Overview

MedicationDispense represents the response to an order (ServiceRequest order-medication) based on a given MedicationRequest. It's created by the MediService ERP once an order has been processed and is available to clients by querying by the MedicationRequest-ID (supportingInformation) or the order-medication ServiceRequest-ID (authorizingPrescription).

A dispense records one of two outcomes, indicated by status:

• completed — the medication was dispensed and shipped to the patient.
• declined — the pharmacy did not dispense the medication, and statusReason holds the explanation.

The outcome determines which elements are present, and what medication refers to.

Elements by status

Medication

medication always identifies the medication the dispense concerns.

For a completed dispense it is the medication that was shipped to the patient. If the medication was substituted this differs from the medication on the referenced MedicationRequest.

For a declined dispense nothing was shipped to the patient so it holds the same values as the referenced MedicationRequest.

Substitution

substitution.wasSubstituted states whether the dispensed medication differs from the one requested in the referenced MedicationRequest. It applies only to a completed dispense. On a declined dispense nothing was dispensed and therefore nothing could have been substituted.

Type

The type defines the nature of the dispensation. It can be one of partially-dispensed or fully-dispensed. In case of a partial dispensation further orders for a MedicationRequest can be placed. In case of a full dispensation no further order for the MedicationRequest can be placed.

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

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
MedicationDispense	C	0..*	MedicationDispense	Dispensing a medication to a named patient Constraints: mdd-1, trxhub-md-1, trxhub-md-2, trxhub-md-3, trxhub-md-4, trxhub-md-5, trxhub-md-6
MedicationDispense.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
MedicationDispense.Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
MedicationDispense.Slices for extension.extension:shipmentTrackingUrl	S This element must be supported.	0..1	url	Shipment Tracking URL URL: https://trxhub.mediservice.ch/fhir/StructureDefinition/trxhub-shipment-tracking-url
MedicationDispense.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
MedicationDispense.status	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	1..1	code	preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown Binding: TRxHub MedicationDispense Status ValueSet (required)
MedicationDispense.statusReason[x]	S This element must be supported.	0..1	CodeableConcept	Why a dispense was not performed Binding: TRxHub MedicationDispense Status Reason ValueSet (required)
MedicationDispense.statusReason[x].coding	S This element must be supported. Σ This element is included in summaries.	1..1	Coding	Code defined by a terminology system
MedicationDispense.statusReason[x].coding.system	S This element must be supported. Σ This element is included in summaries.	1..1	uri	Identity of the terminology system Required Pattern: https://trxhub.mediservice.ch/fhir/CodeSystem/trxhub-medication-dispense-status-reason
MedicationDispense.statusReason[x].coding.code	S This element must be supported. Σ This element is included in summaries.	1..1	code	Symbol in syntax defined by the system
MedicationDispense.medication[x]	S This element must be supported. Σ This element is included in summaries.	1..1	CodeableConcept	The exact medication that has been dispensed, may differ from the requested medication if substituted; for a declined dispense, the medication that was requested but not dispensed Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying which substance or product can be dispensed.
MedicationDispense.medication[x].Slices for coding	S This element must be supported. Σ This element is included in summaries.	1..*	Coding	Code defined by a terminology system Slice: Unordered, Closed by value:system Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
MedicationDispense.medication[x].Slices for coding.coding:pharmacode	S This element must be supported. Σ This element is included in summaries.	0..1	Coding	Code defined by a terminology system
MedicationDispense.medication[x].Slices for coding.coding:pharmacode.system	S This element must be supported. Σ This element is included in summaries.	1..1	uri	Identity of the terminology system Fixed Value: urn:oid:2.51.1.3
MedicationDispense.medication[x].Slices for coding.coding:pharmacode.code	S This element must be supported. Σ This element is included in summaries.	1..1	code	Symbol in syntax defined by the system
MedicationDispense.medication[x].Slices for coding.coding:gtin	S This element must be supported. Σ This element is included in summaries.	0..1	Coding	Code defined by a terminology system
MedicationDispense.medication[x].Slices for coding.coding:gtin.system	S This element must be supported. Σ This element is included in summaries.	1..1	uri	Identity of the terminology system Fixed Value: urn:oid:1.3.160
MedicationDispense.medication[x].Slices for coding.coding:gtin.code	S This element must be supported. Σ This element is included in summaries.	1..1	code	Symbol in syntax defined by the system
MedicationDispense.medication[x].text	S This element must be supported. Σ This element is included in summaries.	0..1	string	Plain text representation of the concept
