedicationDispense.statusReason[x].coding:amendmentStatusReason.version

Short Version of the system - if relevant

Definition

Cardinality 0..1

Summary True

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

MedicationDispense.statusReason[x].coding:amendmentStatusReason.code

Short Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Cardinality 1..1

Summary True

Requirements

Need to refer to a particular code in the system.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

MedicationDispense.statusReason[x].coding:amendmentStatusReason.display

Short Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Cardinality 0..1

Summary True

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

MedicationDispense.statusReason[x].coding:amendmentStatusReason.userSelected

Short If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Cardinality 0..1

Summary True

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

MedicationDispense.statusReason[x].text

Short Plain text representation of the concept

Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Cardinality 0..1

Summary True

Requirements

Comments

Very often the text is the same as a displayName of one of the codings.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

MedicationDispense.category

Short Type of medication dispense

Definition

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

Cardinality 0..1

MedicationDispense Category Codes (preferred)

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

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.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication dispense"].value

MedicationDispense.category.id

Short Unique id for inter-element referencing

Definition

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

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.category.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

MedicationDispense.category.coding

Short Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Cardinality 0..*

Summary True

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

MedicationDispense.category.coding.id

Short Unique id for inter-element referencing

Definition

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

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.category.coding.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

MedicationDispense.category.coding.system

Short Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Cardinality 1..1

Summary True

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

MedicationDispense.category.coding.version

Short Version of the system - if relevant

Definition

Cardinality 0..1

Summary True

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

MedicationDispense.category.coding.code

Short Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Cardinality 1..1

Summary True

Requirements

Need to refer to a particular code in the system.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

MedicationDispense.category.coding.display

Short Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Cardinality 0..1

Summary True

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

MedicationDispense.category.coding.userSelected

Short If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Cardinality 0..1

Summary True

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

MedicationDispense.category.text

Short Plain text representation of the concept

Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Cardinality 0..1

Summary True

Requirements

Comments

Very often the text is the same as a displayName of one of the codings.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

MedicationDispense.medication[x]

Short What medication was supplied

Definition

Actual Medical Product Packs (AMPP) SHOULD be used. It is valid to include a FHIR Medication resource within the FHIR Message, this practice is discouraged to simplify handling of the event messages.

<table> <thead> <th data-no-sort width="25%"> dm+d Category </th> <th data-no-sort width="50%"> dm+d Description </th> <th data-no-sort width="25%"> UK SNOMED Members Of </th>

<br>

"medicationCodeableConcept": {
        "coding":  [
        {
            "system": "http://snomed.info/sct",
            "code": "10460811000001109",
            "display": "Amoxil 500mg capsules (Dowelhurst Ltd) 12 capsule"
        }
    ]
}

Cardinality 1..1

Type NHSDigitalMedicationDispenseCodeableConcept, Reference(NHSDigitalMedicationDispenseMedication)

NHS Digital Medication Code (extensible)

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

Must Support True

Summary True

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

workflow: Event.code
w5: FiveWs.what[x]
v2: RXD-2-Dispense/Give Code
rim: .participation[typeCode=PRD].role
rx-dispense-rmim: CombinedMedicationRequest.component1.AdministrationRequest.consumable

MedicationDispense.subject

Short Who the dispense is for

Definition

"subject": {
    "type": "Patient",
    "identifier": {
        "system": "https://fhir.nhs.uk/Id/nhs-number",
        "value": "2300992742"
    }
}

Second option uses a FHIR Patient resource to convey the NHS Number.

The reference in the MedicationDispesnse is now a resource reference.

 "subject": {
                    "type": "Patient",
                    "reference": "urn:uuid:bde9eba6-079f-4210-8108-6ea8db58de8c",
                    "display": "Miss Bernie Kanfeld"
                }

The NHS Number has moved to the Patient resource alongside other patient identifiers such as MRN. E.g.

"fullUrl": "urn:uuid:bde9eba6-079f-4210-8108-6ea8db58de8c",
"resource": {
                "resourceType": "Patient",
                "identifier": [
                    {
                        "extension": [
                            {
                                "url": "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberVerificationStatus",
                                "valueCodeableConcept": {
                                    "coding": [
                                        {
                                            "system": "https://fhir.hl7.org.uk/CodeSystem/UKCore-NHSNumberVerificationStatus",
                                            "code": "01",
                                            "display": "Number present and verified"
                                        }
                                    ]
                                }
                            }
                        ],
                        "system": "https://fhir.nhs.uk/Id/nhs-number",
                        "value": "9876543210"
                    },
                    {
                        "system": "https://fhir.leedsth.nhs.uk/Id/pas-number",
                        "value": "ABC8650149"
                    },
                    {
                        "system": "https://fhir.leedsth.nhs.uk/Id/PPMIdentifier",
                        "value": "1"
                    }
                ],
               ... other elements removed from example.
            }

It is anticipated that hospital pharmacies will prefer the later option for compatibility with other systems. Community pharmacies are anticipated to prefer the former option.

Cardinality 1..1

Type Reference(NHSDigitalPatientPDS)

Must Support True

Summary True

Comments

SubstanceAdministration->subject->Patient.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
eps-2: subject - An identifier reference or resource reference must be provided
(reference.exists() or (identifier.exists()))
patient-nhs: Length of the supplied NHS Number is wrong.
identifier.where(system='https://fhir.nhs.uk/Id/nhs-number').exists().not() or (identifier.where(system='https://fhir.nhs.uk/Id/nhs-number').exists() and identifier.where(system='https://fhir.nhs.uk/Id/nhs-number').value.matches('^([0-9]{10})$'))

Mappings

workflow: Event.subject
w5: FiveWs.subject[x]
v2: PID-3-Patient ID List
rim: .participation[typeCode=SBJ].role[classCode=PAT]
w5: FiveWs.subject

MedicationDispense.subject.id

Short Unique id for inter-element referencing

Definition

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

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.subject.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

MedicationDispense.subject.reference

Short Literal reference, Relative, internal or absolute URL

Definition

Cardinality 0..1

Summary True

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ref-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

MedicationDispense.subject.type

Short Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Cardinality 0..1

Aa resource (or, for logical models, the URI of the logical model).

