Name	Flags	Card.	Type	Description & Constraints
MedicationDispense		0..*	MedicationDispense	CH EMED MedicationDispense (DIS)
contained		1..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
treatmentReason		0..1	string	Treatment reason URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentreason
prescription		0..1	(Complex)	Reference to the medication prescription URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription
pharmaceuticalAdvice		0..1	(Complex)	Reference to the pharmaceutical advice URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-pharmaceuticaladvice
treatmentPlan		0..1	(Complex)	Reference to the medication treatment plan URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan
identifier		1..1	Identifier	MedicationDispense Identifier
system		1..1	uri	The namespace for the identifier value Fixed Value: urn:ietf:rfc:3986
value		1..1	string	Identifier value as UUID Example CH EMED: urn:uuid:daa8cd41-34a1-4a9c-9a6d-cd3f850142e9
status		1..1	code	preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown Fixed Value: completed
Slices for medication[x]		1..1	CodeableConcept, Reference(Medication)	What medication was supplied Slice: Unordered, Open by type:$this
medication[x]:medicationReference		0..1	Reference(CH EMED Medication (MedicationDispense)) {c}	Reference to the contained medication
subject		0..1	Reference(CH Core Patient)	Patient
reference		1..1	string	Literal reference, Relative, internal or absolute URL
performer		1..1	BackboneElement	Who performed event
actor		1..1	Reference(CH EMED PractitionerRole)	The author of the medical decision, see also 'Guidance - Authorship'
reference		1..1	string	Literal reference, Relative, internal or absolute URL
quantity		1..1	SimpleQuantity	Number of packages
whenHandedOver		1..1	dateTime	When product was given out
Slices for dosageInstruction		1..*	Dosage	How the medication should be taken Slice: Unordered, Closed by profile:$this
dosageInstruction:baseEntry		1..1	CHEMEDDosage	Base entry of the dosage instruction
dosageInstruction:additionalEntry		0..*	CHEMEDDosageSplit	Additional entry of the dosage instruction
substitution	C	0..1	BackboneElement	Whether a substitution was performed on the dispense ch-emed-dis-1: If no substitution was performed, no type is expected.
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)
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
MedicationDispense.substitution.type	required	ActSubstanceAdminSubstitutionCode

Constraints

Id	Grade	Path(s)	Details	Requirements
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())

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	MedicationDispense	CH EMED MedicationDispense (DIS)
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
contained		1..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
treatmentReason		0..1	string	Treatment reason URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentreason
prescription		0..1	(Complex)	Reference to the medication prescription URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription
pharmaceuticalAdvice		0..1	(Complex)	Reference to the pharmaceutical advice URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-pharmaceuticaladvice
treatmentPlan		0..1	(Complex)	Reference to the medication treatment plan URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		1..1	Identifier	MedicationDispense Identifier
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
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
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
Slices for medication[x]	Σ	1..1		What medication was supplied Slice: Unordered, Open by type:$this Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying which substance or product can be dispensed.
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(Medication)
medication[x]:medicationReference	Σ	0..1	Reference(CH EMED Medication (MedicationDispense)) {c}	Reference to the contained medication
subject	Σ	0..1	Reference(CH Core Patient)	Patient
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
performer		1..1	BackboneElement	Who performed event
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
actor		1..1	Reference(CH EMED PractitionerRole)	The author of the medical decision, see also 'Guidance - Authorship'
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
quantity		1..1	SimpleQuantity	Number of packages
whenHandedOver		1..1	dateTime	When product was given out
Slices for dosageInstruction		1..*	Dosage	How the medication should be taken Slice: Unordered, Closed by profile:$this
dosageInstruction:baseEntry	C	1..1	CHEMEDDosage	Base entry of the dosage instruction
dosageInstruction:additionalEntry		0..*	CHEMEDDosageSplit	Additional entry of the dosage instruction
substitution	C	0..1	BackboneElement	Whether a substitution was performed on the dispense ch-emed-dis-1: If no substitution was performed, no type is expected.
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
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)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
MedicationDispense.identifier.use	required	IdentifierUse
MedicationDispense.status	required	Fixed Value: completed
MedicationDispense.medication[x]	example	SNOMEDCTMedicationCodes
MedicationDispense.substitution.type	required	ActSubstanceAdminSubstitutionCode

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-emed-dis-1	error	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

