{
"description": "This profile defines the UK constraints and extensions on the International FHIR resource [MedicationDispense](https://hl7.org/fhir/R4/MedicationDispense.html).",
"_filename": "UKCore-MedicationDispense.json",
"package_name": "fhir.r4.ukcore.stu3.currentbuild",
"date": "2024-07-11",
"derivation": "constraint",
"publisher": "HL7 UK",
"fhirVersion": "4.0.1",
"purpose": "This profile covers the supply of medications to a patient. Examples include dispensing and pick-up from an outpatient or community pharmacy, dispensing patient-specific medications from inpatient pharmacy to ward, as well as issuing a single dose from ward stock to a patient for consumption. The medication dispense is the result of a pharmacy system responding to a medication order.",
"name": "UKCoreMedicationDispense",
"abstract": false,
"copyright": "Copyright © 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the \"License\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \"AS IS\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at https://www.hl7.org/fhir/license.html.",
"type": "MedicationDispense",
"experimental": null,
"resourceType": "StructureDefinition",
"title": "UK Core Medication Dispense",
"package_version": "0.0.17-pre-release",
"snapshot": {
"element": [ {
"constraint": [ {
"key": "dom-2",
"human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
"xpath": "not(parent::f:contained and f:contained)",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "error",
"expression": "contained.contained.empty()"
}, {
"key": "dom-4",
"human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
"xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "error",
"expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"
}, {
"key": "dom-3",
"human": "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",
"xpath": "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "error",
"expression": "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()"
}, {
"key": "dom-6",
"human": "A resource should have narrative for robust management",
"xpath": "exists(f:text/h:div)",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "warning",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
"valueBoolean": true
}, {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation",
"valueMarkdown": "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."
} ],
"expression": "text.`div`.exists()"
}, {
"key": "dom-5",
"human": "If a resource is contained in another resource, it SHALL NOT have a security label",
"xpath": "not(exists(f:contained/*/f:meta/f:security))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "error",
"expression": "contained.meta.security.empty()"
}, {
"key": "mdd-1",
"human": "whenHandedOver cannot be before whenPrepared",
"xpath": "not(exists(f:whenHandedOver/@value)) or not(exists(f:whenPrepared/@value)) or ( f:whenHandedOver/@value >= f:whenPrepared/@value)",
"source": "http://hl7.org/fhir/StructureDefinition/MedicationDispense",
"severity": "error",
"expression": "whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared"
} ],
"path": "MedicationDispense",
"min": 0,
"definition": "Indicates that a medication product is to be or has been dispensed for a named person/patient. This includes a description of the medication product (supply) provided and the instructions for administering the medication. The medication dispense is the result of a pharmacy system responding to a medication order.",
"short": "Dispensing a medication to a named patient",
"mapping": [ {
"map": "Entity. Role, or Act",
"identity": "rim"
}, {
"map": "Event",
"identity": "workflow"
}, {
"map": "Supply[moodCode=EVN]",
"identity": "rim"
} ],
"max": "*",
"id": "MedicationDispense",
"base": {
"max": "*",
"min": 0,
"path": "MedicationDispense"
}
}, {
"path": "MedicationDispense.id",
"min": 0,
"definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
"short": "Logical id of this artifact",
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"max": "1",
"id": "MedicationDispense.id",
"comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
"base": {
"max": "1",
"min": 0,
"path": "Resource.id"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationDispense.meta",
"min": 0,
"definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.",
"short": "Metadata about the resource",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Meta"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"max": "1",
"id": "MedicationDispense.meta",
"condition": [ "ele-1" ],
"base": {
"max": "1",
"min": 0,
"path": "Resource.meta"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationDispense.implicitRules",
"min": 0,
"definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.",
"isModifier": true,
"short": "A set of rules under which this content was created",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "uri"
} ],
"max": "1",
"id": "MedicationDispense.implicitRules",
"condition": [ "ele-1" ],
"comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.",
"base": {
"max": "1",
"min": 0,
"path": "Resource.implicitRules"
},
"isModifierReason": "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationDispense.language",
"min": 0,
"definition": "The base language in which the resource is written.",
"short": "Language of the resource content",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"binding": {
"strength": "preferred",
"valueSet": "http://hl7.org/fhir/ValueSet/languages",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
"valueCanonical": "http://hl7.org/fhir/ValueSet/all-languages"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "Language"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
"valueBoolean": true
} ],
"description": "A human language."
},
"max": "1",
"id": "MedicationDispense.language",
"condition": [ "ele-1" ],
"comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
"base": {
"max": "1",
"min": 0,
"path": "Resource.language"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationDispense.text",
"min": 0,
"definition": "A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
"short": "Text summary of the resource, for human interpretation",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "N/A",
"identity": "rim"
}, {
"map": "Act.text?",
"identity": "rim"
} ],
"type": [ {
"code": "Narrative"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"alias": [ "narrative", "html", "xhtml", "display" ],
"max": "1",
"id": "MedicationDispense.text",
"condition": [ "ele-1" ],
"comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded information is added later.",
"base": {
"max": "1",
"min": 0,
"path": "DomainResource.text"
}
}, {
"path": "MedicationDispense.contained",
"min": 0,
"definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
"short": "Contained, inline Resources",
"mapping": [ {
"map": "Entity. Role, or Act",
"identity": "rim"
}, {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Resource"
} ],
"alias": [ "inline resources", "anonymous resources", "contained resources" ],
"max": "*",
"id": "MedicationDispense.contained",
"comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.",
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.contained"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationDispense.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "N/A",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationDispense.extension",
"condition": [ "ele-1" ],
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.extension"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationDispense.modifierExtension",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"isModifier": true,
"short": "Extensions that cannot be ignored",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "N/A",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationDispense.modifierExtension",
"condition": [ "ele-1" ],
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.modifierExtension"
},
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them"
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationDispense.identifier",
"min": 0,
"definition": "Identifiers associated with this Medication Dispense that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.",
"short": "Allows the resource to be referenced within / by other resources.",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)",
"identity": "v2"
}, {
"map": "II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]",
"identity": "rim"
}, {
"map": "Identifier",
"identity": "servd"
}, {
"map": "Event.identifier",
"identity": "workflow"
}, {
"map": "FiveWs.identifier",
"identity": "w5"
}, {
"map": ".id",
"identity": "rim"
}, {
"map": "CombinedMedicationDispense.id",
"identity": "rx-dispense-rmim"
} ],
"type": [ {
"code": "Identifier"
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"max": "*",
"id": "MedicationDispense.identifier",
"condition": [ "ele-1" ],
"comment": "This is a business identifier, not a resource identifier.",
"base": {
"max": "*",
"min": 0,
"path": "MedicationDispense.identifier"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ref-1",
"human": "SHALL have a contained resource if a local reference is provided",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference",
"severity": "error",
"expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"
} ],
"path": "MedicationDispense.partOf",
"min": 0,
"definition": "The procedure that trigger the dispense.",
"short": "Event that dispense is part of",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
"identity": "rim"
}, {
"map": "Event.partOf",
"identity": "workflow"
}, {
"map": ".outboundRelationship[typeCode=COMP]/target[classCode=PROC,moodCode=EVN]",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Procedure" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"max": "*",
"id": "MedicationDispense.partOf",
"condition": [ "ele-1" ],
"comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
"base": {
"max": "*",
"min": 0,
"path": "MedicationDispense.partOf"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationDispense.status",
"min": 1,
"definition": "A code specifying the state of the set of dispense events.",
"isModifier": true,
"short": "A code that describes the status of the dispensing event.",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "Event.status",
"identity": "workflow"
}, {
"map": "FiveWs.status",
"identity": "w5"
}, {
"map": ".statusCode",
"identity": "rim"
}, {
"map": "CombinedMedicationDispense.SupplyEvent.statusCode",
"identity": "rx-dispense-rmim"
} ],
"type": [ {
"code": "code"
} ],
"mustSupport": true,
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/medicationdispense-status|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationDispenseStatus"
} ],
"description": "A coded concept specifying the state of the dispense event."