Summary True

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

MedicationDispense.subject.identifier

Short Logical reference, when literal reference is not known

Definition

Cardinality 0..1

Summary True

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .identifier

MedicationDispense.subject.identifier.id

Short Unique id for inter-element referencing

Definition

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

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.subject.identifier.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

MedicationDispense.subject.identifier.use

Short usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Cardinality 0..1

Identifies the purpose for this identifier, if known .

Modifier True

Summary True

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Role.code or implied by context

MedicationDispense.subject.identifier.type

Short Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Cardinality 0..1

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Summary True

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.5
rim: Role.code or implied by context

MedicationDispense.subject.identifier.system

Short The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Cardinality 1..1

Summary True

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Auto Value

https://fhir.nhs.uk/Id/nhs-number

Examples

General

http://www.acme.com/identifiers/patient

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

MedicationDispense.subject.identifier.value

Short The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Cardinality 1..1

Summary True

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples

General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

MedicationDispense.subject.identifier.period

Short Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Cardinality 0..1

Summary True

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

MedicationDispense.subject.identifier.assigner

Short Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Cardinality 0..1

Type Reference()

Summary True

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

MedicationDispense.subject.display

Short Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Cardinality 0..1

Summary True

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

MedicationDispense.context

Short Encounter / Episode associated with event

Definition

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

Cardinality 0..1

Type Reference( | NHSDigitalEncounter)

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

workflow: Event.context
rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]

MedicationDispense.context.id

Short Unique id for inter-element referencing

Definition

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

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.context.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

MedicationDispense.context.reference

Short Literal reference, Relative, internal or absolute URL

Definition

Cardinality 0..1

Summary True

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ref-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

MedicationDispense.context.type

Short Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Cardinality 0..1

Aa resource (or, for logical models, the URI of the logical model).

Summary True

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

MedicationDispense.context.identifier

Short Logical reference, when literal reference is not known

Definition

Cardinality 0..1

Summary True

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .identifier

MedicationDispense.context.identifier.id

Short Unique id for inter-element referencing

Definition

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

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.context.identifier.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

MedicationDispense.context.identifier.use

Short usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Cardinality 0..1

Identifies the purpose for this identifier, if known .

Modifier True

Summary True

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Role.code or implied by context

MedicationDispense.context.identifier.type

Short Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Cardinality 0..1

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Summary True

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.5
rim: Role.code or implied by context

MedicationDispense.context.identifier.system

Short The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Cardinality 0..1

Summary True

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples

General

http://www.acme.com/identifiers/patient

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

MedicationDispense.context.identifier.value

Short The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Cardinality 0..1

Summary True

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples

General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

MedicationDispense.context.identifier.period

Short Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Cardinality 0..1

Summary True

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

MedicationDispense.context.identifier.assigner

Short Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Cardinality 0..1

Type Reference()

Summary True

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

MedicationDispense.context.display

Short Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Cardinality 0..1

Summary True

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

MedicationDispense.supportingInformation

Short Information that supports the dispensing of the medication

Definition

Additional information that supports the medication being dispensed.

Cardinality 0..*

Type Reference(Resource)

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

w5: FiveWs.context
rim: .outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]

MedicationDispense.supportingInformation.id

Short Unique id for inter-element referencing

Definition

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

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.supportingInformation.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

MedicationDispense.supportingInformation.reference

Short Literal reference, Relative, internal or absolute URL

Definition

Cardinality 0..1

Summary True

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ref-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

MedicationDispense.supportingInformation.type

Short Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Cardinality 0..1

Aa resource (or, for logical models, the URI of the logical model).

Summary True

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

MedicationDispense.supportingInformation.identifier

Short Logical reference, when literal reference is not known

Definition

Cardinality 0..1

Summary True

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .identifier

MedicationDispense.supportingInformation.identifier.id

Short Unique id for inter-element referencing

Definition

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

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.supportingInformation.identifier.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

MedicationDispense.supportingInformation.identifier.use

Short usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Cardinality 0..1

Identifies the purpose for this identifier, if known .

Modifier True

Summary True

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Role.code or implied by context

MedicationDispense.supportingInformation.identifier.type

Short Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Cardinality 0..1

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Summary True

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.5
rim: Role.code or implied by context

MedicationDispense.supportingInformation.identifier.system

Short The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Cardinality 0..1

Summary True

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples

General

http://www.acme.com/identifiers/patient

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

MedicationDispense.supportingInformation.identifier.value

Short The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Cardinality 0..1

Summary True

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples

General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

MedicationDispense.supportingInformation.identifier.period

Short Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Cardinality 0..1

Summary True

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

MedicationDispense.supportingInformation.identifier.assigner

Short Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Cardinality 0..1

Type Reference()

Summary True

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

MedicationDispense.supportingInformation.display

Short Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Cardinality 0..1

Summary True

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

MedicationDispense.performer

Short Who performed event

Definition

 "performer": [
    {
        "actor": {
            "reference" : "#performer"
        }
    }
],

The contained PractitionerRole:

{
    "resourceType": "MedicationDispense",
    "id": "06167339-9337-d030-0366-514a6a46da17",
    "contained": [
        {
                        "resourceType": "PractitionerRole",
                        "id": "performer",
                        "identifier": [
                            {
                                "system": "https://fhir.nhs.uk/Id/sds-role-profile-id",
                                "value": "741555508105"
                            }
                        ],
                        "code": [
                            {
                                "coding": [
                                    {
                                        "system": "https://fhir.nhs.uk/CodeSystem/NHSDigital-SDS-JobRoleCode",
                                        "code": "S0030:G0100:R0620"
                                    }
                                ]
                            }
                        ],
                        "practitioner": {
                            "identifier": {
                                "system": "https://fhir.nhs.uk/Id/sds-user-id",
                                "value": "7654321"
                            },
                            "display": "Mr Peter Potion"
                        },
                        "organization": {
                            "reference": "urn:uuid:2bf9f37c-d88b-4f86-ad5f-373c1416e04b"
                        },
                        "telecom": [
                            {
                                "system": "phone",
                                "use": "work",
                                "value": "0532567890"
                            }
                        ]
                   }
    ],

Cardinality 1..*

Must Support True

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

workflow: Event.performer
rim: .participation[typeCode=PRF]

MedicationDispense.performer.id

Short Unique id for inter-element referencing

Definition

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

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.performer.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Constraints

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()

Mappings

rim: n/a

MedicationDispense.performer.modifierExtension

Short Extensions that cannot be ignored even if unrecognized

Definition

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

Cardinality 0..*

Modifier True

Summary True

Alias extensions, user content, modifiers

Requirements

Comments

Constraints

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()

Mappings

rim: N/A

MedicationDispense.performer.function

Short Who performed the dispense and what they did

Definition

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

Cardinality 0..1

MedicationDispense Performer Function Codes (example)

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

Requirements

Allows disambiguation of the types of involvement of different performers.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: participation[typeCode=PRF].functionCode

MedicationDispense.performer.actor

Short A reference from one resource to another

Definition

A reference from one resource to another.

Cardinality 1..1

Type NHSDigitalReference(NHSDigitalPractitionerRoleSDS)

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
performer: An identifier reference or resource reference must be provided
(reference.exists() or identifier.exists())

Mappings

workflow: Event.performer.actor
rim: .role
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)

MedicationDispense.performer.actor.id

Short Unique id for inter-element referencing

Definition

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

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.performer.actor.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

MedicationDispense.performer.actor.reference

Short Literal reference, Relative, internal or absolute URL

Definition

Cardinality 1..1

Summary True

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ref-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

MedicationDispense.performer.actor.type

Short Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Cardinality 0..1

Aa resource (or, for logical models, the URI of the logical model).

Summary True

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

MedicationDispense.performer.actor.identifier

Short An identifier intended for computation

Definition

An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.

Cardinality 0..1

Summary True

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .identifier
rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd: Identifier

MedicationDispense.performer.actor.identifier.id

Short Unique id for inter-element referencing

Definition

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

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.performer.actor.identifier.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

MedicationDispense.performer.actor.identifier.use

Short usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Cardinality 0..1

Identifies the purpose for this identifier, if known .

Modifier True

Summary True

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Role.code or implied by context

MedicationDispense.performer.actor.identifier.type

Short Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Cardinality 0..1

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Summary True

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.5
rim: Role.code or implied by context

MedicationDispense.performer.actor.identifier.system

Short The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Cardinality 1..1

Summary True

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples

General

http://www.acme.com/identifiers/patient

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

MedicationDispense.performer.actor.identifier.value

Short The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Cardinality 1..1

Summary True

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples

General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

MedicationDispense.performer.actor.identifier.period

Short Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Cardinality 0..1

Summary True

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

MedicationDispense.performer.actor.identifier.assigner

Short Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Cardinality 0..1

Type Reference()

Summary True

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

MedicationDispense.performer.actor.display

Short Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Cardinality 0..1

Summary True

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

MedicationDispense.location

Short Where the dispense occurred

Definition

The principal physical location where the dispense was performed.

Cardinality 0..1

Type Reference(NHSDigitalLocation)

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .participation[typeCode=LOC].role

MedicationDispense.location.id

Short Unique id for inter-element referencing

Definition

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

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.location.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

MedicationDispense.location.reference

Short Literal reference, Relative, internal or absolute URL

Definition

Cardinality 0..1

Summary True

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ref-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

MedicationDispense.location.type

Short Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Cardinality 0..1

Aa resource (or, for logical models, the URI of the logical model).

Summary True

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

MedicationDispense.location.identifier

Short Logical reference, when literal reference is not known

Definition

Cardinality 0..1

Summary True

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .identifier

MedicationDispense.location.identifier.id

Short Unique id for inter-element referencing

Definition

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

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.location.identifier.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

MedicationDispense.location.identifier.use

Short usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Cardinality 0..1

Identifies the purpose for this identifier, if known .

Modifier True

Summary True

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Role.code or implied by context

MedicationDispense.location.identifier.type

Short Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Cardinality 0..1

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Summary True

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.5
rim: Role.code or implied by context

MedicationDispense.location.identifier.system

Short The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Cardinality 1..1

Summary True

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples

General

http://www.acme.com/identifiers/patient

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

MedicationDispense.location.identifier.value

Short The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Cardinality 1..1

Summary True

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples

General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

MedicationDispense.location.identifier.period

Short Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Cardinality 0..1

Summary True

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

MedicationDispense.location.identifier.assigner

Short Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Cardinality 0..1

Type Reference()

Summary True

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

MedicationDispense.location.display

Short Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Cardinality 1..1

Summary True

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

MedicationDispense.authorizingPrescription

Short Medication order that authorizes the dispense

Definition

A reference to the MedicationRequest.