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	MedicationDispense	CH EMED MedicationDispense (DIS)
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): 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		0..*	Extension	Extension Slice: Unordered, Open by value:url
treatmentReason		0..1	string	Treatment reason URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentreason
prescription		0..1	(Complex)	Reference to the medication prescription URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription
pharmaceuticalAdvice		0..1	(Complex)	Reference to the pharmaceutical advice URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-pharmaceuticaladvice
treatmentPlan		0..1	(Complex)	Reference to the medication treatment plan URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
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		0..*	Reference(Procedure)	Event that dispense is part of
status	?!Σ	1..1	code	preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown Binding: MedicationDispense Status Codes (required): A coded concept specifying the state of the dispense event. Fixed Value: completed
statusReason[x]		0..1		Why a dispense was not performed Binding: MedicationDispense Status Reason Codes (example): A code describing why a dispense was not performed.
statusReasonCodeableConcept			CodeableConcept
statusReasonReference			Reference(DetectedIssue)
category		0..1	CodeableConcept	Type of medication dispense Binding: MedicationDispense Category Codes (preferred): A code describing where the dispensed medication is expected to be consumed or administered.
Slices for medication[x]	Σ	1..1		What medication was supplied Slice: Unordered, Open by type:$this Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying which substance or product can be dispensed.
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(Medication)
medication[x]:medicationReference	Σ	0..1	Reference(CH EMED Medication (MedicationDispense)) {c}	Reference to the contained medication
subject	Σ	0..1	Reference(CH Core Patient)	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		0..1	Reference(Encounter | EpisodeOfCare)	Encounter / Episode associated with event
supportingInformation		0..*	Reference(Resource)	Information that supports the dispensing of the medication
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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function		0..1	CodeableConcept	Who performed the dispense and what they did Binding: MedicationDispense Performer Function Codes (example): A code describing the role an individual played in dispensing a medication.
actor		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		0..1	Reference(Location)	Where the dispense occurred
authorizingPrescription		0..*	Reference(MedicationRequest)	Medication order that authorizes the dispense
type		0..1	CodeableConcept	Trial fill, partial fill, emergency fill, etc. Binding: ActPharmacySupplyType (example): Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.
quantity		1..1	SimpleQuantity	Number of packages
daysSupply		0..1	SimpleQuantity	Amount of medication expressed as a timing amount
whenPrepared	Σ	0..1	dateTime	When product was packaged and reviewed
whenHandedOver		1..1	dateTime	When product was given out
destination		0..1	Reference(Location)	Where the medication was sent
receiver		0..*	Reference(Patient | Practitioner)	Who collected the medication
note		0..*	Annotation	Information about the dispense
Slices for dosageInstruction		1..*	Dosage	How the medication should be taken Slice: Unordered, Closed by profile:$this
dosageInstruction:baseEntry	C	1..1	CHEMEDDosage	Base entry of the dosage instruction
dosageInstruction:additionalEntry		0..*	CHEMEDDosageSplit	Additional entry of the dosage instruction
substitution	C	0..1	BackboneElement	Whether a substitution was performed on the dispense 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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
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)
reason		0..*	CodeableConcept	Why was substitution made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
responsibleParty		0..*	Reference(Practitioner | PractitionerRole)	Who is responsible for the substitution
detectedIssue		0..*	Reference(DetectedIssue)	Clinical issue with action
eventHistory		0..*	Reference(Provenance)	A list of relevant lifecycle events
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
MedicationDispense.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
MedicationDispense.identifier.use	required	IdentifierUse
MedicationDispense.identifier.type	extensible	Identifier Type Codes
MedicationDispense.status	required	Fixed Value: completed
MedicationDispense.statusReason[x]	example	MedicationDispense Status Reason Codes
MedicationDispense.category	preferred	MedicationDispense Category Codes
MedicationDispense.medication[x]	example	SNOMEDCTMedicationCodes
MedicationDispense.subject.type	extensible	ResourceType
MedicationDispense.performer.function	example	MedicationDispense Performer Function Codes
MedicationDispense.performer.actor.type	extensible	ResourceType
MedicationDispense.type	example	ActPharmacySupplyType
MedicationDispense.substitution.type	required	ActSubstanceAdminSubstitutionCode
MedicationDispense.substitution.reason	example	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-emed-dis-1	error	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

Summary

Mandatory: 10 elements (1 nested mandatory element)
Fixed Value: 2 elements

Structures

This structure refers to these other structures:

• CH EMED Medication (MedicationDispense) (http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-medication-medicationdispense)
• CH Core Patient (http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient)
• CH EMED PractitionerRole (http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-practitionerrole)
• CH EMED Dosage (MedicationStatement / MedicationDispense) (http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-dosage)
• CH EMED Dosage Split (http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-dosage-split)

Extensions

This structure refers to these extensions:

• http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentreason
• http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription
• http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-pharmaceuticaladvice
• http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan

Slices

This structure defines the following Slices:

• The element MedicationDispense.medication[x] is sliced based on the value of type:$this
• The element MedicationDispense.dosageInstruction is sliced based on the value of profile:$this (Closed)

