This page is part of the CH EMED (R4) (v5.0.0: STU 5) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

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Resource Profile: CH EMED MedicationDispense (LIST)

Definition of the medication dispense for the medication list document

Usage:

• Refer to this Resource Profile: CH EMED Medication List Composition
• Examples for this Resource Profile: MedicationDispense/2-1-MedDispTriatec

Formal Views of Profile Content

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

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

This structure is derived from CHEMEDMedicationDispense

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense		0..*	CHEMEDMedicationDispense	CH EMED MedicationDispense (LIST)
Slices for extension				Content/Rules for all slices
parentDocument		0..1	(Complex)	Reference to the parent document URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense
authorDocument		0..1	Reference(CH Core Patient | CH Core PractitionerRole | RelatedPerson)	Author of the original document if different from the author of the medical decision (MedicationDispense.performer.actor), see also 'Guidance - Authorship' URL: http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-author
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	CHEMEDMedicationDispense	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.
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
contained		1..*	Resource	Contained, inline Resources
Slices for extension				Content/Rules for all slices
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 the medication prescription 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		0..1	(Complex)	Reference to the pharmaceutical advice 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		0..1	(Complex)	Reference to the medication treatment plan 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		0..1	(Complex)	Reference to the parent document 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	Reference(CH Core Patient | CH Core PractitionerRole | RelatedPerson)	Author of the original document if different from the author of the medical decision (MedicationDispense.performer.actor), see also 'Guidance - Authorship' 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
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
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
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
Slices for medication[x]	Σ	1..1		What medication was supplied Slice: Unordered, Open by type:$this Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying which substance or product can be dispensed. ele-1: All FHIR elements must have a @value or children
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(CH Core Medication)
medication[x]:medicationReference	Σ	0..1	Reference(CH EMED Medication (MedicationDispense)) {c}	Reference to the contained medication ele-1: All FHIR elements must have a @value or children
performer		1..1	BackboneElement	Who performed event ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
actor		1..1	Reference(CH EMED PractitionerRole)	The author of the medical decision, see also 'Guidance - Authorship' ele-1: All FHIR elements must have a @value or children
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL ele-1: All FHIR elements must have a @value or children
quantity		1..1	SimpleQuantity	Number of packages ele-1: All FHIR elements must have a @value or children
whenHandedOver		1..1	dateTime	When product was given out ele-1: All FHIR elements must have a @value or children
Slices for dosageInstruction		1..*	CHCoreDosage	How the medication should be taken Slice: Unordered, Closed by profile:$this ele-1: All FHIR elements must have a @value or children
dosageInstruction:baseEntry	C	1..1	CHEMEDDosage	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..*	CHEMEDDosageSplit	Additional entry of the dosage instruction 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.medication[x]	example	SNOMEDCTMedicationCodes http://hl7.org/fhir/ValueSet/medication-codes from the FHIR Standard

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

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	CHEMEDMedicationDispense	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.
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..*	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
parentDocument		0..1	(Complex)	Reference to the parent document URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense
authorDocument		0..1	Reference(CH Core Patient | CH Core PractitionerRole | RelatedPerson)	Author of the original document if different from the author of the medical decision (MedicationDispense.performer.actor), see also 'Guidance - Authorship' URL: http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-author
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(CH Core 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..*	CHCoreDosage	How the medication should be taken Slice: Unordered, Closed by profile:$this
dosageInstruction:baseEntry	C	1..1	CHEMEDDosage	Base entry of the dosage instruction ch-dosage-4: For split dosage timing event and dose/rate are required
dosageInstruction:additionalEntry		0..*	CHEMEDDosageSplit	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
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	URI
MedicationDispense.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
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.medication[x]	example	SNOMEDCTMedicationCodes http://hl7.org/fhir/ValueSet/medication-codes 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

This structure is derived from CHEMEDMedicationDispense

Summary

Extensions

This structure refers to these extensions:

• http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense
• http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-author

Differential View

This structure is derived from CHEMEDMedicationDispense

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense		0..*	CHEMEDMedicationDispense	CH EMED MedicationDispense (LIST)
Slices for extension				Content/Rules for all slices
parentDocument		0..1	(Complex)	Reference to the parent document URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense
authorDocument		0..1	Reference(CH Core Patient | CH Core PractitionerRole | RelatedPerson)	Author of the original document if different from the author of the medical decision (MedicationDispense.performer.actor), see also 'Guidance - Authorship' URL: http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-author
Documentation for this format

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	CHEMEDMedicationDispense	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.
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
contained		1..*	Resource	Contained, inline Resources
Slices for extension				Content/Rules for all slices
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 the medication prescription 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		0..1	(Complex)	Reference to the pharmaceutical advice 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		0..1	(Complex)	Reference to the medication treatment plan 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		0..1	(Complex)	Reference to the parent document 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	Reference(CH Core Patient | CH Core PractitionerRole | RelatedPerson)	Author of the original document if different from the author of the medical decision (MedicationDispense.performer.actor), see also 'Guidance - Authorship' 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
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
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
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
Slices for medication[x]	Σ	1..1		What medication was supplied Slice: Unordered, Open by type:$this Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying which substance or product can be dispensed. ele-1: All FHIR elements must have a @value or children
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(CH Core Medication)
medication[x]:medicationReference	Σ	0..1	Reference(CH EMED Medication (MedicationDispense)) {c}	Reference to the contained medication ele-1: All FHIR elements must have a @value or children
performer		1..1	BackboneElement	Who performed event ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
actor		1..1	Reference(CH EMED PractitionerRole)	The author of the medical decision, see also 'Guidance - Authorship' ele-1: All FHIR elements must have a @value or children
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL ele-1: All FHIR elements must have a @value or children
quantity		1..1	SimpleQuantity	Number of packages ele-1: All FHIR elements must have a @value or children
whenHandedOver		1..1	dateTime	When product was given out ele-1: All FHIR elements must have a @value or children
Slices for dosageInstruction		1..*	CHCoreDosage	How the medication should be taken Slice: Unordered, Closed by profile:$this ele-1: All FHIR elements must have a @value or children
dosageInstruction:baseEntry	C	1..1	CHEMEDDosage	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..*	CHEMEDDosageSplit	Additional entry of the dosage instruction 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.medication[x]	example	SNOMEDCTMedicationCodes http://hl7.org/fhir/ValueSet/medication-codes from the FHIR Standard

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

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
MedicationDispense	C	0..*	CHEMEDMedicationDispense	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.
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..*	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
parentDocument		0..1	(Complex)	Reference to the parent document URL: http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense
authorDocument		0..1	Reference(CH Core Patient | CH Core PractitionerRole | RelatedPerson)	Author of the original document if different from the author of the medical decision (MedicationDispense.performer.actor), see also 'Guidance - Authorship' URL: http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-author
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(CH Core 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..*	CHCoreDosage	How the medication should be taken Slice: Unordered, Closed by profile:$this
dosageInstruction:baseEntry	C	1..1	CHEMEDDosage	Base entry of the dosage instruction ch-dosage-4: For split dosage timing event and dose/rate are required
dosageInstruction:additionalEntry		0..*	CHEMEDDosageSplit	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
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	URI
MedicationDispense.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
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.medication[x]	example	SNOMEDCTMedicationCodes http://hl7.org/fhir/ValueSet/medication-codes 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

This structure is derived from CHEMEDMedicationDispense

Summary

Extensions

This structure refers to these extensions:

• http://fhir.ch/ig/ch-emed/StructureDefinition/ch-emed-ext-dispense
• http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-author

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