MedicationDispense.subject	S This element must be supported. Σ This element is included in summaries. C	1..1	Reference(Patient)	Who the dispense is for Constraints: trxhub-inv-patient-ref-only
MedicationDispense.supportingInformation	S This element must be supported. C	1..1	Reference(ServiceRequest)	order-medication ServiceRequest Constraints: trxhub-inv-service-request-ref-only
MedicationDispense.authorizingPrescription	S This element must be supported. C	1..1	Reference(MedicationRequest)	Medication order that authorizes the dispense Constraints: trxhub-inv-medication-request-ref-only
MedicationDispense.type	S This element must be supported.	0..1	CodeableConcept	Trial fill, partial fill, emergency fill, etc. Binding: TRxHub MedicationDispense Type ValueSet (required)
MedicationDispense.type.coding	S This element must be supported. Σ This element is included in summaries.	1..1	Coding	Code defined by a terminology system
MedicationDispense.type.coding.system	S This element must be supported. Σ This element is included in summaries.	1..1	uri	Identity of the terminology system Required Pattern: https://trxhub.mediservice.ch/fhir/CodeSystem/trxhub-medication-dispense-type
MedicationDispense.type.coding.code	S This element must be supported. Σ This element is included in summaries.	1..1	code	Symbol in syntax defined by the system
MedicationDispense.quantity	S This element must be supported. C	0..1	SimpleQuantity(4.0.1)	Amount dispensed Constraints: sqty-1
MedicationDispense.quantity.value	S This element must be supported. Σ This element is included in summaries.	1..1	decimal	Numerical value (with implicit precision)
MedicationDispense.whenHandedOver	S This element must be supported.	0..1	dateTime	When medicament was shipped
MedicationDispense.note	S This element must be supported.	0..1	Annotation	Information about the dispense
MedicationDispense.note.text	S This element must be supported. Σ This element is included in summaries.	1..1	markdown	The annotation - text content (as markdown)
MedicationDispense.substitution	S This element must be supported.	0..1	BackboneElement	Whether a substitution was performed on the dispense
MedicationDispense.substitution.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
MedicationDispense.substitution.wasSubstituted	S This element must be supported.	1..1	boolean	Whether a substitution was or was not performed on the dispense
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
MedicationDispense.status	Base	required	TRxHub MedicationDispense Status ValueSet	📦0.1.0	This IG
MedicationDispense.statusReason[x]	Base	required	TRxHub MedicationDispense Status Reason ValueSet	📦0.1.0	This IG
MedicationDispense.medication[x]	Base	example	SNOMED CT Medication Codes	📍4.0.1	FHIR Std.
MedicationDispense.type	Base	required	TRxHub MedicationDispense Type ValueSet	📦0.1.0	This IG

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	MedicationDispense	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	MedicationDispense	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationDispense	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationDispense	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	MedicationDispense	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
mdd-1	error	MedicationDispense	whenHandedOver cannot be before whenPrepared	whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared
sqty-1	error	MedicationDispense.quantity	The comparator is not used on a SimpleQuantity	comparator.empty()
trxhub-inv-medication-request-ref-only	error	MedicationDispense.authorizingPrescription	Reference must point to a MedicationRequest resource	reference.exists() implies (reference.startsWith('MedicationRequest/') or reference.startsWith('urn:uuid:'))
trxhub-inv-patient-ref-only	error	MedicationDispense.subject	Reference must point to a Patient resource	reference.exists() implies (reference.startsWith('Patient/') or reference.startsWith('urn:uuid:'))
trxhub-inv-service-request-ref-only	error	MedicationDispense.supportingInformation	Reference must point to a ServiceRequest resource	reference.exists() implies (reference.startsWith('ServiceRequest/') or reference.startsWith('urn:uuid:'))
trxhub-md-1	error	MedicationDispense	statusReason must be present when status is declined	status = 'declined' implies statusReason.exists()
trxhub-md-2	error	MedicationDispense	statusReason must not be present when status is completed	status = 'completed' implies statusReason.empty()
trxhub-md-3	error	MedicationDispense	type, quantity, whenHandedOver and substitution are required when status is completed	status = 'completed' implies (type.exists() and quantity.exists() and whenHandedOver.exists() and substitution.exists())
trxhub-md-4	error	MedicationDispense	type, quantity, whenHandedOver and substitution must not be present when status is declined	status = 'declined' implies (type.empty() and quantity.empty() and whenHandedOver.empty() and substitution.empty())
trxhub-md-5	error	MedicationDispense	shipmentTrackingUrl is required when status is completed	status = 'completed' implies extension('https://trxhub.mediservice.ch/fhir/StructureDefinition/trxhub-shipment-tracking-url').exists()
trxhub-md-6	error	MedicationDispense	shipmentTrackingUrl must not be present when status is declined	status = 'declined' implies extension('https://trxhub.mediservice.ch/fhir/StructureDefinition/trxhub-shipment-tracking-url').empty()