"authorizingPrescription": [
    {
        "reference": "#m1"
    }
]

When a MedicationDispesne is sent in a FHIR Message bundle, which is the case with EPS NextGen dispense-notifications, a contained MedicationRequest is required.

This MedicationRequest MUST follow the rules in NHSDigital-MedicationRequest and it is strongly recommended to reuse the MedicationRequest received when the prescription was downloaded.

For example:

{
                "resourceType": "MedicationDispense",
                "contained":  [
                    {
                        "resourceType": "MedicationRequest",
                        "id": "m1",
                        "identifier":  [
                            {
                                "system": "https://fhir.nhs.uk/Id/prescription-order-item-number",
                                "value": "299c610b-f4f1-4eac-a7d7-4fb6b0556e11"
                            }
                        ],
                        "status": "active",
                        "intent": "order",
                        "medicationCodeableConcept": {
                            "coding":  [
                                {
                                    "system": "http://snomed.info/sct",
                                    "code": "39720311000001101",
                                    "display": "Paracetamol 500mg soluble tablets"
                                }
                            ]
                        },
                        "subject": {
                            "identifier": {
                                "system": "https://fhir.nhs.uk/Id/nhs-number",
                                "value": "9876543210"
                            }
                        },
                        "groupIdentifier": {
                            "extension":  [
                                {
                                    "url": "https://fhir.nhs.uk/StructureDefinition/Extension-DM-PrescriptionId",
                                    "valueIdentifier": {
                                        "system": "https://fhir.nhs.uk/Id/prescription",
                                        "value": "b2fc79f0-2793-4736-9b2d-0976c21e73a5"
                                    }
                                }
                            ],
                            "system": "https://fhir.nhs.uk/Id/prescription-order-number",
                            "value": "82D996-C81010-11DB12"
                        },
                        "dispenseRequest": {
                            "quantity": {
                                "value": 100,
                                "unit": "tablet",
                                "system": "http://snomed.info/sct",
                                "code": "732936001"
                            }
                        },
                        "substitution": {
                            "allowedBoolean": false
                        }
                    }
                ],
                "authorizingPrescription":  [
                    {
                        "reference": "#m1"
                    }
                ],

        "subject": {
            "reference": "urn:uuid:78d3c2eb-009e-4ec8-a358-b042954aa9b2"
        },
        "authoredOn": "2020-12-21T18:15:29+00:00",
        "requester": {
            "reference": "urn:uuid:56166769-c1c4-4d07-afa8-132b5dfca666"
        },

The requester reference can be removed and the subject reference changed to use the Patient's NHSNumber e.g.

        "subject": {
            "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9876543210"
        }
    },

Cardinality 1..*

Type Reference(NHSDigitalMedicationRequestMinimal)

Must Support True

Comments

Maps to basedOn in Event logical model.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

workflow: Event.basedOn
v2: ORC-2 Placer Order Number
rim: .outboundRelationship[typeCode=FLFS].target[moodCode=RQO]
rx-dispense-rmim: CombinedMedicationDispense.inFulfillmentOf

MedicationDispense.authorizingPrescription.id

Short Unique id for inter-element referencing

Definition

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

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.authorizingPrescription.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

MedicationDispense.authorizingPrescription.reference

Short Literal reference, Relative, internal or absolute URL

Definition

Cardinality 1..1

Summary True

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ref-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

MedicationDispense.authorizingPrescription.type

Short Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Cardinality 0..1

Aa resource (or, for logical models, the URI of the logical model).

Summary True

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

MedicationDispense.authorizingPrescription.identifier

Short Logical reference, when literal reference is not known

Definition

Cardinality 0..1

Summary True

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .identifier

MedicationDispense.authorizingPrescription.identifier.id

Short Unique id for inter-element referencing

Definition

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

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.authorizingPrescription.identifier.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

MedicationDispense.authorizingPrescription.identifier.use

Short usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Cardinality 0..1

Identifies the purpose for this identifier, if known .

Modifier True

Summary True

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Role.code or implied by context

MedicationDispense.authorizingPrescription.identifier.type

Short Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Cardinality 0..1

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Summary True

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.5
rim: Role.code or implied by context

MedicationDispense.authorizingPrescription.identifier.system

Short The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Cardinality 0..1

Summary True

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples

General

http://www.acme.com/identifiers/patient

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

MedicationDispense.authorizingPrescription.identifier.value

Short The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Cardinality 0..1

Summary True

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples

General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

MedicationDispense.authorizingPrescription.identifier.period

Short Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Cardinality 0..1

Summary True

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

MedicationDispense.authorizingPrescription.identifier.assigner

Short Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Cardinality 0..1

Type Reference()

Summary True

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

MedicationDispense.authorizingPrescription.display

Short Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Cardinality 0..1

Summary True

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

MedicationDispense.type

Short Trial fill, partial fill, emergency fill, etc.

Definition

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

"type": {
    "coding": [
        {
            "system": "https://fhir.nhs.uk/CodeSystem/medicationdispense-type",
            "code": "0001",
            "display": "Item fully dispensed"
        }
    ]
}

Cardinality 0..1

MedicationDispenseType (required)

A ValueSet to identify the type of medication item status.