},
"max": "1",
"id": "MedicationDispense.status",
"condition": [ "ele-1" ],
"comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
"base": {
"max": "1",
"min": 1,
"path": "MedicationDispense.status"
},
"isModifierReason": "This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationDispense.statusReason[x]",
"min": 0,
"definition": "Indicates the reason why a dispense was not performed.",
"short": "Why a dispense was not performed",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "Event.statusReason",
"identity": "workflow"
}, {
"map": ".outboundRelationship[typeCode=RSON]/target[classCode=OBS,moodCode=EVN, code=\"not done reason\"].value",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
}, {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/DetectedIssue" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/medicationdispense-status-reason",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationDispenseStatusReason"
} ],
"description": "A code describing why a dispense was not performed."
},
"max": "1",
"id": "MedicationDispense.statusReason[x]",
"condition": [ "ele-1" ],
"base": {
"max": "1",
"min": 0,
"path": "MedicationDispense.statusReason[x]"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationDispense.category",
"min": 0,
"definition": "Indicates the type of medication dispense (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)).",
"short": "Type of medication dispense",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "CE/CNE/CWE",
"identity": "v2"
}, {
"map": "CD",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
"identity": "orim"
}, {
"map": ".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code=\"type of medication dispense\"].value",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"binding": {
"strength": "preferred",
"valueSet": "http://hl7.org/fhir/ValueSet/medicationdispense-category",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationDispenseCategory"
} ],
"description": "A code describing where the dispensed medication is expected to be consumed or administered."
},
"max": "1",
"id": "MedicationDispense.category",
"condition": [ "ele-1" ],
"comment": "The category can be used to include where the medication is expected to be consumed or other types of dispenses. Invariants can be used to bind to different value sets when profiling to bind.",
"base": {
"max": "1",
"min": 0,
"path": "MedicationDispense.category"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationDispense.medication[x]",
"min": 1,
"definition": "Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.",
"short": "What medication was supplied.",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "Event.code",
"identity": "workflow"
}, {
"map": "FiveWs.what[x]",
"identity": "w5"
}, {
"map": "RXD-2-Dispense/Give Code",
"identity": "v2"
}, {
"map": ".participation[typeCode=PRD].role",
"identity": "rim"
}, {
"map": "CombinedMedicationRequest.component1.AdministrationRequest.consumable",
"identity": "rx-dispense-rmim"
} ],
"type": [ {
"code": "CodeableConcept"
}, {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Medication" ]
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationCode",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationCode"
} ],
"description": "A coded concept identifying which substance or product can be dispensed."
},
"max": "1",
"id": "MedicationDispense.medication[x]",
"condition": [ "ele-1" ],
"comment": "If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource.",
"base": {
"max": "1",
"min": 1,
"path": "MedicationDispense.medication[x]"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ref-1",
"human": "SHALL have a contained resource if a local reference is provided",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference",
"severity": "error",
"expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"
} ],
"path": "MedicationDispense.subject",
"min": 0,
"definition": "A link to a resource representing the person or the group to whom the medication will be given.",
"short": "Identifies the patient.",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
"identity": "rim"
}, {
"map": "Event.subject",
"identity": "workflow"
}, {
"map": "FiveWs.subject[x]",
"identity": "w5"
}, {
"map": "PID-3-Patient ID List",
"identity": "v2"
}, {
"map": ".participation[typeCode=SBJ].role[classCode=PAT]",
"identity": "rim"
}, {
"map": "FiveWs.subject",
"identity": "w5"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Patient", "http://hl7.org/fhir/StructureDefinition/Group" ]
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"max": "1",
"id": "MedicationDispense.subject",
"condition": [ "ele-1" ],
"comment": "SubstanceAdministration->subject->Patient.",
"base": {
"max": "1",
"min": 0,
"path": "MedicationDispense.subject"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ref-1",
"human": "SHALL have a contained resource if a local reference is provided",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference",
"severity": "error",
"expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"
} ],
"path": "MedicationDispense.context",
"min": 0,
"definition": "The encounter or episode of care that establishes the context for this event.",
"short": "Encounter / Episode associated with event",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
"identity": "rim"
}, {
"map": "Event.context",
"identity": "workflow"
}, {
"map": ".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code=\"type of encounter or episode\"]",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Encounter", "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"max": "1",
"id": "MedicationDispense.context",
"condition": [ "ele-1" ],
"comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
"base": {
"max": "1",
"min": 0,
"path": "MedicationDispense.context"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ref-1",
"human": "SHALL have a contained resource if a local reference is provided",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference",
"severity": "error",
"expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"
} ],
"path": "MedicationDispense.supportingInformation",
"min": 0,
"definition": "Additional information that supports the medication being dispensed.",
"short": "Information that supports the dispensing of the medication",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
"identity": "rim"
}, {
"map": "FiveWs.context",
"identity": "w5"
}, {
"map": ".outboundRelationship[typeCode=PERT].target[A_SupportingClinicalStatement CMET minimal with many different choices of classCodes(ORG, ENC, PROC, SPLY, SBADM, OBS) and each of the act class codes draws from one or more of the following moodCodes (EVN, DEF, INT PRMS, RQO, PRP, APT, ARQ, GOL)]",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Resource" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"max": "*",
"id": "MedicationDispense.supportingInformation",
"condition": [ "ele-1" ],
"comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
"base": {
"max": "*",
"min": 0,
"path": "MedicationDispense.supportingInformation"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationDispense.performer",
"min": 0,
"definition": "Indicates who or what performed the event.",
"short": "Who or what performed the dispensing event.",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "Event.performer",
"identity": "workflow"
}, {
"map": ".participation[typeCode=PRF]",
"identity": "rim"
} ],
"type": [ {
"code": "BackboneElement"
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"max": "*",
"id": "MedicationDispense.performer",
"condition": [ "ele-1" ],
"base": {
"max": "*",
"min": 0,
"path": "MedicationDispense.performer"
}
}, {
"path": "MedicationDispense.performer.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationDispense.performer.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationDispense.performer.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "N/A",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationDispense.performer.extension",
"condition": [ "ele-1" ],
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationDispense.performer.modifierExtension",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"isModifier": true,
"short": "Extensions that cannot be ignored even if unrecognized",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"alias": [ "extensions", "user content", "modifiers" ],
"max": "*",
"id": "MedicationDispense.performer.modifierExtension",
"condition": [ "ele-1" ],
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "BackboneElement.modifierExtension"
},
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationDispense.performer.function",
"requirements": "Allows disambiguation of the types of involvement of different performers.",
"min": 0,
"definition": "Distinguishes the type of performer in the dispense. For example, date enterer, packager, final checker.",
"short": "Who performed the dispense and what they did",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "CE/CNE/CWE",
"identity": "v2"
}, {
"map": "CD",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
"identity": "orim"
}, {
"map": "participation[typeCode=PRF].functionCode",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/medicationdispense-performer-function",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationDispensePerformerFunction"
} ],
"description": "A code describing the role an individual played in dispensing a medication."
},
"max": "1",
"id": "MedicationDispense.performer.function",
"condition": [ "ele-1" ],
"comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
"base": {
"max": "1",
"min": 0,
"path": "MedicationDispense.performer.function"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ref-1",
"human": "SHALL have a contained resource if a local reference is provided",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference",
"severity": "error",
"expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"
} ],
"path": "MedicationDispense.performer.actor",
"min": 1,
"definition": "The device, practitioner, etc. who performed the action. It should be assumed that the actor is the dispenser of the medication.",
"short": "Individual who was performing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
"identity": "rim"
}, {
"map": "Event.performer.actor",
"identity": "workflow"
}, {
"map": ".role",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/PractitionerRole", "http://hl7.org/fhir/StructureDefinition/Organization", "http://hl7.org/fhir/StructureDefinition/Patient", "http://hl7.org/fhir/StructureDefinition/Device", "http://hl7.org/fhir/StructureDefinition/RelatedPerson" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"max": "1",
"id": "MedicationDispense.performer.actor",
"condition": [ "ele-1" ],
"comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
"base": {
"max": "1",
"min": 1,
"path": "MedicationDispense.performer.actor"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ref-1",
"human": "SHALL have a contained resource if a local reference is provided",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference",
"severity": "error",
"expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"
} ],
"path": "MedicationDispense.location",
"min": 0,
"definition": "The principal physical location where the dispense was performed.",
"short": "Where the dispense occurred",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
"identity": "rim"
}, {
"map": ".participation[typeCode=LOC].role",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Location" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"max": "1",
"id": "MedicationDispense.location",
"condition": [ "ele-1" ],
"comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
"base": {
"max": "1",
"min": 0,
"path": "MedicationDispense.location"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ref-1",
"human": "SHALL have a contained resource if a local reference is provided",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference",
"severity": "error",
"expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"
} ],
"path": "MedicationDispense.authorizingPrescription",
"min": 0,
"definition": "Indicates the medication order that is being dispensed against.",
"short": "Medication order that authorizes the dispense",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
"identity": "rim"
}, {
"map": "Event.basedOn",
"identity": "workflow"
}, {
"map": "ORC-2 Placer Order Number",
"identity": "v2"
}, {
"map": ".outboundRelationship[typeCode=FLFS].target[moodCode=RQO]",
"identity": "rim"
}, {
"map": "CombinedMedicationDispense.inFulfillmentOf",
"identity": "rx-dispense-rmim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/MedicationRequest" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"max": "*",
"id": "MedicationDispense.authorizingPrescription",
"condition": [ "ele-1" ],
"comment": "Maps to basedOn in Event logical model.",
"base": {
"max": "*",
"min": 0,
"path": "MedicationDispense.authorizingPrescription"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationDispense.type",
"min": 0,
"definition": "Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.",
"short": "Trial fill, partial fill, emergency fill, etc.",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "CE/CNE/CWE",
"identity": "v2"
}, {
"map": "CD",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
"identity": "orim"
}, {
"map": "RXD-33-Dispense Type",
"identity": "v2"
}, {
"map": ".code",
"identity": "rim"
}, {
"map": "CombinedMedicationDispense.SupplyEvent.code",
"identity": "rx-dispense-rmim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"binding": {
"strength": "extensible",
"valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationSupplyType",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationDispenseType"
} ],
"description": "Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc."