This structure is derived from MedicationDispense

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
MedicationDispense	C	0..*	MedicationDispense	Dispensing a medication to a named patient Constraints: trxhub-md-1, trxhub-md-2, trxhub-md-3, trxhub-md-4, trxhub-md-5, trxhub-md-6
MedicationDispense.Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
MedicationDispense.Slices for extension.extension:shipmentTrackingUrl	S This element must be supported.	0..1	url	Shipment Tracking URL URL: https://trxhub.mediservice.ch/fhir/StructureDefinition/trxhub-shipment-tracking-url
MedicationDispense.status	S This element must be supported.	1..1	code	preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown Binding: TRxHub MedicationDispense Status ValueSet (required)
MedicationDispense.statusReason[x]	S This element must be supported.	0..1	CodeableConcept	Why a dispense was not performed Binding: TRxHub MedicationDispense Status Reason ValueSet (required)
MedicationDispense.statusReason[x].coding	S This element must be supported.	1..1	Coding	Code defined by a terminology system
MedicationDispense.statusReason[x].coding.system	S This element must be supported.	1..1	uri	Identity of the terminology system Required Pattern: https://trxhub.mediservice.ch/fhir/CodeSystem/trxhub-medication-dispense-status-reason
MedicationDispense.statusReason[x].coding.code	S This element must be supported.	1..1	code	Symbol in syntax defined by the system
MedicationDispense.medication[x]	S This element must be supported.	1..1	CodeableConcept	The exact medication that has been dispensed, may differ from the requested medication if substituted; for a declined dispense, the medication that was requested but not dispensed
MedicationDispense.medication[x].Slices for coding	S This element must be supported.	1..*	Coding	Code defined by a terminology system Slice: Unordered, Closed by value:system Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
MedicationDispense.medication[x].Slices for coding.coding:pharmacode	S This element must be supported.	0..1	Coding	Code defined by a terminology system
MedicationDispense.medication[x].Slices for coding.coding:pharmacode.system	S This element must be supported.	1..1	uri	Identity of the terminology system Fixed Value: urn:oid:2.51.1.3
MedicationDispense.medication[x].Slices for coding.coding:pharmacode.code	S This element must be supported.	1..1	code	Symbol in syntax defined by the system
MedicationDispense.medication[x].Slices for coding.coding:gtin	S This element must be supported.	0..1	Coding	Code defined by a terminology system
MedicationDispense.medication[x].Slices for coding.coding:gtin.system	S This element must be supported.	1..1	uri	Identity of the terminology system Fixed Value: urn:oid:1.3.160
MedicationDispense.medication[x].Slices for coding.coding:gtin.code	S This element must be supported.	1..1	code	Symbol in syntax defined by the system
MedicationDispense.medication[x].text	S This element must be supported.	0..1	string	Plain text representation of the concept
MedicationDispense.subject	S This element must be supported. C	1..1	Reference(Patient)	Who the dispense is for Constraints: trxhub-inv-patient-ref-only
MedicationDispense.supportingInformation	S This element must be supported. C	1..1	Reference(ServiceRequest)	order-medication ServiceRequest Constraints: trxhub-inv-service-request-ref-only
MedicationDispense.authorizingPrescription	S This element must be supported. C	1..1	Reference(MedicationRequest)	Medication order that authorizes the dispense Constraints: trxhub-inv-medication-request-ref-only
MedicationDispense.type	S This element must be supported.	0..1	CodeableConcept	Trial fill, partial fill, emergency fill, etc. Binding: TRxHub MedicationDispense Type ValueSet (required)
MedicationDispense.type.coding	S This element must be supported.	1..1	Coding	Code defined by a terminology system
MedicationDispense.type.coding.system	S This element must be supported.	1..1	uri	Identity of the terminology system Required Pattern: https://trxhub.mediservice.ch/fhir/CodeSystem/trxhub-medication-dispense-type
MedicationDispense.type.coding.code	S This element must be supported.	1..1	code	Symbol in syntax defined by the system
MedicationDispense.quantity	S This element must be supported.	0..1	SimpleQuantity(4.0.1)	Amount dispensed
MedicationDispense.quantity.value	S This element must be supported.	1..1	decimal	Numerical value (with implicit precision)
MedicationDispense.whenHandedOver	S This element must be supported.	0..1	dateTime	When medicament was shipped
MedicationDispense.note	S This element must be supported.	0..1	Annotation	Information about the dispense
MedicationDispense.note.text	S This element must be supported.	1..1	markdown	The annotation - text content (as markdown)
MedicationDispense.substitution	S This element must be supported.	0..1	BackboneElement	Whether a substitution was performed on the dispense
MedicationDispense.substitution.wasSubstituted	S This element must be supported.	1..1	boolean	Whether a substitution was or was not performed on the dispense
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
MedicationDispense.status	Base	required	TRxHub MedicationDispense Status ValueSet	📦0.1.0	This IG
MedicationDispense.statusReason[x]	Base	required	TRxHub MedicationDispense Status Reason ValueSet	📦0.1.0	This IG
MedicationDispense.type	Base	required	TRxHub MedicationDispense Type ValueSet	📦0.1.0	This IG

