This page is part of the FHIR eMedication exchange formats for the implementation effort of CARA within its EPR community (v2.0.0: STU2) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

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Resource Profile: PML MedicationDispense

Definition of the medication dispense for the medication list document

Usage:

• Refer to this Resource Profile: PML Composition
• Examples for this Resource Profile: MedicationDispense/MedicationDispenseTriatecPml

Formal Views of Profile Content

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

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	CHEMEDMedicationDispenseList	CH EMED MedicationDispense (LIST) dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management mdd-1: whenHandedOver cannot be before whenPrepared ch-dosage-meddis: If one dosage element is present, it should not have a sequence number. If more than one dosage element is present, the base entry has the sequence number 1. split-dosage-instruction-unit-must-match-base-dosage-instruction: The unit for doseAndRate of different dosages (split dosage) belonging to the same statement/request/dispense must match.
contained		1..*	Resource	Contained, inline Resources
Slices for extension		2..*	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
treatmentReason		0..*	string	Treatment reason URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentreason ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
prescription		0..1	(Complex)	Reference to te medication prescription. This item is mandantory if the treatment has already been prescribed. URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
pharmaceuticalAdvice	D	0..1	(Complex)	✕ This element is not supported URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-pharmaceuticaladvice ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
treatmentPlan		1..1	(Complex)	CH EMED Extension URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
parentDocument		1..1	(Complex)	CH EMED Extension URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
authorDocument		0..1	(Complex)	Optional Extensions Element URL: http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-author ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension		0..0
url		1..1	uri	"http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-author"
Slices for value[x]		1..1	Reference()	Value of extension Slice: Unordered, Closed by type:$this ele-1: All FHIR elements must have a @value or children
value[x]:valueReference		1..1	Reference(CH EMED EPR PractitionerRole | CH EMED EPR Patient | CH EMED EPR RelatedPerson)	Author of the content ele-1: All FHIR elements must have a @value or children
Slices for extension				Content/Rules for all slices
time		0..1	dateTime	Timestamp of the authorship/data input URL: http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-epr-time ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL ele-1: All FHIR elements must have a @value or children
identifier		1..1	Identifier	MedicationDispense Identifier ele-1: All FHIR elements must have a @value or children
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . ele-1: All FHIR elements must have a @value or children
system	Σ	1..1	uri	The namespace for the identifier value ele-1: All FHIR elements must have a @value or children Fixed Value: urn:ietf:rfc:3986
value	Σ	1..1	string	Identifier value as UUID ele-1: All FHIR elements must have a @value or children Example General: 123456 Example CH EMED: urn:uuid:daa8cd41-34a1-4a9c-9a6d-cd3f850142e9
partOf	D	0..*	Reference(Procedure)	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
status	?!Σ	1..1	code	preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown Binding: MedicationDispense Status Codes (required): A coded concept specifying the state of the dispense event. ele-1: All FHIR elements must have a @value or children Fixed Value: completed
statusReason[x]	D	0..1		✕ This is only meaningful when the dispense was not performed Binding: MedicationDispense Status Reason Codes (example): A code describing why a dispense was not performed. ele-1: All FHIR elements must have a @value or children
statusReasonCodeableConcept			CodeableConcept
statusReasonReference			Reference(DetectedIssue)
category	D	0..1	CodeableConcept	✕ This element is not supported Binding: MedicationDispense Category Codes (preferred): A code describing where the dispensed medication is expected to be consumed or administered. ele-1: All FHIR elements must have a @value or children
Slices for medication[x]	Σ	1..1	Reference(CH Core Medication)	What medication was supplied Slice: Unordered, Closed by type:$this ele-1: All FHIR elements must have a @value or children
medication[x]:medicationReference	Σ	0..1	Reference(CH EMED EPR Medication (DIS)) {c}	Reference to the contained medication ele-1: All FHIR elements must have a @value or children
subject	Σ	0..1	Reference(CH EMED EPR Patient) {r, b}	Patient ele-1: All FHIR elements must have a @value or children
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL ele-1: All FHIR elements must have a @value or children
context	D	0..1	Reference(Encounter | EpisodeOfCare)	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
supportingInformation	D	0..*	Reference(Resource)	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
performer		1..1	BackboneElement	Who performed event ele-1: All FHIR elements must have a @value or children
actor		1..1	Reference(CH EMED PractitionerRole)	The author of the medical decision, see also 'Guidance - Authorship' ele-1: All FHIR elements must have a @value or children
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL ele-1: All FHIR elements must have a @value or children
location	D	0..1	Reference(Location)	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
authorizingPrescription	D	0..*	Reference(MedicationRequest)	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
type	D	0..1	CodeableConcept	✕ This element is not supported Binding: ActPharmacySupplyType (example): Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc. ele-1: All FHIR elements must have a @value or children
quantity		1..1	CHEMEDEPRAmountQuantity	Number of packages ele-1: All FHIR elements must have a @value or children
daysSupply	D	0..1	CHEMEDEPRTimeQuantity	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
whenPrepared	ΣD	0..1	dateTime	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
whenHandedOver		1..1	dateTime	When product was given out ele-1: All FHIR elements must have a @value or children
destination	D	0..1	Reference(Location)	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
receiver	D	0..*	Reference(Patient | Practitioner)	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
Slices for dosageInstruction		1..*	CHCoreDosage	How the medication should be taken Slice: Unordered, Closed by profile:$this ele-1: All FHIR elements must have a @value or children
dosageInstruction:baseEntry	C	1..1	CHEMEDEPRDosage	Base entry of the dosage instruction ele-1: All FHIR elements must have a @value or children ch-dosage-4: For split dosage timing event and dose/rate are required
dosageInstruction:additionalEntry		0..*	CHEMEDEPRDosageSplit	Additional entry of the dosage instruction ele-1: All FHIR elements must have a @value or children
detectedIssue	D	0..*	Reference(DetectedIssue)	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
eventHistory	D	0..*	Reference(Provenance)	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
MedicationDispense.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
MedicationDispense.status	required	Fixed Value: completed http://hl7.org/fhir/ValueSet/medicationdispense-status|4.0.1 from the FHIR Standard
MedicationDispense.statusReason[x]	example	MedicationDispense Status Reason Codes http://hl7.org/fhir/ValueSet/medicationdispense-status-reason from the FHIR Standard
MedicationDispense.category	preferred	MedicationDispense Category Codes http://hl7.org/fhir/ValueSet/medicationdispense-category from the FHIR Standard
MedicationDispense.type	example	ActPharmacySupplyType http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType

Constraints

Id	Grade	Path(s)	Details	Requirements
ch-dosage-4	error	MedicationDispense.dosageInstruction:baseEntry	For split dosage timing event and dose/rate are required : sequence.exists() implies (timing.repeat.when.exists() and doseAndRate.dose.exists())
ch-dosage-meddis	error	MedicationDispense	If one dosage element is present, it should not have a sequence number. If more than one dosage element is present, the base entry has the sequence number 1. : (dosageInstruction.count() > 1 implies dosageInstruction.where($this.conformsTo('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-dosage') and sequence = 1).exists()) and (dosageInstruction.count() = 1 implies dosageInstruction.single().sequence.exists().not())
dom-2	error	MedicationDispense	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationDispense	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationDispense	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationDispense	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	MedicationDispense	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
mdd-1	error	MedicationDispense	whenHandedOver cannot be before whenPrepared : whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared
split-dosage-instruction-unit-must-match-base-dosage-instruction	error	MedicationDispense	The unit for doseAndRate of different dosages (split dosage) belonging to the same statement/request/dispense must match. : (dosageInstruction.count() > 1) implies dosageInstruction.doseAndRate.dose.ofType(Quantity).code.union(dosageInstruction.doseAndRate.dose.ofType(Range).low.code).union(dosageInstruction.doseAndRate.dose.ofType(Range).high.code).union(dosageInstruction.doseAndRate.rate.numerator.code).count() = 1

This structure is derived from CHEMEDMedicationDispenseList

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	CHEMEDMedicationDispenseList	CH EMED MedicationDispense (LIST) split-dosage-instruction-unit-must-match-base-dosage-instruction: The unit for doseAndRate of different dosages (split dosage) belonging to the same statement/request/dispense must match.
meta
extension	D	0..*	Extension	✕ This element is not supported
versionId	D	0..1	id	✕ This element is not supported
lastUpdated	D	0..1	instant	✕ This element is not supported
source	D	0..1	uri	✕ This element is not supported
security	D	0..*	Coding	✕ This element is not supported
tag	D	0..*	Coding	✕ This element is not supported
implicitRules		0..0
extension		2..*	Extension	Extension
Slices for extension				Content/Rules for all slices
extension:prescription		0..1	CHEMEDExtPrescription	Reference to te medication prescription. This item is mandantory if the treatment has already been prescribed.
extension:pharmaceuticalAdvice	D	0..1	CHEMEDExtPharmaceuticalAdvice	✕ This element is not supported
extension:treatmentPlan		1..1	CHEMEDExtTreatmentPlan	CH EMED Extension
extension:parentDocument		1..1	CHEMEDExtDispense	CH EMED Extension
extension:authorDocument		0..1	Author	Optional Extensions Element
Slices for value[x]				Content/Rules for all slices
value[x]:valueReference		1..1	Reference(CH EMED EPR PractitionerRole | CH EMED EPR Patient | CH EMED EPR RelatedPerson)	Author of the content
modifierExtension		0..0
partOf	D	0..*	Reference(Procedure)	✕ This element is not supported
statusReason[x]	D	0..1	CodeableConcept, Reference(DetectedIssue)	✕ This is only meaningful when the dispense was not performed
category	D	0..1	CodeableConcept	✕ This element is not supported
medication[x]		1..1	Reference(CH Core Medication)	What medication was supplied
Slices for medication[x]				Content/Rules for all slices
medication[x]:medicationReference		0..1	Reference(CH EMED EPR Medication (DIS)) {c}	Reference to the contained medication
subject		0..1	Reference(CH EMED EPR Patient) {r, b}	Patient
context	D	0..1	Reference(Encounter | EpisodeOfCare)	✕ This element is not supported
supportingInformation	D	0..*	Reference(Resource)	✕ This element is not supported
performer
modifierExtension		0..0
location	D	0..1	Reference(Location)	✕ This element is not supported
authorizingPrescription	D	0..*	Reference(MedicationRequest)	✕ This element is not supported
type	D	0..1	CodeableConcept	✕ This element is not supported
quantity		1..1	CHEMEDEPRAmountQuantity	Number of packages
daysSupply	D	0..1	CHEMEDEPRTimeQuantity	✕ This element is not supported
whenPrepared	D	0..1	dateTime	✕ This element is not supported
destination	D	0..1	Reference(Location)	✕ This element is not supported
receiver	D	0..*	Reference(Patient | Practitioner)	✕ This element is not supported
note
id	D	0..1	string	✕ This element is not supported
extension	D	0..*	Extension	✕ This element is not supported
author[x]	D	0..1	Reference(Practitioner | Patient | RelatedPerson | Organization), string	✕ The note author is ignored, as it cannot be different than the document and/or entry's author
time	D	0..1	dateTime	✕ This element is not supported
text		1..1	markdown	The annotation text content (as raw text, no markdown allowed).
Slices for dosageInstruction				Content/Rules for all slices
dosageInstruction:baseEntry		1..1	CHEMEDEPRDosage	Base entry of the dosage instruction
dosageInstruction:additionalEntry		0..*	CHEMEDEPRDosageSplit	Additional entry of the dosage instruction
substitution
modifierExtension		0..0
type
coding		0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-substanceAdminSubstitution
code		1..1	code	Symbol in syntax defined by the system Fixed Value: E
display		1..1	string	Representation defined by the system Fixed Value: equivalent
reason	D	0..*	CodeableConcept	✕ This element is not supported
responsibleParty	D	0..*	Reference(Practitioner | PractitionerRole)	✕ This element is not supported
detectedIssue	D	0..*	Reference(DetectedIssue)	✕ This element is not supported
eventHistory	D	0..*	Reference(Provenance)	✕ This element is not supported
Documentation for this format