},
"max": "1",
"id": "MedicationDispense.type",
"condition": [ "ele-1" ],
"comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
"base": {
"max": "1",
"min": 0,
"path": "MedicationDispense.type"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "qty-3",
"human": "If a code for the unit is present, the system SHALL also be present",
"xpath": "not(exists(f:code)) or exists(f:system)",
"source": "http://hl7.org/fhir/StructureDefinition/Quantity",
"severity": "error",
"expression": "code.empty() or system.exists()"
}, {
"key": "sqty-1",
"human": "The comparator is not used on a SimpleQuantity",
"xpath": "not(exists(f:comparator))",
"source": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity",
"severity": "error",
"expression": "comparator.empty()"
} ],
"path": "MedicationDispense.quantity",
"min": 0,
"definition": "The amount of medication that has been dispensed. Includes unit of measure.",
"isModifier": false,
"short": "Quantity of medication dispensed.",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "SN (see also Range) or CQ",
"identity": "v2"
}, {
"map": "PQ, IVL, MO, CO, depending on the values",
"identity": "rim"
}, {
"map": "RXD-4-Actual Dispense Amount / RXD-5.1-Actual Dispense Units.code / RXD-5.3-Actual Dispense Units.name of coding system",
"identity": "v2"
}, {
"map": ".quantity",
"identity": "rim"
}, {
"map": "CombinedMedicationDispense.SupplyEvent.quantity",
"identity": "rx-dispense-rmim"
} ],
"type": [ {
"code": "Quantity",
"profile": [ "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" ]
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"max": "1",
"id": "MedicationDispense.quantity",
"condition": [ "ele-1" ],
"comment": "The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.",
"base": {
"max": "1",
"min": 0,
"path": "MedicationDispense.quantity"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "qty-3",
"human": "If a code for the unit is present, the system SHALL also be present",
"xpath": "not(exists(f:code)) or exists(f:system)",
"source": "http://hl7.org/fhir/StructureDefinition/Quantity",
"severity": "error",
"expression": "code.empty() or system.exists()"
}, {
"key": "sqty-1",
"human": "The comparator is not used on a SimpleQuantity",
"xpath": "not(exists(f:comparator))",
"source": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity",
"severity": "error",
"expression": "comparator.empty()"
} ],
"path": "MedicationDispense.daysSupply",
"min": 0,
"definition": "The amount of medication expressed as a timing amount.",
"isModifier": false,
"short": "Amount of medication expressed as a timing amount",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "SN (see also Range) or CQ",
"identity": "v2"
}, {
"map": "PQ, IVL, MO, CO, depending on the values",
"identity": "rim"
}, {
"map": "TQ1.6 Timing/Quantity Segment Service Duration.\rPrior to v2.5, ORC.7.3 Common Order Segment / Quantity/Timing / Duration component. This is a formatted string, first character for the time unit (e.g., D=days), followed by the value. For example, “D14” represents “14 days supply”\rFrom v2.5 on, TQ1.6 Timing/Quantity Segment / Service Duration. This is a CQ data type ( ^ ), thus for days supply, assuming the unit of measure is “days”, the numeric value is TQ1.6.1 (…|14^\rFor backwards compatibility, ORC.7 was permitted through v2.6. Both forms (field and segment) may be present in v2.5, v2.5.1, and v2.6",
"identity": "v2"
}, {
"map": "effectiveUseTime",
"identity": "rim"
} ],
"type": [ {
"code": "Quantity",
"profile": [ "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"max": "1",
"id": "MedicationDispense.daysSupply",
"condition": [ "ele-1" ],
"comment": "The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.",
"base": {
"max": "1",
"min": 0,
"path": "MedicationDispense.daysSupply"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationDispense.whenPrepared",
"min": 0,
"definition": "The time when the dispensed product was packaged and reviewed.",
"short": "Timestamp for when the medication was prepared.",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "RXD-3-Date/Time Dispensed",
"identity": "v2"
}, {
"map": ".effectiveTime[xmi:type=IVL_TS].low",
"identity": "rim"
}, {
"map": "CombinedMedicationDispense.SupplyEvent.effectiveTime",
"identity": "rx-dispense-rmim"
} ],
"type": [ {
"code": "dateTime"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationDispense.whenPrepared",
"condition": [ "ele-1" ],
"base": {
"max": "1",
"min": 0,
"path": "MedicationDispense.whenPrepared"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationDispense.whenHandedOver",
"min": 0,
"definition": "The time the dispensed product was provided to the patient or their representative.",
"short": "When product was given out",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "Event.occurrence[x]",
"identity": "workflow"
}, {
"map": "RXD-3-Date/Time Dispensed",
"identity": "v2"
}, {
"map": ".effectiveTime[xmi:type=IVL_TS].high",
"identity": "rim"
}, {
"map": "CombinedMedicationDispense.SupplyEvent.effectiveTime",
"identity": "rx-dispense-rmim"
} ],
"type": [ {
"code": "dateTime"
} ],
"max": "1",
"id": "MedicationDispense.whenHandedOver",
"condition": [ "ele-1" ],
"base": {
"max": "1",
"min": 0,
"path": "MedicationDispense.whenHandedOver"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ref-1",
"human": "SHALL have a contained resource if a local reference is provided",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference",
"severity": "error",
"expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"
} ],
"path": "MedicationDispense.destination",
"min": 0,
"definition": "Identification of the facility/location where the medication was shipped to, as part of the dispense event.",
"short": "Where the medication was sent",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
"identity": "rim"
}, {
"map": "RXD-13 Dispense-to Location; RXD-30 Dispense to Pharmacy; RXD-31 Dispense to Pharmacy Address",
"identity": "v2"
}, {
"map": ".participation[typeCode=DST].role",
"identity": "rim"
}, {
"map": "CombinedMedicationDispense.SupplyEvent.destination",
"identity": "rx-dispense-rmim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Location" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"max": "1",
"id": "MedicationDispense.destination",
"condition": [ "ele-1" ],
"comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
"base": {
"max": "1",
"min": 0,
"path": "MedicationDispense.destination"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ref-1",
"human": "SHALL have a contained resource if a local reference is provided",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference",
"severity": "error",
"expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"
} ],
"path": "MedicationDispense.receiver",
"min": 0,
"definition": "Identifies the person who picked up the medication. This will usually be a patient or their caregiver, but some cases exist where it can be a healthcare professional.",
"short": "Who collected the medication",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
"identity": "rim"
}, {
"map": ".participation[typeCode=RCV].role",
"identity": "rim"
}, {
"map": "CombinedMedicationDispense.SupplyEvent.receiver",
"identity": "rx-dispense-rmim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Patient", "http://hl7.org/fhir/StructureDefinition/Practitioner" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"max": "*",
"id": "MedicationDispense.receiver",
"condition": [ "ele-1" ],
"comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
"base": {
"max": "*",
"min": 0,
"path": "MedicationDispense.receiver"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationDispense.note",
"min": 0,
"definition": "Extra information about the dispense that could not be conveyed in the other attributes.",
"short": "Information about the dispense",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "N/A",
"identity": "v2"
}, {
"map": "Act",
"identity": "rim"
}, {
"map": "Event.note",
"identity": "workflow"