Constraints

Id	Grade	Path(s)	Description	Expression
trxhub-inv-medication-request-ref-only	error	MedicationDispense.authorizingPrescription	Reference must point to a MedicationRequest resource	reference.exists() implies (reference.startsWith('MedicationRequest/') or reference.startsWith('urn:uuid:'))
trxhub-inv-patient-ref-only	error	MedicationDispense.subject	Reference must point to a Patient resource	reference.exists() implies (reference.startsWith('Patient/') or reference.startsWith('urn:uuid:'))
trxhub-inv-service-request-ref-only	error	MedicationDispense.supportingInformation	Reference must point to a ServiceRequest resource	reference.exists() implies (reference.startsWith('ServiceRequest/') or reference.startsWith('urn:uuid:'))
trxhub-md-1	error	MedicationDispense	statusReason must be present when status is declined	status = 'declined' implies statusReason.exists()
trxhub-md-2	error	MedicationDispense	statusReason must not be present when status is completed	status = 'completed' implies statusReason.empty()
trxhub-md-3	error	MedicationDispense	type, quantity, whenHandedOver and substitution are required when status is completed	status = 'completed' implies (type.exists() and quantity.exists() and whenHandedOver.exists() and substitution.exists())
trxhub-md-4	error	MedicationDispense	type, quantity, whenHandedOver and substitution must not be present when status is declined	status = 'declined' implies (type.empty() and quantity.empty() and whenHandedOver.empty() and substitution.empty())
trxhub-md-5	error	MedicationDispense	shipmentTrackingUrl is required when status is completed	status = 'completed' implies extension('https://trxhub.mediservice.ch/fhir/StructureDefinition/trxhub-shipment-tracking-url').exists()
trxhub-md-6	error	MedicationDispense	shipmentTrackingUrl must not be present when status is declined	status = 'declined' implies extension('https://trxhub.mediservice.ch/fhir/StructureDefinition/trxhub-shipment-tracking-url').empty()