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense		0..*	MedicationDispense	CH EMED MedicationDispense (DIS)
contained		1..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
treatmentReason		0..1	string	Treatment reason URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentreason
prescription		0..1	(Complex)	Reference to the medication prescription URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription
pharmaceuticalAdvice		0..1	(Complex)	Reference to the pharmaceutical advice URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-pharmaceuticaladvice
treatmentPlan		0..1	(Complex)	Reference to the medication treatment plan URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan
identifier		1..1	Identifier	MedicationDispense Identifier
system		1..1	uri	The namespace for the identifier value Fixed Value: urn:ietf:rfc:3986
value		1..1	string	Identifier value as UUID Example CH EMED: urn:uuid:daa8cd41-34a1-4a9c-9a6d-cd3f850142e9
status		1..1	code	preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown Fixed Value: completed
Slices for medication[x]		1..1	CodeableConcept, Reference(Medication)	What medication was supplied Slice: Unordered, Open by type:$this
medication[x]:medicationReference		0..1	Reference(CH EMED Medication (MedicationDispense)) {c}	Reference to the contained medication
subject		0..1	Reference(CH Core Patient)	Patient
reference		1..1	string	Literal reference, Relative, internal or absolute URL
performer		1..1	BackboneElement	Who performed event
actor		1..1	Reference(CH EMED PractitionerRole)	The author of the medical decision, see also 'Guidance - Authorship'
reference		1..1	string	Literal reference, Relative, internal or absolute URL
quantity		1..1	SimpleQuantity	Number of packages
whenHandedOver		1..1	dateTime	When product was given out
Slices for dosageInstruction		1..*	Dosage	How the medication should be taken Slice: Unordered, Closed by profile:$this
dosageInstruction:baseEntry		1..1	CHEMEDDosage	Base entry of the dosage instruction
dosageInstruction:additionalEntry		0..*	CHEMEDDosageSplit	Additional entry of the dosage instruction
substitution	C	0..1	BackboneElement	Whether a substitution was performed on the dispense ch-emed-dis-1: If no substitution was performed, no type is expected.
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)
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
MedicationDispense.substitution.type	required	ActSubstanceAdminSubstitutionCode

Constraints

Id	Grade	Path(s)	Details	Requirements
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())

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	MedicationDispense	CH EMED MedicationDispense (DIS)
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
contained		1..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
treatmentReason		0..1	string	Treatment reason URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentreason
prescription		0..1	(Complex)	Reference to the medication prescription URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription
pharmaceuticalAdvice		0..1	(Complex)	Reference to the pharmaceutical advice URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-pharmaceuticaladvice
treatmentPlan		0..1	(Complex)	Reference to the medication treatment plan URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		1..1	Identifier	MedicationDispense Identifier
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
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
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
Slices for medication[x]	Σ	1..1		What medication was supplied Slice: Unordered, Open by type:$this Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying which substance or product can be dispensed.
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(Medication)
medication[x]:medicationReference	Σ	0..1	Reference(CH EMED Medication (MedicationDispense)) {c}	Reference to the contained medication
subject	Σ	0..1	Reference(CH Core Patient)	Patient
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
performer		1..1	BackboneElement	Who performed event
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
actor		1..1	Reference(CH EMED PractitionerRole)	The author of the medical decision, see also 'Guidance - Authorship'
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
quantity		1..1	SimpleQuantity	Number of packages
whenHandedOver		1..1	dateTime	When product was given out
Slices for dosageInstruction		1..*	Dosage	How the medication should be taken Slice: Unordered, Closed by profile:$this
dosageInstruction:baseEntry	C	1..1	CHEMEDDosage	Base entry of the dosage instruction
dosageInstruction:additionalEntry		0..*	CHEMEDDosageSplit	Additional entry of the dosage instruction
substitution	C	0..1	BackboneElement	Whether a substitution was performed on the dispense ch-emed-dis-1: If no substitution was performed, no type is expected.
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
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)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
MedicationDispense.identifier.use	required	IdentifierUse
MedicationDispense.status	required	Fixed Value: completed
MedicationDispense.medication[x]	example	SNOMEDCTMedicationCodes
MedicationDispense.substitution.type	required	ActSubstanceAdminSubstitutionCode

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-emed-dis-1	error	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