Constraints

Id	Grade	Path(s)	Details	Requirements
split-dosage-instruction-unit-must-match-base-dosage-instruction	error	MedicationDispense	The unit for doseAndRate of different dosages (split dosage) belonging to the same statement/request/dispense must match. : (dosageInstruction.count() > 1) implies dosageInstruction.doseAndRate.dose.ofType(Quantity).code.union(dosageInstruction.doseAndRate.dose.ofType(Range).low.code).union(dosageInstruction.doseAndRate.dose.ofType(Range).high.code).union(dosageInstruction.doseAndRate.rate.numerator.code).count() = 1

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	CHEMEDMedicationDispenseList	CH EMED MedicationDispense (LIST) mdd-1: whenHandedOver cannot be before whenPrepared ch-dosage-meddis: If one dosage element is present, it should not have a sequence number. If more than one dosage element is present, the base entry has the sequence number 1. split-dosage-instruction-unit-must-match-base-dosage-instruction: The unit for doseAndRate of different dosages (split dosage) belonging to the same statement/request/dispense must match.
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
id		0..1	string	Unique id for inter-element referencing
extension	D	0..*	Extension	✕ This element is not supported Slice: Unordered, Open by value:url
versionId	ΣD	0..1	id	✕ This element is not supported
lastUpdated	ΣD	0..1	instant	✕ This element is not supported
source	ΣD	0..1	uri	✕ This element is not supported
profile	Σ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
security	ΣD	0..*	Coding	✕ This element is not supported Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag	ΣD	0..*	Coding	✕ This element is not supported Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		1..*	Resource	Contained, inline Resources
Slices for extension		2..*	Extension	Extension Slice: Unordered, Open by value:url
treatmentReason		0..*	string	Treatment reason URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentreason
prescription		0..1	(Complex)	Reference to te medication prescription. This item is mandantory if the treatment has already been prescribed. URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription
pharmaceuticalAdvice	D	0..1	(Complex)	✕ This element is not supported URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-pharmaceuticaladvice
treatmentPlan		1..1	(Complex)	CH EMED Extension URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan
parentDocument		1..1	(Complex)	CH EMED Extension URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense
authorDocument		0..1	(Complex)	Optional Extensions Element URL: http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-author
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-author"
Slices for value[x]		1..1	Reference()	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueReference		1..1	Reference(CH EMED EPR PractitionerRole | CH EMED EPR Patient | CH EMED EPR RelatedPerson)	Author of the content
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
time		0..1	dateTime	Timestamp of the authorship/data input URL: http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-epr-time
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
identifier		1..1	Identifier	MedicationDispense Identifier
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: urn:ietf:rfc:3986
value	Σ	1..1	string	Identifier value as UUID Example General: 123456 Example CH EMED: urn:uuid:daa8cd41-34a1-4a9c-9a6d-cd3f850142e9
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
partOf	D	0..*	Reference(Procedure)	✕ This element is not supported
status	?!Σ	1..1	code	preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown Binding: MedicationDispense Status Codes (required): A coded concept specifying the state of the dispense event. Fixed Value: completed
statusReason[x]	D	0..1		✕ This is only meaningful when the dispense was not performed Binding: MedicationDispense Status Reason Codes (example): A code describing why a dispense was not performed.
statusReasonCodeableConcept			CodeableConcept
statusReasonReference			Reference(DetectedIssue)
category	D	0..1	CodeableConcept	✕ This element is not supported Binding: MedicationDispense Category Codes (preferred): A code describing where the dispensed medication is expected to be consumed or administered.
Slices for medication[x]	Σ	1..1	Reference(CH Core Medication)	What medication was supplied Slice: Unordered, Closed by type:$this
medication[x]:medicationReference	Σ	0..1	Reference(CH EMED EPR Medication (DIS)) {c}	Reference to the contained medication
subject	Σ	0..1	Reference(CH EMED EPR Patient) {r, b}	Patient
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
context	D	0..1	Reference(Encounter | EpisodeOfCare)	✕ This element is not supported
supportingInformation	D	0..*	Reference(Resource)	✕ This element is not supported
performer		1..1	BackboneElement	Who performed event
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
function		0..1	CodeableConcept	Who performed the dispense and what they did Binding: MedicationDispense Performer Function Codes (example): A code describing the role an individual played in dispensing a medication.
actor		1..1	Reference(CH EMED PractitionerRole)	The author of the medical decision, see also 'Guidance - Authorship'
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
location	D	0..1	Reference(Location)	✕ This element is not supported
authorizingPrescription	D	0..*	Reference(MedicationRequest)	✕ This element is not supported
type	D	0..1	CodeableConcept	✕ This element is not supported Binding: ActPharmacySupplyType (example): Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.
quantity		1..1	CHEMEDEPRAmountQuantity	Number of packages
daysSupply	D	0..1	CHEMEDEPRTimeQuantity	✕ This element is not supported
whenPrepared	ΣD	0..1	dateTime	✕ This element is not supported
whenHandedOver		1..1	dateTime	When product was given out
destination	D	0..1	Reference(Location)	✕ This element is not supported
receiver	D	0..*	Reference(Patient | Practitioner)	✕ This element is not supported
note		0..*	Annotation	Information about the dispense
id	D	0..1	string	✕ This element is not supported
extension	D	0..*	Extension	✕ This element is not supported Slice: Unordered, Open by value:url
author[x]	ΣD	0..1		✕ The note author is ignored, as it cannot be different than the document and/or entry's author
authorReference			Reference(Practitioner | Patient | RelatedPerson | Organization)
authorString			string
time	ΣD	0..1	dateTime	✕ This element is not supported
text	Σ	1..1	markdown	The annotation text content (as raw text, no markdown allowed).
Slices for dosageInstruction		1..*	CHCoreDosage	How the medication should be taken Slice: Unordered, Closed by profile:$this
dosageInstruction:baseEntry	C	1..1	CHEMEDEPRDosage	Base entry of the dosage instruction ch-dosage-4: For split dosage timing event and dose/rate are required
dosageInstruction:additionalEntry		0..*	CHEMEDEPRDosageSplit	Additional entry of the dosage instruction
substitution	C	0..1	BackboneElement	Whether a substitution was performed on the dispense ch-meddis-1: If no substitution was performed, no type is expected. ch-emed-dis-1: If no substitution was performed, no type is expected.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
wasSubstituted		1..1	boolean	Whether a substitution was (true) or was not (false) performed on the dispense
type		0..1	CodeableConcept	If 'wasSubstituted = true', the type can be defined in addition (optional). If 'wasSubstituted = false', no type is expected. Binding: ActSubstanceAdminSubstitutionCode (required)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-substanceAdminSubstitution
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: E
display		1..1	string	Representation defined by the system Fixed Value: equivalent
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
reason	D	0..*	CodeableConcept	✕ This element is not supported Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
responsibleParty	D	0..*	Reference(Practitioner | PractitionerRole)	✕ This element is not supported
detectedIssue	D	0..*	Reference(DetectedIssue)	✕ This element is not supported
eventHistory	D	0..*	Reference(Provenance)	✕ This element is not supported
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
MedicationDispense.meta.security	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
MedicationDispense.meta.tag	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
MedicationDispense.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
MedicationDispense.extension:authorDocument.value[x]:valueReference.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
MedicationDispense.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
MedicationDispense.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
MedicationDispense.status	required	Fixed Value: completed http://hl7.org/fhir/ValueSet/medicationdispense-status|4.0.1 from the FHIR Standard
MedicationDispense.statusReason[x]	example	MedicationDispense Status Reason Codes http://hl7.org/fhir/ValueSet/medicationdispense-status-reason from the FHIR Standard
MedicationDispense.category	preferred	MedicationDispense Category Codes http://hl7.org/fhir/ValueSet/medicationdispense-category from the FHIR Standard
MedicationDispense.subject.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
MedicationDispense.performer.function	example	MedicationDispense Performer Function Codes http://hl7.org/fhir/ValueSet/medicationdispense-performer-function from the FHIR Standard
MedicationDispense.performer.actor.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
MedicationDispense.type	example	ActPharmacySupplyType http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType
MedicationDispense.substitution.type	required	ActSubstanceAdminSubstitutionCode http://fhir.ch/ig/ch-term/ValueSet/ActSubstanceAdminSubstitutionCode
MedicationDispense.substitution.reason	example	SubstanceAdminSubstitutionReason http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason

Constraints

Id	Grade	Path(s)	Details	Requirements
ch-dosage-4	error	MedicationDispense.dosageInstruction:baseEntry	For split dosage timing event and dose/rate are required : sequence.exists() implies (timing.repeat.when.exists() and doseAndRate.dose.exists())
ch-dosage-meddis	error	MedicationDispense	If one dosage element is present, it should not have a sequence number. If more than one dosage element is present, the base entry has the sequence number 1. : (dosageInstruction.count() > 1 implies dosageInstruction.where($this.conformsTo('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-dosage') and sequence = 1).exists()) and (dosageInstruction.count() = 1 implies dosageInstruction.single().sequence.exists().not())
ch-emed-dis-1	error	MedicationDispense.substitution	If no substitution was performed, no type is expected. : wasSubstituted = true or (wasSubstituted = false and type.exists().not())
ch-meddis-1	warning	MedicationDispense.substitution	If no substitution was performed, no type is expected. : wasSubstituted = true or (wasSubstituted = false and type.exists().not())
dom-2	error	MedicationDispense	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationDispense	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationDispense	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationDispense	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	MedicationDispense	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
mdd-1	error	MedicationDispense	whenHandedOver cannot be before whenPrepared : whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared
split-dosage-instruction-unit-must-match-base-dosage-instruction	error	MedicationDispense	The unit for doseAndRate of different dosages (split dosage) belonging to the same statement/request/dispense must match. : (dosageInstruction.count() > 1) implies dosageInstruction.doseAndRate.dose.ofType(Quantity).code.union(dosageInstruction.doseAndRate.dose.ofType(Range).low.code).union(dosageInstruction.doseAndRate.dose.ofType(Range).high.code).union(dosageInstruction.doseAndRate.rate.numerator.code).count() = 1

This structure is derived from CHEMEDMedicationDispenseList

Summary

Mandatory: 2 elements
Prohibited: 4 elements

Structures

This structure refers to these other structures:

• CH EMED EPR PractitionerRole (http://fhir.ch/ig/ch-emed-epr/StructureDefinition/ch-emed-epr-practitionerrole)
• CH EMED EPR Patient (http://fhir.ch/ig/ch-emed-epr/StructureDefinition/ch-emed-epr-patient)
• CH EMED EPR RelatedPerson (http://fhir.ch/ig/ch-emed-epr/StructureDefinition/ch-emed-epr-related-person)
• CH Core Medication (http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-medication)
• CH EMED EPR Medication (DIS) (http://fhir.ch/ig/ch-emed-epr/StructureDefinition/ch-emed-epr-medication-medicationdispense)
• Amount Quantity (http://fhir.ch/ig/ch-emed-epr/StructureDefinition/ch-emed-epr-amount-quantity)
• Time Quantity (http://fhir.ch/ig/ch-emed-epr/StructureDefinition/ch-emed-epr-time-quantity)
• Dosage (MedicationStatement / MedicationDispense) (http://fhir.ch/ig/ch-emed-epr/StructureDefinition/ch-emed-epr-dosage)
• Dosage Split (http://fhir.ch/ig/ch-emed-epr/StructureDefinition/ch-emed-epr-dosage-split)