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
MedicationDispense	C	0..*	MedicationDispense	Dispensing a medication to a named patient Constraints: mdd-1, trxhub-md-1, trxhub-md-2, trxhub-md-3, trxhub-md-4, trxhub-md-5, trxhub-md-6
MedicationDispense.id	Σ This element is included in summaries.	0..1	id	Logical id of this artifact
MedicationDispense.meta	Σ This element is included in summaries.	0..1	Meta	Metadata about the resource
MedicationDispense.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
MedicationDispense.language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
MedicationDispense.text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
MedicationDispense.contained		0..*	Resource	Contained, inline Resources
MedicationDispense.Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
MedicationDispense.Slices for extension.extension:shipmentTrackingUrl	S This element must be supported.	0..1	url	Shipment Tracking URL URL: https://trxhub.mediservice.ch/fhir/StructureDefinition/trxhub-shipment-tracking-url
MedicationDispense.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
MedicationDispense.identifier		0..*	Identifier	External identifier
MedicationDispense.partOf		0..*	Reference(Procedure)	Event that dispense is part of
MedicationDispense.status	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	1..1	code	preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown Binding: TRxHub MedicationDispense Status ValueSet (required)
MedicationDispense.statusReason[x]	S This element must be supported.	0..1	CodeableConcept	Why a dispense was not performed Binding: TRxHub MedicationDispense Status Reason ValueSet (required)
MedicationDispense.statusReason[x].id		0..1	string	Unique id for inter-element referencing
MedicationDispense.statusReason[x].extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
MedicationDispense.statusReason[x].coding	S This element must be supported. Σ This element is included in summaries.	1..1	Coding	Code defined by a terminology system
MedicationDispense.statusReason[x].coding.id		0..1	string	Unique id for inter-element referencing
MedicationDispense.statusReason[x].coding.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
MedicationDispense.statusReason[x].coding.system	S This element must be supported. Σ This element is included in summaries.	1..1	uri	Identity of the terminology system Required Pattern: https://trxhub.mediservice.ch/fhir/CodeSystem/trxhub-medication-dispense-status-reason
MedicationDispense.statusReason[x].coding.version	Σ This element is included in summaries.	0..1	string	Version of the system - if relevant
MedicationDispense.statusReason[x].coding.code	S This element must be supported. Σ This element is included in summaries.	1..1	code	Symbol in syntax defined by the system
MedicationDispense.statusReason[x].coding.display	Σ This element is included in summaries.	0..1	string	Representation defined by the system
MedicationDispense.statusReason[x].coding.userSelected	Σ This element is included in summaries.	0..1	boolean	If this coding was chosen directly by the user
MedicationDispense.statusReason[x].text	Σ This element is included in summaries.	0..1	string	Plain text representation of the concept
MedicationDispense.category		0..1	CodeableConcept	Type of medication dispense Binding: MedicationDispense Category Codes (preferred): A code describing where the dispensed medication is expected to be consumed or administered.
MedicationDispense.medication[x]	S This element must be supported. Σ This element is included in summaries.	1..1	CodeableConcept	The exact medication that has been dispensed, may differ from the requested medication if substituted; for a declined dispense, the medication that was requested but not dispensed Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying which substance or product can be dispensed.
MedicationDispense.medication[x].id		0..1	string	Unique id for inter-element referencing
MedicationDispense.medication[x].extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
MedicationDispense.medication[x].Slices for coding	S This element must be supported. Σ This element is included in summaries.	1..*	Coding	Code defined by a terminology system Slice: Unordered, Closed by value:system Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
MedicationDispense.medication[x].Slices for coding.coding:pharmacode	S This element must be supported. Σ This element is included in summaries.	0..1	Coding	Code defined by a terminology system
MedicationDispense.medication[x].Slices for coding.coding:pharmacode.id		0..1	string	Unique id for inter-element referencing
MedicationDispense.medication[x].Slices for coding.coding:pharmacode.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
MedicationDispense.medication[x].Slices for coding.coding:pharmacode.system	S This element must be supported. Σ This element is included in summaries.	1..1	uri	Identity of the terminology system Fixed Value: urn:oid:2.51.1.3