Must Support True

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXD-33-Dispense Type
rim: .code
rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.code

MedicationDispense.type.id

Short Unique id for inter-element referencing

Definition

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

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.type.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

MedicationDispense.type.coding

Short Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Cardinality 0..*

Summary True

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

MedicationDispense.type.coding.id

Short Unique id for inter-element referencing

Definition

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

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.type.coding.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

MedicationDispense.type.coding.system

Short Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Cardinality 1..1

Summary True

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

MedicationDispense.type.coding.version

Short Version of the system - if relevant

Definition

Cardinality 0..1

Summary True

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

MedicationDispense.type.coding.code

Short Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Cardinality 1..1

Summary True

Requirements

Need to refer to a particular code in the system.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

MedicationDispense.type.coding.display

Short Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Cardinality 0..1

Summary True

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

MedicationDispense.type.coding.userSelected

Short If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Cardinality 0..1

Summary True

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

MedicationDispense.type.text

Short Plain text representation of the concept

Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Cardinality 0..1

Summary True

Requirements

Comments

Very often the text is the same as a displayName of one of the codings.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

MedicationDispense.quantity

Short Amount dispensed

Definition

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

"quantity": {
    "value": 28,
    "unit": "capsule",
    "system": "http://snomed.info/sct",
    "code": "3316911000001105"
}

If no actual quantity has been dispensed then use a value of zero.

Cardinality 1..1

Must Support True

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense Units.name of coding system
rim: .quantity
rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.quantity

MedicationDispense.quantity.id

Short Unique id for inter-element referencing

Definition

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

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.quantity.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

MedicationDispense.quantity.extension:runningTotal

Short Optional Extensions Element

Definition

Optional Extension Element - found in all resources.

Cardinality 0..1

Type Extension(Quantity)

Alias extensions, user content

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

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()

Mappings

rim: n/a
rim: N/A

MedicationDispense.quantity.value

Short Numerical value (with implicit precision)

Definition

The value of the measured amount. The value includes an implicit precision in the presentation of the value.

Cardinality 1..1

Summary True

Requirements

Precision is handled implicitly in almost all cases of measurement.

Comments

The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: SN.2 / CQ - N/A
rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value

MedicationDispense.quantity.comparator

Short < | <= | >= | > - how to understand the value

Definition

Not allowed to be used in this context

Cardinality 0..0

How the Quantity should be understood and represented.

QuantityComparator (required)

Modifier True

Summary True

Requirements

Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

Meaning when missing

If there is no comparator, then there is no modification of the value

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: SN.1 / CQ.1
rim: IVL properties

MedicationDispense.quantity.unit

Short Unit representation

Definition

A human-readable form of the unit.

Cardinality 1..1

Summary True

Requirements

There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.unit

MedicationDispense.quantity.system

Short System that defines coded unit form

Definition

The identification of the system that provides the coded form of the unit.

Cardinality 1..1

Summary True

Requirements

Need to know the system that defines the coded form of the unit.

Conditions The cardinality or value of this element may be affected by these constraints: qty-3

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: CO.codeSystem, PQ.translation.codeSystem

MedicationDispense.quantity.code

Short Coded form of the unit

Definition

A computer processable form of the unit in some unit representation system.

Cardinality 1..1

Summary True

Requirements

Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

Comments

The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: (see OBX.6 etc.) / CQ.2
rim: PQ.code, MO.currency, PQ.translation.code

MedicationDispense.daysSupply

Short Amount of medication expressed as a timing amount

Definition

The amount of medication expressed as a timing amount.

"daysSupply": {
    "value": 7,
    "unit": "Day",
    "system": "http://unitsofmeasure.org",
    "code": "d"
}

Cardinality 0..1

Must Support True

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: TQ1.6 Timing/Quantity Segment Service Duration. Prior to v2.5, ORC.7.3 Common Order Segment / Quantity/Timing / Duration component. This is a formatted string, first character for the time unit (e.g., D=days), followed by the value. For example, “D14” represents “14 days supply” From v2.5 on, TQ1.6 Timing/Quantity Segment / Service Duration. This is a CQ data type (<Quantity (NM)> ^ <Units (CWE)>), thus for days supply, assuming the unit of measure is “days”, the numeric value is TQ1.6.1 (…|14^ For backwards compatibility, ORC.7 was permitted through v2.6. Both forms (field and segment) may be present in v2.5, v2.5.1, and v2.6
rim: effectiveUseTime

MedicationDispense.whenPrepared

Short When product was packaged and reviewed

Definition

The time when the dispensed product was packaged and reviewed.

"whenPrepared": "2004-09-16T16:30:00+00:00"

Cardinality 0..1

Must Support True

Summary True

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXD-3-Date/Time Dispensed
rim: .effectiveTime[xmi:type=IVL_TS].low
rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.effectiveTime

MedicationDispense.whenHandedOver

Short When product was given out

Definition

The time the dispensed product was provided to the patient or their representative. In HL7 v3 this is: The date and local time that the medication is issued by the dispenser.

"whenHandedOver": "2004-09-16T16:30:00+00:00"

Cardinality 0..1

Must Support True

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

workflow: Event.occurrence[x]
v2: RXD-3-Date/Time Dispensed
rim: .effectiveTime[xmi:type=IVL_TS].high
rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.effectiveTime

MedicationDispense.destination

Short Where the medication was sent

Definition

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

Cardinality 0..1

Type Reference()

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXD-13 Dispense-to Location; RXD-30 Dispense to Pharmacy; RXD-31 Dispense to Pharmacy Address
rim: .participation[typeCode=DST].role
rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.destination

MedicationDispense.destination.id

Short Unique id for inter-element referencing

Definition

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

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.destination.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

MedicationDispense.destination.reference

Short Literal reference, Relative, internal or absolute URL

Definition

Cardinality 0..1

Summary True

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ref-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

MedicationDispense.destination.type

Short Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Cardinality 0..1

Aa resource (or, for logical models, the URI of the logical model).