}, {
"map": "RXD-9 Dispense Notes",
"identity": "v2"
}, {
"map": ".inboundRelationship[typeCode=SUBJ]/source[classCode=ACT,moodCode=EVN]",
"identity": "rim"
} ],
"type": [ {
"code": "Annotation"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"max": "*",
"id": "MedicationDispense.note",
"condition": [ "ele-1" ],
"comment": "For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. *Annotations SHOULD NOT* be used to communicate \"modifying\" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).",
"base": {
"max": "*",
"min": 0,
"path": "MedicationDispense.note"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationDispense.dosageInstruction",
"min": 0,
"definition": "Indicates how the medication is to be used by the patient.",
"short": "Dosage instruction for the dispensed medication.",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": ".outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]",
"identity": "rim"
} ],
"type": [ {
"code": "Dosage"
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "trial-use"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"max": "*",
"id": "MedicationDispense.dosageInstruction",
"condition": [ "ele-1" ],
"comment": "When the dose or rate is intended to change over the entire administration period (e.g. Tapering dose prescriptions), multiple instances of dosage instructions will need to be supplied to convey the different doses/rates.\rThe pharmacist reviews the medication order prior to dispense and updates the dosageInstruction based on the actual product being dispensed.",
"base": {
"max": "*",
"min": 0,
"path": "MedicationDispense.dosageInstruction"
}
}, {
"path": "MedicationDispense.dosageInstruction.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationDispense.dosageInstruction.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationDispense.dosageInstruction.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "N/A",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationDispense.dosageInstruction.extension",
"condition": [ "ele-1" ],
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationDispense.dosageInstruction.modifierExtension",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"isModifier": true,
"short": "Extensions that cannot be ignored even if unrecognized",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"alias": [ "extensions", "user content", "modifiers" ],
"max": "*",
"id": "MedicationDispense.dosageInstruction.modifierExtension",
"condition": [ "ele-1" ],
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "BackboneElement.modifierExtension"
},
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationDispense.dosageInstruction.sequence",
"requirements": "If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential.",
"min": 0,
"definition": "Indicates the order in which the dosage instructions should be applied or interpreted.",
"short": "The order of the dosage instructions",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "TQ1-1",
"identity": "v2"
}, {
"map": ".text",
"identity": "rim"
} ],
"type": [ {
"code": "integer"
} ],
"max": "1",
"id": "MedicationDispense.dosageInstruction.sequence",
"condition": [ "ele-1" ],
"comment": "32 bit number; for values larger than this, use decimal",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.sequence"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationDispense.dosageInstruction.text",
"requirements": "Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text.",
"min": 0,
"definition": "Free text dosage instructions e.g. SIG.",
"short": "Free text dosage instructions.",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "RXO-6; RXE-21",
"identity": "v2"
}, {
"map": ".text",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"mustSupport": true,
"max": "1",
"id": "MedicationDispense.dosageInstruction.text",
"condition": [ "ele-1" ],
"comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.text"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationDispense.dosageInstruction.additionalInstruction",
"requirements": "Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, \"Swallow with plenty of water\" which might or might not be coded.",
"min": 0,
"definition": "Supplemental instructions to the patient on how to take the medication (e.g. \"with meals\" or\"take half to one hour before food\") or warnings for the patient about the medication (e.g. \"may cause drowsiness\" or \"avoid exposure of skin to direct sunlight or sunlamps\").",
"short": "Supplemental instruction or warnings to the patient - e.g. \"with meals\", \"may cause drowsiness\"",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "CE/CNE/CWE",
"identity": "v2"
}, {
"map": "CD",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
"identity": "orim"
}, {
"map": "RXO-7",
"identity": "v2"
}, {
"map": ".text",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/additional-instruction-codes",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "AdditionalInstruction"
} ],
"description": "A coded concept identifying additional instructions such as \"take with water\" or \"avoid operating heavy machinery\"."
},
"max": "*",
"id": "MedicationDispense.dosageInstruction.additionalInstruction",
"condition": [ "ele-1" ],
"comment": "Information about administration or preparation of the medication (e.g. \"infuse as rapidly as possibly via intraperitoneal port\" or \"immediately following drug x\") should be populated in dosage.text.",
"base": {
"max": "*",
"min": 0,
"path": "Dosage.additionalInstruction"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationDispense.dosageInstruction.patientInstruction",
"min": 0,
"definition": "Instructions in terms that are understood by the patient or consumer.",
"short": "Patient or consumer oriented instructions",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "RXO-7",
"identity": "v2"
}, {
"map": ".text",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"max": "1",
"id": "MedicationDispense.dosageInstruction.patientInstruction",
"condition": [ "ele-1" ],
"comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.patientInstruction"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationDispense.dosageInstruction.timing",
"requirements": "The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: \"Every 8 hours\"; \"Three times a day\"; \"1/2 an hour before breakfast for 10 days from 23-Dec 2011:\"; \"15 Oct 2013, 17 Oct 2013 and 1 Nov 2013\". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.",
"min": 0,
"definition": "When medication should be administered.",
"short": "When medication should be administered.",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "N/A",
"identity": "v2"
}, {
"map": "QSET (GTS)",
"identity": "rim"
}, {
"map": ".effectiveTime",
"identity": "rim"
} ],
"type": [ {
"code": "Timing"
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"max": "1",
"id": "MedicationDispense.dosageInstruction.timing",
"condition": [ "ele-1" ],
"comment": "This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing.",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.timing"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationDispense.dosageInstruction.asNeeded[x]",
"min": 0,
"definition": "Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept).",
"short": "Take \"as needed\" (for x)",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "TQ1-9",
"identity": "v2"
}, {
"map": ".outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code=\"as needed\"].value=boolean or codable concept",
"identity": "rim"
} ],
"type": [ {
"code": "boolean"
}, {
"code": "CodeableConcept"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"binding": {
"strength": "preferred",
"valueSet": "http://hl7.org/fhir/ValueSet/medication-as-needed-reason",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationAsNeededReason"
} ],
"description": "A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example \"pain\", \"30 minutes prior to sexual intercourse\", \"on flare-up\" etc."