MedicationDispense.medication[x].Slices for coding.coding:pharmacode.version	Σ This element is included in summaries.	0..1	string	Version of the system - if relevant
MedicationDispense.medication[x].Slices for coding.coding:pharmacode.code	S This element must be supported. Σ This element is included in summaries.	1..1	code	Symbol in syntax defined by the system
MedicationDispense.medication[x].Slices for coding.coding:pharmacode.display	Σ This element is included in summaries.	0..1	string	Representation defined by the system
MedicationDispense.medication[x].Slices for coding.coding:pharmacode.userSelected	Σ This element is included in summaries.	0..1	boolean	If this coding was chosen directly by the user
MedicationDispense.medication[x].Slices for coding.coding:gtin	S This element must be supported. Σ This element is included in summaries.	0..1	Coding	Code defined by a terminology system
MedicationDispense.medication[x].Slices for coding.coding:gtin.id		0..1	string	Unique id for inter-element referencing
MedicationDispense.medication[x].Slices for coding.coding:gtin.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
MedicationDispense.medication[x].Slices for coding.coding:gtin.system	S This element must be supported. Σ This element is included in summaries.	1..1	uri	Identity of the terminology system Fixed Value: urn:oid:1.3.160
MedicationDispense.medication[x].Slices for coding.coding:gtin.version	Σ This element is included in summaries.	0..1	string	Version of the system - if relevant
MedicationDispense.medication[x].Slices for coding.coding:gtin.code	S This element must be supported. Σ This element is included in summaries.	1..1	code	Symbol in syntax defined by the system
MedicationDispense.medication[x].Slices for coding.coding:gtin.display	Σ This element is included in summaries.	0..1	string	Representation defined by the system
MedicationDispense.medication[x].Slices for coding.coding:gtin.userSelected	Σ This element is included in summaries.	0..1	boolean	If this coding was chosen directly by the user
MedicationDispense.medication[x].text	S This element must be supported. Σ This element is included in summaries.	0..1	string	Plain text representation of the concept
MedicationDispense.subject	S This element must be supported. Σ This element is included in summaries. C	1..1	Reference(Patient)	Who the dispense is for Constraints: trxhub-inv-patient-ref-only
MedicationDispense.context		0..1	Reference(Encounter | EpisodeOfCare)	Encounter / Episode associated with event
MedicationDispense.supportingInformation	S This element must be supported. C	1..1	Reference(ServiceRequest)	order-medication ServiceRequest Constraints: trxhub-inv-service-request-ref-only
MedicationDispense.performer		0..*	BackboneElement	Who performed event
MedicationDispense.performer.id		0..1	string	Unique id for inter-element referencing
MedicationDispense.performer.extension		0..*	Extension	Additional content defined by implementations
MedicationDispense.performer.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
MedicationDispense.performer.function		0..1	CodeableConcept	Who performed the dispense and what they did Binding: MedicationDispense Performer Function Codes (example): A code describing the role an individual played in dispensing a medication.
MedicationDispense.performer.actor		1..1	Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson)	Individual who was performing
MedicationDispense.location		0..1	Reference(Location)	Where the dispense occurred
MedicationDispense.authorizingPrescription	S This element must be supported. C	1..1	Reference(MedicationRequest)	Medication order that authorizes the dispense Constraints: trxhub-inv-medication-request-ref-only
MedicationDispense.type	S This element must be supported.	0..1	CodeableConcept	Trial fill, partial fill, emergency fill, etc. Binding: TRxHub MedicationDispense Type ValueSet (required)
MedicationDispense.type.id		0..1	string	Unique id for inter-element referencing
MedicationDispense.type.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
MedicationDispense.type.coding	S This element must be supported. Σ This element is included in summaries.	1..1	Coding	Code defined by a terminology system
MedicationDispense.type.coding.id		0..1	string	Unique id for inter-element referencing
MedicationDispense.type.coding.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
MedicationDispense.type.coding.system	S This element must be supported. Σ This element is included in summaries.	1..1	uri	Identity of the terminology system Required Pattern: https://trxhub.mediservice.ch/fhir/CodeSystem/trxhub-medication-dispense-type
MedicationDispense.type.coding.version	Σ This element is included in summaries.	0..1	string	Version of the system - if relevant
MedicationDispense.type.coding.code	S This element must be supported. Σ This element is included in summaries.	1..1	code	Symbol in syntax defined by the system
MedicationDispense.type.coding.display	Σ This element is included in summaries.	0..1	string	Representation defined by the system