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	MedicationDispense	CH EMED MedicationDispense (DIS)
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): 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		0..*	Extension	Extension Slice: Unordered, Open by value:url
treatmentReason		0..1	string	Treatment reason URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentreason
prescription		0..1	(Complex)	Reference to the medication prescription URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription
pharmaceuticalAdvice		0..1	(Complex)	Reference to the pharmaceutical advice URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-pharmaceuticaladvice
treatmentPlan		0..1	(Complex)	Reference to the medication treatment plan URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
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		0..*	Reference(Procedure)	Event that dispense is part of
status	?!Σ	1..1	code	preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown Binding: MedicationDispense Status Codes (required): A coded concept specifying the state of the dispense event. Fixed Value: completed
statusReason[x]		0..1		Why a dispense was not performed Binding: MedicationDispense Status Reason Codes (example): A code describing why a dispense was not performed.
statusReasonCodeableConcept			CodeableConcept
statusReasonReference			Reference(DetectedIssue)
category		0..1	CodeableConcept	Type of medication dispense Binding: MedicationDispense Category Codes (preferred): A code describing where the dispensed medication is expected to be consumed or administered.
Slices for medication[x]	Σ	1..1		What medication was supplied Slice: Unordered, Open by type:$this Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying which substance or product can be dispensed.
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(Medication)
medication[x]:medicationReference	Σ	0..1	Reference(CH EMED Medication (MedicationDispense)) {c}	Reference to the contained medication
subject	Σ	0..1	Reference(CH Core Patient)	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		0..1	Reference(Encounter | EpisodeOfCare)	Encounter / Episode associated with event
supportingInformation		0..*	Reference(Resource)	Information that supports the dispensing of the medication
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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function		0..1	CodeableConcept	Who performed the dispense and what they did Binding: MedicationDispense Performer Function Codes (example): A code describing the role an individual played in dispensing a medication.
actor		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		0..1	Reference(Location)	Where the dispense occurred
authorizingPrescription		0..*	Reference(MedicationRequest)	Medication order that authorizes the dispense
type		0..1	CodeableConcept	Trial fill, partial fill, emergency fill, etc. Binding: ActPharmacySupplyType (example): Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.
quantity		1..1	SimpleQuantity	Number of packages
daysSupply		0..1	SimpleQuantity	Amount of medication expressed as a timing amount
whenPrepared	Σ	0..1	dateTime	When product was packaged and reviewed
whenHandedOver		1..1	dateTime	When product was given out
destination		0..1	Reference(Location)	Where the medication was sent
receiver		0..*	Reference(Patient | Practitioner)	Who collected the medication
note		0..*	Annotation	Information about the dispense
Slices for dosageInstruction		1..*	Dosage	How the medication should be taken Slice: Unordered, Closed by profile:$this
dosageInstruction:baseEntry	C	1..1	CHEMEDDosage	Base entry of the dosage instruction
dosageInstruction:additionalEntry		0..*	CHEMEDDosageSplit	Additional entry of the dosage instruction
substitution	C	0..1	BackboneElement	Whether a substitution was performed on the dispense 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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
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)
reason		0..*	CodeableConcept	Why was substitution made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
responsibleParty		0..*	Reference(Practitioner | PractitionerRole)	Who is responsible for the substitution
detectedIssue		0..*	Reference(DetectedIssue)	Clinical issue with action
eventHistory		0..*	Reference(Provenance)	A list of relevant lifecycle events
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
MedicationDispense.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
MedicationDispense.identifier.use	required	IdentifierUse
MedicationDispense.identifier.type	extensible	Identifier Type Codes
MedicationDispense.status	required	Fixed Value: completed
MedicationDispense.statusReason[x]	example	MedicationDispense Status Reason Codes
MedicationDispense.category	preferred	MedicationDispense Category Codes
MedicationDispense.medication[x]	example	SNOMEDCTMedicationCodes
MedicationDispense.subject.type	extensible	ResourceType
MedicationDispense.performer.function	example	MedicationDispense Performer Function Codes
MedicationDispense.performer.actor.type	extensible	ResourceType
MedicationDispense.type	example	ActPharmacySupplyType
MedicationDispense.substitution.type	required	ActSubstanceAdminSubstitutionCode
MedicationDispense.substitution.reason	example	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-emed-dis-1	error	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

Summary

Mandatory: 10 elements (1 nested mandatory element)
Fixed Value: 2 elements

Structures

This structure refers to these other structures:

• CH EMED Medication (MedicationDispense) (http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-medication-medicationdispense)
• CH Core Patient (http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient)
• CH EMED PractitionerRole (http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-practitionerrole)
• CH EMED Dosage (MedicationStatement / MedicationDispense) (http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-dosage)
• CH EMED Dosage Split (http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-dosage-split)

Extensions

This structure refers to these extensions:

• http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentreason
• http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-prescription
• http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-pharmaceuticaladvice
• http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-treatmentplan

Slices

This structure defines the following Slices:

• The element MedicationDispense.medication[x] is sliced based on the value of type:$this
• The element MedicationDispense.dosageInstruction is sliced based on the value of profile:$this (Closed)