Summary True

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

MedicationDispense.destination.identifier

Short Logical reference, when literal reference is not known

Definition

Cardinality 0..1

Summary True

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .identifier

MedicationDispense.destination.identifier.id

Short Unique id for inter-element referencing

Definition

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

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.destination.identifier.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

MedicationDispense.destination.identifier.use

Short usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Cardinality 0..1

Identifies the purpose for this identifier, if known .

Modifier True

Summary True

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Role.code or implied by context

MedicationDispense.destination.identifier.type

Short Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Cardinality 0..1

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Summary True

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.5
rim: Role.code or implied by context

MedicationDispense.destination.identifier.system

Short The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Cardinality 0..1

Summary True

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples

General

http://www.acme.com/identifiers/patient

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

MedicationDispense.destination.identifier.value

Short The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Cardinality 0..1

Summary True

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples

General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

MedicationDispense.destination.identifier.period

Short Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Cardinality 0..1

Summary True

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

MedicationDispense.destination.identifier.assigner

Short Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Cardinality 0..1

Type Reference()

Summary True

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

MedicationDispense.destination.display

Short Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Cardinality 0..1

Summary True

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

MedicationDispense.receiver

Short Who collected the medication

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.

Cardinality 0..1

Type Reference( | )

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .participation[typeCode=RCV].role
rx-dispense-rmim: CombinedMedicationDispense.SupplyEvent.receiver

MedicationDispense.receiver.id

Short Unique id for inter-element referencing

Definition

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

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.receiver.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

MedicationDispense.receiver.reference

Short Literal reference, Relative, internal or absolute URL

Definition

Cardinality 0..1

Summary True

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ref-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

MedicationDispense.receiver.type

Short Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Cardinality 0..1

Aa resource (or, for logical models, the URI of the logical model).

Summary True

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

MedicationDispense.receiver.identifier

Short Logical reference, when literal reference is not known

Definition

Cardinality 0..1

Summary True

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .identifier

MedicationDispense.receiver.identifier.id

Short Unique id for inter-element referencing

Definition

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

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.receiver.identifier.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

MedicationDispense.receiver.identifier.use

Short usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Cardinality 0..1

Identifies the purpose for this identifier, if known .

Modifier True

Summary True

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Role.code or implied by context

MedicationDispense.receiver.identifier.type

Short Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Cardinality 0..1

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Summary True

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.5
rim: Role.code or implied by context

MedicationDispense.receiver.identifier.system

Short The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Cardinality 0..1

Summary True

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples

General

http://www.acme.com/identifiers/patient

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

MedicationDispense.receiver.identifier.value

Short The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Cardinality 0..1

Summary True

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples

General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

MedicationDispense.receiver.identifier.period

Short Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Cardinality 0..1

Summary True

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

MedicationDispense.receiver.identifier.assigner

Short Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Cardinality 0..1

Type Reference()

Summary True

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

MedicationDispense.receiver.display

Short Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Cardinality 0..1

Summary True

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

MedicationDispense.note

Short Information about the dispense

Definition

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

Cardinality 0..*

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

workflow: Event.note
v2: RXD-9 Dispense Notes
rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=ACT,moodCode=EVN]

MedicationDispense.note.id

Short Unique id for inter-element referencing

Definition

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

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.note.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

MedicationDispense.note.author[x]

Short Individual responsible for the annotation

Definition

The individual responsible for making the annotation.

Cardinality 0..1

Type Reference( | | | ), string

Summary True

Comments

Organization is used when there's no need for specific attribution as to who made the comment.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Act.participant[typeCode=AUT].role

MedicationDispense.note.time

Short When the annotation was made

Definition

Indicates when this particular annotation was made.

Cardinality 0..1

Summary True

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Act.effectiveTime

MedicationDispense.note.text

Short The annotation - text content (as markdown)

Definition

The text of the annotation in markdown format.

Cardinality 1..1

Summary True

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Act.text

MedicationDispense.dosageInstruction

Short How the medication is/was taken or should be taken

Definition

At present only the text element MUST be provided. It is recommended the guidance in FHIR Dose Syntax Implementation Guidance is followed.

Note the structure of this section is similar as the NHSDigital-MedicationRequest from the prescription-order.

"dosageInstruction": [
    {
        "text": "4 times a day for 7 days",
        "timing": {
            "repeat": {
                "boundsDuration": {
                    "value": 7,
                    "unit": "d"
                },
                "frequency": 4,
                "period": 1,
                "periodUnit": "d"
            }
        },
        "doseAndRate": [
            {
                "doseQuantity": {
                    "value": 1,
                    "unit": "capsule",
                    "system": "http://snomed.info/sct",
                    "code": "3316911000001105"
                }
            }
        ]
    }
]

Cardinality 0..*

Must Support True

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]
rim: n/a

MedicationDispense.dosageInstruction.id

Short Unique id for inter-element referencing

Definition

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

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.dosageInstruction.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

MedicationDispense.dosageInstruction.modifierExtension

Short Extensions that cannot be ignored even if unrecognized

Definition

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

Cardinality 0..*

Modifier True

Summary True

Alias extensions, user content, modifiers

Requirements

Comments

Constraints

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()

Mappings

rim: N/A

MedicationDispense.dosageInstruction.sequence

Short The order of the dosage instructions

Definition

Indicates the order in which the dosage instructions should be applied or interpreted.

Cardinality 0..1

Summary True

Requirements

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: TQ1-1
rim: .text

MedicationDispense.dosageInstruction.text

Short Free text dosage instructions e.g. SIG

Definition

Free text dosage instructions e.g. SIG.

Cardinality 0..1

Summary True

Requirements

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXO-6; RXE-21
rim: .text

MedicationDispense.dosageInstruction.additionalInstruction

Short Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"

Definition

Cardinality 0..*

SNOMEDCTAdditionalDosageInstructions (example)

A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".