},
"max": "1",
"id": "MedicationDispense.dosageInstruction.asNeeded[x]",
"condition": [ "ele-1" ],
"comment": "Can express \"as needed\" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express \"as needed\" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not \"prn\" or \"as needed\".",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.asNeeded[x]"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationDispense.dosageInstruction.site",
"requirements": "A coded specification of the anatomic site where the medication first enters the body.",
"min": 0,
"definition": "Body site to administer to.",
"short": "Body site to administer to",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "CE/CNE/CWE",
"identity": "v2"
}, {
"map": "CD",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
"identity": "orim"
}, {
"map": "RXR-2",
"identity": "v2"
}, {
"map": ".approachSiteCode",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-BodySite",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationAdministrationSite"
} ],
"description": "A coded concept describing the site location the medicine enters into or onto the body."
},
"max": "1",
"id": "MedicationDispense.dosageInstruction.site",
"condition": [ "ele-1" ],
"comment": "If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [bodySite](extension-bodysite.html). May be a summary code, or a reference to a very precise definition of the location, or both.",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.site"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationDispense.dosageInstruction.route",
"requirements": "A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body.",
"min": 0,
"definition": "How drug should enter body.",
"short": "How drug should enter body",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "CE/CNE/CWE",
"identity": "v2"
}, {
"map": "CD",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
"identity": "orim"
}, {
"map": "RXR-1",
"identity": "v2"
}, {
"map": ".routeCode",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-SubstanceOrProductAdministrationRoute",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "RouteOfAdministration"
} ],
"description": "A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject."
},
"max": "1",
"id": "MedicationDispense.dosageInstruction.route",
"condition": [ "ele-1" ],
"comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.route"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationDispense.dosageInstruction.method",
"requirements": "A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV.",
"min": 0,
"definition": "Technique for administering medication.",
"short": "Technique for administering medication",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "CE/CNE/CWE",
"identity": "v2"
}, {
"map": "CD",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
"identity": "orim"
}, {
"map": "RXR-4",
"identity": "v2"
}, {
"map": ".doseQuantity",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationDosageMethod",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationAdministrationMethod"
} ],
"description": "A coded concept describing the technique by which the medicine is administered."
},
"max": "1",
"id": "MedicationDispense.dosageInstruction.method",
"condition": [ "ele-1" ],
"comment": "Terminologies used often pre-coordinate this term with the route and or form of administration.",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.method"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationDispense.dosageInstruction.doseAndRate",
"min": 0,
"definition": "The amount of medication administered.",
"short": "Dosage instructions for the medication.",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "TQ1-2",
"identity": "v2"
} ],
"type": [ {
"code": "Element"
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"max": "*",
"id": "MedicationDispense.dosageInstruction.doseAndRate",
"condition": [ "ele-1" ],
"base": {
"max": "*",
"min": 0,
"path": "Dosage.doseAndRate"
},
"isSummary": true
}, {
"path": "MedicationDispense.dosageInstruction.doseAndRate.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationDispense.dosageInstruction.doseAndRate.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationDispense.dosageInstruction.doseAndRate.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "N/A",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationDispense.dosageInstruction.doseAndRate.extension",
"condition": [ "ele-1" ],
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationDispense.dosageInstruction.doseAndRate.type",
"requirements": "If the type is not populated, assume to be \"ordered\".",
"min": 0,
"definition": "The kind of dose or rate specified, for example, ordered or calculated.",
"short": "The kind of dose or rate specified",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "CE/CNE/CWE",
"identity": "v2"
}, {
"map": "CD",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
"identity": "orim"
}, {
"map": "RXO-21; RXE-23",
"identity": "v2"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/dose-rate-type",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "DoseAndRateType"
} ],
"description": "The kind of dose or rate specified."
},
"max": "1",
"id": "MedicationDispense.dosageInstruction.doseAndRate.type",
"condition": [ "ele-1" ],
"comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.doseAndRate.type"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationDispense.dosageInstruction.doseAndRate.dose[x]",
"requirements": "The amount of therapeutic or other substance given at one administration event.",
"min": 0,
"definition": "Amount of medication per dose.",
"short": "Quantity of medication administered.",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "RXO-2, RXE-3",
"identity": "v2"
}, {
"map": ".doseQuantity",
"identity": "rim"
} ],
"type": [ {
"code": "Range"
}, {
"code": "Quantity",
"profile": [ "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" ]
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"max": "1",
"id": "MedicationDispense.dosageInstruction.doseAndRate.dose[x]",
"condition": [ "ele-1" ],
"comment": "Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours.",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.doseAndRate.dose[x]"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationDispense.dosageInstruction.doseAndRate.rate[x]",
"requirements": "Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period.",
"min": 0,
"definition": "Amount of medication per unit of time.",
"short": "Rate at which the medication is to be administered.",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "RXE22, RXE23, RXE-24",
"identity": "v2"
}, {
"map": ".rateQuantity",
"identity": "rim"
} ],
"type": [ {
"code": "Ratio"
}, {
"code": "Range"
}, {
"code": "Quantity",
"profile": [ "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" ]
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"max": "1",
"id": "MedicationDispense.dosageInstruction.doseAndRate.rate[x]",
"condition": [ "ele-1" ],
"comment": "It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate.\r\rIt is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour.",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.doseAndRate.rate[x]"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "rat-1",
"human": "Numerator and denominator SHALL both be present, or both are absent. If both are absent, there SHALL be some extension present",
"xpath": "(count(f:numerator) = count(f:denominator)) and ((count(f:numerator) > 0) or (count(f:extension) > 0))",
"source": "http://hl7.org/fhir/StructureDefinition/Ratio",
"severity": "error",
"expression": "(numerator.empty() xor denominator.exists()) and (numerator.exists() or extension.exists())"
} ],
"path": "MedicationDispense.dosageInstruction.maxDosePerPeriod",
"requirements": "The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours.",
"min": 0,
"definition": "Upper limit on medication per unit of time.",
"short": "Upper limit on medication per unit of time",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "N/A",
"identity": "v2"