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	CHEMEDMedicationDispenseList	CH EMED MedicationDispense (LIST) dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management mdd-1: whenHandedOver cannot be before whenPrepared ch-dosage-meddis: If one dosage element is present, it should not have a sequence number. If more than one dosage element is present, the base entry has the sequence number 1. split-dosage-instruction-unit-must-match-base-dosage-instruction: The unit for doseAndRate of different dosages (split dosage) belonging to the same statement/request/dispense must match.
contained		1..*	Resource	Contained, inline Resources
Slices for extension		2..*	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
treatmentReason		0..*	string	Treatment reason URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentreason ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
prescription		0..1	(Complex)	Reference to te medication prescription. This item is mandantory if the treatment has already been prescribed. URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
pharmaceuticalAdvice	D	0..1	(Complex)	✕ This element is not supported URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-pharmaceuticaladvice ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
treatmentPlan		1..1	(Complex)	CH EMED Extension URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
parentDocument		1..1	(Complex)	CH EMED Extension URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
authorDocument		0..1	(Complex)	Optional Extensions Element URL: http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-author ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension		0..0
url		1..1	uri	"http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-author"
Slices for value[x]		1..1	Reference()	Value of extension Slice: Unordered, Closed by type:$this ele-1: All FHIR elements must have a @value or children
value[x]:valueReference		1..1	Reference(CH EMED EPR PractitionerRole | CH EMED EPR Patient | CH EMED EPR RelatedPerson)	Author of the content ele-1: All FHIR elements must have a @value or children
Slices for extension				Content/Rules for all slices
time		0..1	dateTime	Timestamp of the authorship/data input URL: http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-epr-time ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL ele-1: All FHIR elements must have a @value or children
identifier		1..1	Identifier	MedicationDispense Identifier ele-1: All FHIR elements must have a @value or children
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . ele-1: All FHIR elements must have a @value or children
system	Σ	1..1	uri	The namespace for the identifier value ele-1: All FHIR elements must have a @value or children Fixed Value: urn:ietf:rfc:3986
value	Σ	1..1	string	Identifier value as UUID ele-1: All FHIR elements must have a @value or children Example General: 123456 Example CH EMED: urn:uuid:daa8cd41-34a1-4a9c-9a6d-cd3f850142e9
partOf	D	0..*	Reference(Procedure)	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
status	?!Σ	1..1	code	preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown Binding: MedicationDispense Status Codes (required): A coded concept specifying the state of the dispense event. ele-1: All FHIR elements must have a @value or children Fixed Value: completed
statusReason[x]	D	0..1		✕ This is only meaningful when the dispense was not performed Binding: MedicationDispense Status Reason Codes (example): A code describing why a dispense was not performed. ele-1: All FHIR elements must have a @value or children
statusReasonCodeableConcept			CodeableConcept
statusReasonReference			Reference(DetectedIssue)
category	D	0..1	CodeableConcept	✕ This element is not supported Binding: MedicationDispense Category Codes (preferred): A code describing where the dispensed medication is expected to be consumed or administered. ele-1: All FHIR elements must have a @value or children
Slices for medication[x]	Σ	1..1	Reference(CH Core Medication)	What medication was supplied Slice: Unordered, Closed by type:$this ele-1: All FHIR elements must have a @value or children
medication[x]:medicationReference	Σ	0..1	Reference(CH EMED EPR Medication (DIS)) {c}	Reference to the contained medication ele-1: All FHIR elements must have a @value or children
subject	Σ	0..1	Reference(CH EMED EPR Patient) {r, b}	Patient ele-1: All FHIR elements must have a @value or children
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL ele-1: All FHIR elements must have a @value or children
context	D	0..1	Reference(Encounter | EpisodeOfCare)	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
supportingInformation	D	0..*	Reference(Resource)	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
performer		1..1	BackboneElement	Who performed event ele-1: All FHIR elements must have a @value or children
actor		1..1	Reference(CH EMED PractitionerRole)	The author of the medical decision, see also 'Guidance - Authorship' ele-1: All FHIR elements must have a @value or children
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL ele-1: All FHIR elements must have a @value or children
location	D	0..1	Reference(Location)	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
authorizingPrescription	D	0..*	Reference(MedicationRequest)	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
type	D	0..1	CodeableConcept	✕ This element is not supported Binding: ActPharmacySupplyType (example): Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc. ele-1: All FHIR elements must have a @value or children
quantity		1..1	CHEMEDEPRAmountQuantity	Number of packages ele-1: All FHIR elements must have a @value or children
daysSupply	D	0..1	CHEMEDEPRTimeQuantity	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
whenPrepared	ΣD	0..1	dateTime	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
whenHandedOver		1..1	dateTime	When product was given out ele-1: All FHIR elements must have a @value or children
destination	D	0..1	Reference(Location)	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
receiver	D	0..*	Reference(Patient | Practitioner)	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
Slices for dosageInstruction		1..*	CHCoreDosage	How the medication should be taken Slice: Unordered, Closed by profile:$this ele-1: All FHIR elements must have a @value or children
dosageInstruction:baseEntry	C	1..1	CHEMEDEPRDosage	Base entry of the dosage instruction ele-1: All FHIR elements must have a @value or children ch-dosage-4: For split dosage timing event and dose/rate are required
dosageInstruction:additionalEntry		0..*	CHEMEDEPRDosageSplit	Additional entry of the dosage instruction ele-1: All FHIR elements must have a @value or children
detectedIssue	D	0..*	Reference(DetectedIssue)	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
eventHistory	D	0..*	Reference(Provenance)	✕ This element is not supported ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
MedicationDispense.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
MedicationDispense.status	required	Fixed Value: completed http://hl7.org/fhir/ValueSet/medicationdispense-status|4.0.1 from the FHIR Standard
MedicationDispense.statusReason[x]	example	MedicationDispense Status Reason Codes http://hl7.org/fhir/ValueSet/medicationdispense-status-reason from the FHIR Standard
MedicationDispense.category	preferred	MedicationDispense Category Codes http://hl7.org/fhir/ValueSet/medicationdispense-category from the FHIR Standard
MedicationDispense.type	example	ActPharmacySupplyType http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType

Constraints

Id	Grade	Path(s)	Details	Requirements
ch-dosage-4	error	MedicationDispense.dosageInstruction:baseEntry	For split dosage timing event and dose/rate are required : sequence.exists() implies (timing.repeat.when.exists() and doseAndRate.dose.exists())
ch-dosage-meddis	error	MedicationDispense	If one dosage element is present, it should not have a sequence number. If more than one dosage element is present, the base entry has the sequence number 1. : (dosageInstruction.count() > 1 implies dosageInstruction.where($this.conformsTo('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-dosage') and sequence = 1).exists()) and (dosageInstruction.count() = 1 implies dosageInstruction.single().sequence.exists().not())
dom-2	error	MedicationDispense	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationDispense	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationDispense	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationDispense	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	MedicationDispense	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
mdd-1	error	MedicationDispense	whenHandedOver cannot be before whenPrepared : whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared
split-dosage-instruction-unit-must-match-base-dosage-instruction	error	MedicationDispense	The unit for doseAndRate of different dosages (split dosage) belonging to the same statement/request/dispense must match. : (dosageInstruction.count() > 1) implies dosageInstruction.doseAndRate.dose.ofType(Quantity).code.union(dosageInstruction.doseAndRate.dose.ofType(Range).low.code).union(dosageInstruction.doseAndRate.dose.ofType(Range).high.code).union(dosageInstruction.doseAndRate.rate.numerator.code).count() = 1

Differential View

This structure is derived from CHEMEDMedicationDispenseList

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	CHEMEDMedicationDispenseList	CH EMED MedicationDispense (LIST) split-dosage-instruction-unit-must-match-base-dosage-instruction: The unit for doseAndRate of different dosages (split dosage) belonging to the same statement/request/dispense must match.
meta
extension	D	0..*	Extension	✕ This element is not supported
versionId	D	0..1	id	✕ This element is not supported
lastUpdated	D	0..1	instant	✕ This element is not supported
source	D	0..1	uri	✕ This element is not supported
security	D	0..*	Coding	✕ This element is not supported
tag	D	0..*	Coding	✕ This element is not supported
implicitRules		0..0
extension		2..*	Extension	Extension
Slices for extension				Content/Rules for all slices
extension:prescription		0..1	CHEMEDExtPrescription	Reference to te medication prescription. This item is mandantory if the treatment has already been prescribed.
extension:pharmaceuticalAdvice	D	0..1	CHEMEDExtPharmaceuticalAdvice	✕ This element is not supported
extension:treatmentPlan		1..1	CHEMEDExtTreatmentPlan	CH EMED Extension
extension:parentDocument		1..1	CHEMEDExtDispense	CH EMED Extension
extension:authorDocument		0..1	Author	Optional Extensions Element
Slices for value[x]				Content/Rules for all slices
value[x]:valueReference		1..1	Reference(CH EMED EPR PractitionerRole | CH EMED EPR Patient | CH EMED EPR RelatedPerson)	Author of the content
modifierExtension		0..0
partOf	D	0..*	Reference(Procedure)	✕ This element is not supported
statusReason[x]	D	0..1	CodeableConcept, Reference(DetectedIssue)	✕ This is only meaningful when the dispense was not performed
category	D	0..1	CodeableConcept	✕ This element is not supported
medication[x]		1..1	Reference(CH Core Medication)	What medication was supplied
Slices for medication[x]				Content/Rules for all slices
medication[x]:medicationReference		0..1	Reference(CH EMED EPR Medication (DIS)) {c}	Reference to the contained medication
subject		0..1	Reference(CH EMED EPR Patient) {r, b}	Patient
context	D	0..1	Reference(Encounter | EpisodeOfCare)	✕ This element is not supported
supportingInformation	D	0..*	Reference(Resource)	✕ This element is not supported
performer
modifierExtension		0..0
location	D	0..1	Reference(Location)	✕ This element is not supported
authorizingPrescription	D	0..*	Reference(MedicationRequest)	✕ This element is not supported
type	D	0..1	CodeableConcept	✕ This element is not supported
quantity		1..1	CHEMEDEPRAmountQuantity	Number of packages
daysSupply	D	0..1	CHEMEDEPRTimeQuantity	✕ This element is not supported
whenPrepared	D	0..1	dateTime	✕ This element is not supported
destination	D	0..1	Reference(Location)	✕ This element is not supported
receiver	D	0..*	Reference(Patient | Practitioner)	✕ This element is not supported
note
id	D	0..1	string	✕ This element is not supported
extension	D	0..*	Extension	✕ This element is not supported
author[x]	D	0..1	Reference(Practitioner | Patient | RelatedPerson | Organization), string	✕ The note author is ignored, as it cannot be different than the document and/or entry's author
time	D	0..1	dateTime	✕ This element is not supported
text		1..1	markdown	The annotation text content (as raw text, no markdown allowed).
Slices for dosageInstruction				Content/Rules for all slices
dosageInstruction:baseEntry		1..1	CHEMEDEPRDosage	Base entry of the dosage instruction
dosageInstruction:additionalEntry		0..*	CHEMEDEPRDosageSplit	Additional entry of the dosage instruction
substitution
modifierExtension		0..0
type
coding		0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-substanceAdminSubstitution
code		1..1	code	Symbol in syntax defined by the system Fixed Value: E
display		1..1	string	Representation defined by the system Fixed Value: equivalent
reason	D	0..*	CodeableConcept	✕ This element is not supported
responsibleParty	D	0..*	Reference(Practitioner | PractitionerRole)	✕ This element is not supported
detectedIssue	D	0..*	Reference(DetectedIssue)	✕ This element is not supported
eventHistory	D	0..*	Reference(Provenance)	✕ This element is not supported
Documentation for this format