Summary True

Requirements

Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded.

Comments

Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXO-7
rim: .text

MedicationDispense.dosageInstruction.patientInstruction

Short Patient or consumer oriented instructions

Definition

Instructions in terms that are understood by the patient or consumer.

Cardinality 0..1

Summary True

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXO-7
rim: .text

MedicationDispense.dosageInstruction.timing

Short When medication should be administered

Definition

When medication should be administered.

Cardinality 0..1

Summary True

Requirements

Comments

This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .effectiveTime

MedicationDispense.dosageInstruction.asNeeded[x]

Short Take "as needed" (for x)

Definition

Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).

Cardinality 0..1

Type boolean, CodeableConcept

Summary True

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: TQ1-9
rim: .outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept

MedicationDispense.dosageInstruction.site

Short Body site to administer to

Definition

Body site to administer to.

Cardinality 0..1

A coded concept describing the site location the medicine enters into or onto the body.

Summary True

Requirements

A coded specification of the anatomic site where the medication first enters the body.

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXR-2
rim: .approachSiteCode

MedicationDispense.dosageInstruction.route

Short How drug should enter body

Definition

How drug should enter body.

Cardinality 0..1

A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

Summary True

Requirements

A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXR-1
rim: .routeCode

MedicationDispense.dosageInstruction.method

Short Technique for administering medication

Definition

Technique for administering medication.

Cardinality 0..1

A coded concept describing the technique by which the medicine is administered.

Summary True

Requirements

A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV.

Comments

Terminologies used often pre-coordinate this term with the route and or form of administration.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXR-4
rim: .doseQuantity

MedicationDispense.dosageInstruction.doseAndRate

Short Amount of medication administered

Definition

The amount of medication administered.

Cardinality 0..*

Summary True

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: TQ1-2

MedicationDispense.dosageInstruction.doseAndRate.id

Short Unique id for inter-element referencing

Definition

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

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.dosageInstruction.doseAndRate.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

MedicationDispense.dosageInstruction.doseAndRate.type

Short The kind of dose or rate specified

Definition

The kind of dose or rate specified, for example, ordered or calculated.

Cardinality 0..1

The kind of dose or rate specified.

DoseAndRateType (example)

Summary True

Requirements

If the type is not populated, assume to be "ordered".

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXO-21; RXE-23

MedicationDispense.dosageInstruction.doseAndRate.dose[x]

Short Amount of medication per dose

Definition

Amount of medication per dose.

Cardinality 0..1

Type Range, SimpleQuantity

Summary True

Requirements

The amount of therapeutic or other substance given at one administration event.

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXO-2, RXE-3
rim: .doseQuantity

MedicationDispense.dosageInstruction.doseAndRate.rate[x]

Short Amount of medication per unit of time

Definition

Amount of medication per unit of time.

Cardinality 0..1

Type Ratio, Range, SimpleQuantity

Summary True

Requirements

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXE22, RXE23, RXE-24
rim: .rateQuantity

MedicationDispense.dosageInstruction.maxDosePerPeriod

Short Upper limit on medication per unit of time

Definition

Upper limit on medication per unit of time.

Cardinality 0..1

Summary True

Requirements

The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours.

Comments

This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day".

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXO-23, RXE-19
rim: .maxDoseQuantity

MedicationDispense.dosageInstruction.maxDosePerAdministration

Short Upper limit on medication per administration

Definition

Upper limit on medication per administration.

Cardinality 0..1

Summary True

Requirements

The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: not supported

MedicationDispense.dosageInstruction.maxDosePerLifetime

Short Upper limit on medication per lifetime of the patient

Definition

Upper limit on medication per lifetime of the patient.

Cardinality 0..1

Summary True

Requirements

The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: not supported

MedicationDispense.substitution

Short Whether a substitution was performed on the dispense

Definition

Cardinality 0..1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .outboundRelationship[typeCode=COMP].target[classCode=SUBST, moodCode=EVN]
rx-dispense-rmim: CombinedMedicationDispense.substitutionMade

MedicationDispense.substitution.id

Short Unique id for inter-element referencing

Definition

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

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.substitution.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Constraints

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()

Mappings

rim: n/a

MedicationDispense.substitution.modifierExtension

Short Extensions that cannot be ignored even if unrecognized

Definition

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

Cardinality 0..*

Modifier True

Summary True

Alias extensions, user content, modifiers

Requirements

Comments

Constraints

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()

Mappings

rim: N/A

MedicationDispense.substitution.wasSubstituted

Short Whether a substitution was or was not performed on the dispense

Definition

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

Cardinality 1..1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .actionNegationInd

MedicationDispense.substitution.type

Short Code signifying whether a different drug was dispensed from what was prescribed

Definition

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

Cardinality 0..1

v3.ActSubstanceAdminSubstitutionCode (example)

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

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: RXO-9-Allow Substitutions / RXE-9-Substitution Status
rim: .code
rx-dispense-rmim: CombinedMedicationDispense.substitutionMade.code

MedicationDispense.substitution.reason

Short Why was substitution made

Definition

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

Cardinality 0..*

v3.SubstanceAdminSubstitutionReason (example)

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

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .reasonCode
rx-dispense-rmim: CombinedMedicationDispense.substitutionMade.reasonCode

MedicationDispense.substitution.responsibleParty

Short Who is responsible for the substitution

Definition

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

Cardinality 0..*

Type Reference( | )

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .participation[typeCode=PFM].role[classCode=ASSIGN]
rx-dispense-rmim: CombinedMedicationDispense.substitutionMade.ResponsibleParty

MedicationDispense.substitution.responsibleParty.id

Short Unique id for inter-element referencing

Definition

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

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.substitution.responsibleParty.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

MedicationDispense.substitution.responsibleParty.reference

Short Literal reference, Relative, internal or absolute URL

Definition

Cardinality 0..1

Summary True

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ref-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

MedicationDispense.substitution.responsibleParty.type

Short Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Cardinality 0..1

Aa resource (or, for logical models, the URI of the logical model).