}, {
"map": "RTO",
"identity": "rim"
}, {
"map": "RXO-23, RXE-19",
"identity": "v2"
}, {
"map": ".maxDoseQuantity",
"identity": "rim"
} ],
"type": [ {
"code": "Ratio"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"max": "1",
"id": "MedicationDispense.dosageInstruction.maxDosePerPeriod",
"condition": [ "ele-1" ],
"comment": "This is intended for use as an adjunct to the dosage when there is an upper cap. For example \"2 tablets every 4 hours to a maximum of 8/day\".",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.maxDosePerPeriod"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "qty-3",
"human": "If a code for the unit is present, the system SHALL also be present",
"xpath": "not(exists(f:code)) or exists(f:system)",
"source": "http://hl7.org/fhir/StructureDefinition/Quantity",
"severity": "error",
"expression": "code.empty() or system.exists()"
}, {
"key": "sqty-1",
"human": "The comparator is not used on a SimpleQuantity",
"xpath": "not(exists(f:comparator))",
"source": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity",
"severity": "error",
"expression": "comparator.empty()"
} ],
"path": "MedicationDispense.dosageInstruction.maxDosePerAdministration",
"requirements": "The maximum total quantity of a therapeutic substance that may be administered to a subject per administration.",
"min": 0,
"definition": "Upper limit on medication per administration.",
"isModifier": false,
"short": "Upper limit on medication per administration",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "SN (see also Range) or CQ",
"identity": "v2"
}, {
"map": "PQ, IVL, MO, CO, depending on the values",
"identity": "rim"
}, {
"map": "not supported",
"identity": "rim"
} ],
"type": [ {
"code": "Quantity",
"profile": [ "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"max": "1",
"id": "MedicationDispense.dosageInstruction.maxDosePerAdministration",
"condition": [ "ele-1" ],
"comment": "This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg.",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.maxDosePerAdministration"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "qty-3",
"human": "If a code for the unit is present, the system SHALL also be present",
"xpath": "not(exists(f:code)) or exists(f:system)",
"source": "http://hl7.org/fhir/StructureDefinition/Quantity",
"severity": "error",
"expression": "code.empty() or system.exists()"
}, {
"key": "sqty-1",
"human": "The comparator is not used on a SimpleQuantity",
"xpath": "not(exists(f:comparator))",
"source": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity",
"severity": "error",
"expression": "comparator.empty()"
} ],
"path": "MedicationDispense.dosageInstruction.maxDosePerLifetime",
"requirements": "The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.",
"min": 0,
"definition": "Upper limit on medication per lifetime of the patient.",
"isModifier": false,
"short": "Upper limit on medication per lifetime of the patient",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "SN (see also Range) or CQ",
"identity": "v2"
}, {
"map": "PQ, IVL, MO, CO, depending on the values",
"identity": "rim"
}, {
"map": "not supported",
"identity": "rim"
} ],
"type": [ {
"code": "Quantity",
"profile": [ "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"max": "1",
"id": "MedicationDispense.dosageInstruction.maxDosePerLifetime",
"condition": [ "ele-1" ],
"comment": "The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.",
"base": {
"max": "1",
"min": 0,
"path": "Dosage.maxDosePerLifetime"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationDispense.substitution",
"min": 0,
"definition": "Indicates whether or not substitution was made as part of the dispense. In some cases, substitution will be expected but does not happen, in other cases substitution is not expected but does happen. This block explains what substitution did or did not happen and why. If nothing is specified, substitution was not done.",
"short": "Whether a substitution was performed on the dispense",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": ".outboundRelationship[typeCode=COMP].target[classCode=SUBST, moodCode=EVN]",
"identity": "rim"
}, {
"map": "CombinedMedicationDispense.substitutionMade",
"identity": "rx-dispense-rmim"
} ],
"type": [ {
"code": "BackboneElement"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"max": "1",
"id": "MedicationDispense.substitution",
"condition": [ "ele-1" ],
"base": {
"max": "1",
"min": 0,
"path": "MedicationDispense.substitution"
}
}, {
"path": "MedicationDispense.substitution.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "MedicationDispense.substitution.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationDispense.substitution.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "N/A",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "MedicationDispense.substitution.extension",
"condition": [ "ele-1" ],
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "MedicationDispense.substitution.modifierExtension",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"isModifier": true,
"short": "Extensions that cannot be ignored even if unrecognized",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"alias": [ "extensions", "user content", "modifiers" ],
"max": "*",
"id": "MedicationDispense.substitution.modifierExtension",
"condition": [ "ele-1" ],
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "BackboneElement.modifierExtension"
},
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationDispense.substitution.wasSubstituted",
"min": 1,
"definition": "True if the dispenser dispensed a different drug or product from what was prescribed.",
"short": "Whether a substitution was or was not performed on the dispense",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": ".actionNegationInd",
"identity": "rim"
} ],
"type": [ {
"code": "boolean"
} ],
"max": "1",
"id": "MedicationDispense.substitution.wasSubstituted",
"condition": [ "ele-1" ],
"base": {
"max": "1",
"min": 1,
"path": "MedicationDispense.substitution.wasSubstituted"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationDispense.substitution.type",
"min": 0,
"definition": "A code signifying whether a different drug was dispensed from what was prescribed.",
"short": "Code signifying whether a different drug was dispensed from what was prescribed",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "CE/CNE/CWE",
"identity": "v2"
}, {
"map": "CD",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
"identity": "orim"
}, {
"map": "RXO-9-Allow Substitutions / RXE-9-Substitution Status",
"identity": "v2"
}, {
"map": ".code",
"identity": "rim"
}, {
"map": "CombinedMedicationDispense.substitutionMade.code",
"identity": "rx-dispense-rmim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"binding": {
"strength": "example",
"valueSet": "http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationIntendedSubstitutionType"
} ],
"description": "A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription."
},
"max": "1",
"id": "MedicationDispense.substitution.type",
"condition": [ "ele-1" ],
"comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
"base": {
"max": "1",
"min": 0,
"path": "MedicationDispense.substitution.type"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "MedicationDispense.substitution.reason",
"min": 0,
"definition": "Indicates the reason for the substitution (or lack of substitution) from what was prescribed.",
"short": "Why was substitution made",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "CE/CNE/CWE",
"identity": "v2"
}, {
"map": "CD",
"identity": "rim"
}, {
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
"identity": "orim"
}, {
"map": ".reasonCode",
"identity": "rim"
}, {
"map": "CombinedMedicationDispense.substitutionMade.reasonCode",
"identity": "rx-dispense-rmim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"binding": {
"strength": "example",
"valueSet": "http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "MedicationIntendedSubstitutionReason"
} ],
"description": "A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed."