Constraints

Id	Grade	Path(s)	Details	Requirements
split-dosage-instruction-unit-must-match-base-dosage-instruction	error	MedicationDispense	The unit for doseAndRate of different dosages (split dosage) belonging to the same statement/request/dispense must match. : (dosageInstruction.count() > 1) implies dosageInstruction.doseAndRate.dose.ofType(Quantity).code.union(dosageInstruction.doseAndRate.dose.ofType(Range).low.code).union(dosageInstruction.doseAndRate.dose.ofType(Range).high.code).union(dosageInstruction.doseAndRate.rate.numerator.code).count() = 1

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	CHEMEDMedicationDispenseList	CH EMED MedicationDispense (LIST) mdd-1: whenHandedOver cannot be before whenPrepared ch-dosage-meddis: If one dosage element is present, it should not have a sequence number. If more than one dosage element is present, the base entry has the sequence number 1. split-dosage-instruction-unit-must-match-base-dosage-instruction: The unit for doseAndRate of different dosages (split dosage) belonging to the same statement/request/dispense must match.
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
id		0..1	string	Unique id for inter-element referencing
extension	D	0..*	Extension	✕ This element is not supported Slice: Unordered, Open by value:url
versionId	ΣD	0..1	id	✕ This element is not supported
lastUpdated	ΣD	0..1	instant	✕ This element is not supported
source	ΣD	0..1	uri	✕ This element is not supported
profile	Σ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
security	ΣD	0..*	Coding	✕ This element is not supported Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag	ΣD	0..*	Coding	✕ This element is not supported Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		1..*	Resource	Contained, inline Resources
Slices for extension		2..*	Extension	Extension Slice: Unordered, Open by value:url
treatmentReason		0..*	string	Treatment reason URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentreason
prescription		0..1	(Complex)	Reference to te medication prescription. This item is mandantory if the treatment has already been prescribed. URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription
pharmaceuticalAdvice	D	0..1	(Complex)	✕ This element is not supported URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-pharmaceuticaladvice
treatmentPlan		1..1	(Complex)	CH EMED Extension URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan
parentDocument		1..1	(Complex)	CH EMED Extension URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense
authorDocument		0..1	(Complex)	Optional Extensions Element URL: http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-author
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-author"
Slices for value[x]		1..1	Reference()	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueReference		1..1	Reference(CH EMED EPR PractitionerRole | CH EMED EPR Patient | CH EMED EPR RelatedPerson)	Author of the content
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
time		0..1	dateTime	Timestamp of the authorship/data input URL: http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-epr-time
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
identifier		1..1	Identifier	MedicationDispense Identifier
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: urn:ietf:rfc:3986
value	Σ	1..1	string	Identifier value as UUID Example General: 123456 Example CH EMED: urn:uuid:daa8cd41-34a1-4a9c-9a6d-cd3f850142e9
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
partOf	D	0..*	Reference(Procedure)	✕ This element is not supported
status	?!Σ	1..1	code	preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown Binding: MedicationDispense Status Codes (required): A coded concept specifying the state of the dispense event. Fixed Value: completed
statusReason[x]	D	0..1		✕ This is only meaningful when the dispense was not performed Binding: MedicationDispense Status Reason Codes (example): A code describing why a dispense was not performed.
statusReasonCodeableConcept			CodeableConcept
statusReasonReference			Reference(DetectedIssue)
category	D	0..1	CodeableConcept	✕ This element is not supported Binding: MedicationDispense Category Codes (preferred): A code describing where the dispensed medication is expected to be consumed or administered.
Slices for medication[x]	Σ	1..1	Reference(CH Core Medication)	What medication was supplied Slice: Unordered, Closed by type:$this
medication[x]:medicationReference	Σ	0..1	Reference(CH EMED EPR Medication (DIS)) {c}	Reference to the contained medication
subject	Σ	0..1	Reference(CH EMED EPR Patient) {r, b}	Patient
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
context	D	0..1	Reference(Encounter | EpisodeOfCare)	✕ This element is not supported
supportingInformation	D	0..*	Reference(Resource)	✕ This element is not supported
performer		1..1	BackboneElement	Who performed event
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
function		0..1	CodeableConcept	Who performed the dispense and what they did Binding: MedicationDispense Performer Function Codes (example): A code describing the role an individual played in dispensing a medication.
actor		1..1	Reference(CH EMED PractitionerRole)	The author of the medical decision, see also 'Guidance - Authorship'
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
location	D	0..1	Reference(Location)	✕ This element is not supported
authorizingPrescription	D	0..*	Reference(MedicationRequest)	✕ This element is not supported
type	D	0..1	CodeableConcept	✕ This element is not supported Binding: ActPharmacySupplyType (example): Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.
quantity		1..1	CHEMEDEPRAmountQuantity	Number of packages
daysSupply	D	0..1	CHEMEDEPRTimeQuantity	✕ This element is not supported
whenPrepared	ΣD	0..1	dateTime	✕ This element is not supported
whenHandedOver		1..1	dateTime	When product was given out
destination	D	0..1	Reference(Location)	✕ This element is not supported
receiver	D	0..*	Reference(Patient | Practitioner)	✕ This element is not supported
note		0..*	Annotation	Information about the dispense
id	D	0..1	string	✕ This element is not supported
extension	D	0..*	Extension	✕ This element is not supported Slice: Unordered, Open by value:url
author[x]	ΣD	0..1		✕ The note author is ignored, as it cannot be different than the document and/or entry's author
authorReference			Reference(Practitioner | Patient | RelatedPerson | Organization)
authorString			string
time	ΣD	0..1	dateTime	✕ This element is not supported
text	Σ	1..1	markdown	The annotation text content (as raw text, no markdown allowed).
Slices for dosageInstruction		1..*	CHCoreDosage	How the medication should be taken Slice: Unordered, Closed by profile:$this
dosageInstruction:baseEntry	C	1..1	CHEMEDEPRDosage	Base entry of the dosage instruction ch-dosage-4: For split dosage timing event and dose/rate are required
dosageInstruction:additionalEntry		0..*	CHEMEDEPRDosageSplit	Additional entry of the dosage instruction
substitution	C	0..1	BackboneElement	Whether a substitution was performed on the dispense ch-meddis-1: If no substitution was performed, no type is expected. ch-emed-dis-1: If no substitution was performed, no type is expected.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
wasSubstituted		1..1	boolean	Whether a substitution was (true) or was not (false) performed on the dispense
type		0..1	CodeableConcept	If 'wasSubstituted = true', the type can be defined in addition (optional). If 'wasSubstituted = false', no type is expected. Binding: ActSubstanceAdminSubstitutionCode (required)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-substanceAdminSubstitution
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: E
display		1..1	string	Representation defined by the system Fixed Value: equivalent
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
reason	D	0..*	CodeableConcept	✕ This element is not supported Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
responsibleParty	D	0..*	Reference(Practitioner | PractitionerRole)	✕ This element is not supported
detectedIssue	D	0..*	Reference(DetectedIssue)	✕ This element is not supported
eventHistory	D	0..*	Reference(Provenance)	✕ This element is not supported
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
MedicationDispense.meta.security	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
MedicationDispense.meta.tag	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
MedicationDispense.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
MedicationDispense.extension:authorDocument.value[x]:valueReference.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
MedicationDispense.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
MedicationDispense.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
MedicationDispense.status	required	Fixed Value: completed http://hl7.org/fhir/ValueSet/medicationdispense-status|4.0.1 from the FHIR Standard
MedicationDispense.statusReason[x]	example	MedicationDispense Status Reason Codes http://hl7.org/fhir/ValueSet/medicationdispense-status-reason from the FHIR Standard
MedicationDispense.category	preferred	MedicationDispense Category Codes http://hl7.org/fhir/ValueSet/medicationdispense-category from the FHIR Standard
MedicationDispense.subject.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
MedicationDispense.performer.function	example	MedicationDispense Performer Function Codes http://hl7.org/fhir/ValueSet/medicationdispense-performer-function from the FHIR Standard
MedicationDispense.performer.actor.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
MedicationDispense.type	example	ActPharmacySupplyType http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType
MedicationDispense.substitution.type	required	ActSubstanceAdminSubstitutionCode http://fhir.ch/ig/ch-term/ValueSet/ActSubstanceAdminSubstitutionCode
MedicationDispense.substitution.reason	example	SubstanceAdminSubstitutionReason http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason

Constraints

Id	Grade	Path(s)	Details	Requirements
ch-dosage-4	error	MedicationDispense.dosageInstruction:baseEntry	For split dosage timing event and dose/rate are required : sequence.exists() implies (timing.repeat.when.exists() and doseAndRate.dose.exists())
ch-dosage-meddis	error	MedicationDispense	If one dosage element is present, it should not have a sequence number. If more than one dosage element is present, the base entry has the sequence number 1. : (dosageInstruction.count() > 1 implies dosageInstruction.where($this.conformsTo('http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-dosage') and sequence = 1).exists()) and (dosageInstruction.count() = 1 implies dosageInstruction.single().sequence.exists().not())
ch-emed-dis-1	error	MedicationDispense.substitution	If no substitution was performed, no type is expected. : wasSubstituted = true or (wasSubstituted = false and type.exists().not())
ch-meddis-1	warning	MedicationDispense.substitution	If no substitution was performed, no type is expected. : wasSubstituted = true or (wasSubstituted = false and type.exists().not())
dom-2	error	MedicationDispense	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationDispense	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationDispense	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationDispense	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	MedicationDispense	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
mdd-1	error	MedicationDispense	whenHandedOver cannot be before whenPrepared : whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared
split-dosage-instruction-unit-must-match-base-dosage-instruction	error	MedicationDispense	The unit for doseAndRate of different dosages (split dosage) belonging to the same statement/request/dispense must match. : (dosageInstruction.count() > 1) implies dosageInstruction.doseAndRate.dose.ofType(Quantity).code.union(dosageInstruction.doseAndRate.dose.ofType(Range).low.code).union(dosageInstruction.doseAndRate.dose.ofType(Range).high.code).union(dosageInstruction.doseAndRate.rate.numerator.code).count() = 1

This structure is derived from CHEMEDMedicationDispenseList

Summary

Mandatory: 2 elements
Prohibited: 4 elements

Structures

This structure refers to these other structures:

• CH EMED EPR PractitionerRole (http://fhir.ch/ig/ch-emed-epr/StructureDefinition/ch-emed-epr-practitionerrole)
• CH EMED EPR Patient (http://fhir.ch/ig/ch-emed-epr/StructureDefinition/ch-emed-epr-patient)
• CH EMED EPR RelatedPerson (http://fhir.ch/ig/ch-emed-epr/StructureDefinition/ch-emed-epr-related-person)
• CH Core Medication (http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-medication)
• CH EMED EPR Medication (DIS) (http://fhir.ch/ig/ch-emed-epr/StructureDefinition/ch-emed-epr-medication-medicationdispense)
• Amount Quantity (http://fhir.ch/ig/ch-emed-epr/StructureDefinition/ch-emed-epr-amount-quantity)
• Time Quantity (http://fhir.ch/ig/ch-emed-epr/StructureDefinition/ch-emed-epr-time-quantity)
• Dosage (MedicationStatement / MedicationDispense) (http://fhir.ch/ig/ch-emed-epr/StructureDefinition/ch-emed-epr-dosage)
• Dosage Split (http://fhir.ch/ig/ch-emed-epr/StructureDefinition/ch-emed-epr-dosage-split)