Summary True

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

MedicationDispense.substitution.responsibleParty.identifier

Short Logical reference, when literal reference is not known

Definition

Cardinality 0..1

Summary True

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .identifier

MedicationDispense.substitution.responsibleParty.identifier.id

Short Unique id for inter-element referencing

Definition

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

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.substitution.responsibleParty.identifier.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

MedicationDispense.substitution.responsibleParty.identifier.use

Short usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Cardinality 0..1

Identifies the purpose for this identifier, if known .

Modifier True

Summary True

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Role.code or implied by context

MedicationDispense.substitution.responsibleParty.identifier.type

Short Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Cardinality 0..1

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Summary True

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.5
rim: Role.code or implied by context

MedicationDispense.substitution.responsibleParty.identifier.system

Short The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Cardinality 0..1

Summary True

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples

General

http://www.acme.com/identifiers/patient

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

MedicationDispense.substitution.responsibleParty.identifier.value

Short The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Cardinality 0..1

Summary True

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples

General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

MedicationDispense.substitution.responsibleParty.identifier.period

Short Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Cardinality 0..1

Summary True

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

MedicationDispense.substitution.responsibleParty.identifier.assigner

Short Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Cardinality 0..1

Type Reference()

Summary True

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

MedicationDispense.substitution.responsibleParty.display

Short Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Cardinality 0..1

Summary True

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

MedicationDispense.detectedIssue

Short Clinical issue with action

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.

Cardinality 0..*

Type Reference(DetectedIssue)

Alias Contraindication, Drug Utilization Review (DUR), Alert

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.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value

MedicationDispense.detectedIssue.id

Short Unique id for inter-element referencing

Definition

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

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.detectedIssue.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

MedicationDispense.detectedIssue.reference

Short Literal reference, Relative, internal or absolute URL

Definition

Cardinality 0..1

Summary True

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ref-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

MedicationDispense.detectedIssue.type

Short Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Cardinality 0..1

Aa resource (or, for logical models, the URI of the logical model).

Summary True

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

MedicationDispense.detectedIssue.identifier

Short Logical reference, when literal reference is not known

Definition

Cardinality 0..1

Summary True

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .identifier

MedicationDispense.detectedIssue.identifier.id

Short Unique id for inter-element referencing

Definition

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

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.detectedIssue.identifier.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

MedicationDispense.detectedIssue.identifier.use

Short usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Cardinality 0..1

Identifies the purpose for this identifier, if known .

Modifier True

Summary True

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Role.code or implied by context

MedicationDispense.detectedIssue.identifier.type

Short Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Cardinality 0..1

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Summary True

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.5
rim: Role.code or implied by context

MedicationDispense.detectedIssue.identifier.system

Short The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Cardinality 0..1

Summary True

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples

General

http://www.acme.com/identifiers/patient

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

MedicationDispense.detectedIssue.identifier.value

Short The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Cardinality 0..1

Summary True

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples

General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

MedicationDispense.detectedIssue.identifier.period

Short Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Cardinality 0..1

Summary True

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

MedicationDispense.detectedIssue.identifier.assigner

Short Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Cardinality 0..1

Type Reference()

Summary True

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

MedicationDispense.detectedIssue.display

Short Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Cardinality 0..1

Summary True

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

MedicationDispense.eventHistory

Short A list of relevant lifecycle events

Definition

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

Cardinality 0..*

Type Reference()

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]

MedicationDispense.eventHistory.id

Short Unique id for inter-element referencing

Definition

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

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.eventHistory.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

MedicationDispense.eventHistory.reference

Short Literal reference, Relative, internal or absolute URL

Definition

Cardinality 0..1

Summary True

Comments

Conditions The cardinality or value of this element may be affected by these constraints: ref-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

MedicationDispense.eventHistory.type

Short Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Cardinality 0..1

Aa resource (or, for logical models, the URI of the logical model).

Summary True

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

MedicationDispense.eventHistory.identifier

Short Logical reference, when literal reference is not known

Definition

Cardinality 0..1

Summary True

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .identifier

MedicationDispense.eventHistory.identifier.id

Short Unique id for inter-element referencing

Definition

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

Cardinality 0..1

Mappings

rim: n/a

MedicationDispense.eventHistory.identifier.extension

Short Additional content defined by implementations

Definition

Cardinality 0..*

Alias extensions, user content

Comments

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

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()

Mappings

rim: n/a

MedicationDispense.eventHistory.identifier.use

Short usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Cardinality 0..1

Identifies the purpose for this identifier, if known .

Modifier True

Summary True

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: N/A
rim: Role.code or implied by context

MedicationDispense.eventHistory.identifier.type

Short Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Cardinality 0..1

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Summary True

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.5
rim: Role.code or implied by context

MedicationDispense.eventHistory.identifier.system

Short The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Cardinality 0..1

Summary True

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples

General

http://www.acme.com/identifiers/patient

Mappings

v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

MedicationDispense.eventHistory.identifier.value

Short The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Cardinality 0..1

Summary True

Comments

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples

General

Mappings

v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

MedicationDispense.eventHistory.identifier.period

Short Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

Cardinality 0..1

Summary True

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

MedicationDispense.eventHistory.identifier.assigner

Short Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Cardinality 0..1

Type Reference()

Summary True

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

MedicationDispense.eventHistory.display

Short Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Cardinality 0..1