},
"max": "*",
"id": "MedicationDispense.substitution.reason",
"condition": [ "ele-1" ],
"comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
"base": {
"max": "*",
"min": 0,
"path": "MedicationDispense.substitution.reason"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ref-1",
"human": "SHALL have a contained resource if a local reference is provided",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference",
"severity": "error",
"expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"
} ],
"path": "MedicationDispense.substitution.responsibleParty",
"min": 0,
"definition": "The person or organization that has primary responsibility for the substitution.",
"short": "Who is responsible for the substitution",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
"identity": "rim"
}, {
"map": ".participation[typeCode=PFM].role[classCode=ASSIGN]",
"identity": "rim"
}, {
"map": "CombinedMedicationDispense.substitutionMade.ResponsibleParty",
"identity": "rx-dispense-rmim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/PractitionerRole" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"max": "*",
"id": "MedicationDispense.substitution.responsibleParty",
"condition": [ "ele-1" ],
"comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
"base": {
"max": "*",
"min": 0,
"path": "MedicationDispense.substitution.responsibleParty"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ref-1",
"human": "SHALL have a contained resource if a local reference is provided",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference",
"severity": "error",
"expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"
} ],
"path": "MedicationDispense.detectedIssue",
"min": 0,
"definition": "Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. drug-drug interaction, duplicate therapy, dosage alert etc.",
"short": "Clinical issue with action",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
"identity": "rim"
}, {
"map": ".inboundRelationship[typeCode=SUBJ]/source[classCode=ALRT,moodCode=EVN].value",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/DetectedIssue" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"alias": [ "Contraindication", "Drug Utilization Review (DUR)", "Alert" ],
"max": "*",
"id": "MedicationDispense.detectedIssue",
"condition": [ "ele-1" ],
"comment": "This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue.",
"base": {
"max": "*",
"min": 0,
"path": "MedicationDispense.detectedIssue"
}
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ref-1",
"human": "SHALL have a contained resource if a local reference is provided",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference",
"severity": "error",
"expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"
} ],
"path": "MedicationDispense.eventHistory",
"min": 0,
"definition": "A summary of the events of interest that have occurred, such as when the dispense was verified.",
"short": "A list of relevant lifecycle events",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
"identity": "rim"
}, {
"map": ".inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Provenance" ]
} ],
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"max": "*",
"id": "MedicationDispense.eventHistory",
"condition": [ "ele-1" ],
"comment": "This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.).",
"base": {
"max": "*",
"min": 0,
"path": "MedicationDispense.eventHistory"
}
} ]
},
"status": "active",
"id": "fa38e6bb-17af-4f55-94b7-0cae965b1efc",
"kind": "resource",
"url": "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationDispense",
"version": "2.4.0",
"differential": {
"element": [ {
"id": "MedicationDispense.identifier",
"path": "MedicationDispense.identifier",
"short": "Allows the resource to be referenced within / by other resources.",
"mustSupport": true
}, {
"id": "MedicationDispense.status",
"path": "MedicationDispense.status",
"short": "A code that describes the status of the dispensing event.",
"mustSupport": true
}, {
"id": "MedicationDispense.medication[x]",
"path": "MedicationDispense.medication[x]",
"short": "What medication was supplied.",
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationCode"
},
"mustSupport": true
}, {
"id": "MedicationDispense.subject",
"path": "MedicationDispense.subject",
"short": "Identifies the patient.",
"mustSupport": true
}, {
"id": "MedicationDispense.performer",
"path": "MedicationDispense.performer",
"short": "Who or what performed the dispensing event.",
"mustSupport": true
}, {
"id": "MedicationDispense.type",
"path": "MedicationDispense.type",
"binding": {
"strength": "extensible",
"valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationSupplyType"
}
}, {
"id": "MedicationDispense.quantity",
"path": "MedicationDispense.quantity",
"short": "Quantity of medication dispensed.",
"mustSupport": true
}, {
"id": "MedicationDispense.whenPrepared",
"path": "MedicationDispense.whenPrepared",
"short": "Timestamp for when the medication was prepared.",
"mustSupport": true
}, {
"id": "MedicationDispense.dosageInstruction",
"path": "MedicationDispense.dosageInstruction",
"short": "Dosage instruction for the dispensed medication.",
"mustSupport": true
}, {
"id": "MedicationDispense.dosageInstruction.text",
"path": "MedicationDispense.dosageInstruction.text",
"short": "Free text dosage instructions.",
"mustSupport": true
}, {
"id": "MedicationDispense.dosageInstruction.timing",
"path": "MedicationDispense.dosageInstruction.timing",
"short": "When medication should be administered.",
"mustSupport": true
}, {
"id": "MedicationDispense.dosageInstruction.asNeeded[x]",
"path": "MedicationDispense.dosageInstruction.asNeeded[x]",
"binding": {
"strength": "preferred"
}
}, {
"id": "MedicationDispense.dosageInstruction.site",
"path": "MedicationDispense.dosageInstruction.site",
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-BodySite"
}
}, {
"id": "MedicationDispense.dosageInstruction.route",
"path": "MedicationDispense.dosageInstruction.route",
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-SubstanceOrProductAdministrationRoute"
}
}, {
"id": "MedicationDispense.dosageInstruction.method",
"path": "MedicationDispense.dosageInstruction.method",
"binding": {
"strength": "preferred",
"valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationDosageMethod"
}
}, {
"id": "MedicationDispense.dosageInstruction.doseAndRate",
"path": "MedicationDispense.dosageInstruction.doseAndRate",
"short": "Dosage instructions for the medication.",
"mustSupport": true
}, {
"id": "MedicationDispense.dosageInstruction.doseAndRate.dose[x]",
"path": "MedicationDispense.dosageInstruction.doseAndRate.dose[x]",
"short": "Quantity of medication administered.",
"mustSupport": true
}, {
"id": "MedicationDispense.dosageInstruction.doseAndRate.rate[x]",
"path": "MedicationDispense.dosageInstruction.doseAndRate.rate[x]",
"short": "Rate at which the medication is to be administered.",
"mustSupport": true
} ]
},
"contact": [ {
"name": "HL7 UK",
"telecom": [ {
"use": "work",
"rank": 1,
"value": "ukcore@hl7.org.uk",
"system": "email"
} ]
} ],
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/MedicationDispense"
}