MedicationDispense.type.coding.userSelected	Σ This element is included in summaries.	0..1	boolean	If this coding was chosen directly by the user
MedicationDispense.type.text	Σ This element is included in summaries.	0..1	string	Plain text representation of the concept
MedicationDispense.quantity	S This element must be supported. C	0..1	SimpleQuantity(4.0.1)	Amount dispensed Constraints: sqty-1
MedicationDispense.quantity.id		0..1	string	Unique id for inter-element referencing
MedicationDispense.quantity.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
MedicationDispense.quantity.value	S This element must be supported. Σ This element is included in summaries.	1..1	decimal	Numerical value (with implicit precision)
MedicationDispense.quantity.unit	Σ This element is included in summaries.	0..1	string	Unit representation
MedicationDispense.quantity.system	Σ This element is included in summaries. C	0..1	uri	System that defines coded unit form
MedicationDispense.quantity.code	Σ This element is included in summaries.	0..1	code	Coded form of the unit
MedicationDispense.daysSupply	C	0..1	SimpleQuantity(4.0.1)	Amount of medication expressed as a timing amount Constraints: sqty-1
MedicationDispense.whenPrepared	Σ This element is included in summaries.	0..1	dateTime	When product was packaged and reviewed
MedicationDispense.whenHandedOver	S This element must be supported.	0..1	dateTime	When medicament was shipped
MedicationDispense.destination		0..1	Reference(Location)	Where the medication was sent
MedicationDispense.receiver		0..*	Reference(Patient | Practitioner)	Who collected the medication
MedicationDispense.note	S This element must be supported.	0..1	Annotation	Information about the dispense
MedicationDispense.note.id		0..1	string	Unique id for inter-element referencing
MedicationDispense.note.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
MedicationDispense.note.author[x]	Σ This element is included in summaries.	0..1		Individual responsible for the annotation
MedicationDispense.note.author[x].authorReference			Reference(Practitioner | Patient | RelatedPerson | Organization)
MedicationDispense.note.author[x].authorString			string
MedicationDispense.note.time	Σ This element is included in summaries.	0..1	dateTime	When the annotation was made
MedicationDispense.note.text	S This element must be supported. Σ This element is included in summaries.	1..1	markdown	The annotation - text content (as markdown)
MedicationDispense.dosageInstruction		0..*	Dosage	How the medication is to be used by the patient or administered by the caregiver
MedicationDispense.substitution	S This element must be supported.	0..1	BackboneElement	Whether a substitution was performed on the dispense
MedicationDispense.substitution.id		0..1	string	Unique id for inter-element referencing
MedicationDispense.substitution.extension		0..*	Extension	Additional content defined by implementations
MedicationDispense.substitution.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
MedicationDispense.substitution.wasSubstituted	S This element must be supported.	1..1	boolean	Whether a substitution was or was not performed on the dispense
MedicationDispense.substitution.type		0..1	CodeableConcept	Code signifying whether a different drug was dispensed from what was prescribed Binding: ActSubstanceAdminSubstitutionCode (example): A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription.
MedicationDispense.substitution.reason		0..*	CodeableConcept	Why was substitution made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
MedicationDispense.substitution.responsibleParty		0..*	Reference(Practitioner | PractitionerRole)	Who is responsible for the substitution
MedicationDispense.detectedIssue		0..*	Reference(DetectedIssue)	Clinical issue with action
MedicationDispense.eventHistory		0..*	Reference(Provenance)	A list of relevant lifecycle events
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
MedicationDispense.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
MedicationDispense.status	Base	required	TRxHub MedicationDispense Status ValueSet	📦0.1.0	This IG
MedicationDispense.statusReason[x]	Base	required	TRxHub MedicationDispense Status Reason ValueSet	📦0.1.0	This IG
MedicationDispense.category	Base	preferred	Medication dispense category codes	📍4.0.1	FHIR Std.
MedicationDispense.medication[x]	Base	example	SNOMED CT Medication Codes	📍4.0.1	FHIR Std.
MedicationDispense.performer.​function	Base	example	Medication dispense performer function codes	📍4.0.1	FHIR Std.
MedicationDispense.type	Base	required	TRxHub MedicationDispense Type ValueSet	📦0.1.0	This IG
MedicationDispense.substitution.​type	Base	example	ActSubstanceAdminSubstitutionCode	📦3.0.0	THO v7.4
MedicationDispense.substitution.​reason	Base	example	SubstanceAdminSubstitutionReason	📦3.0.0	THO v7.4

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	MedicationDispense	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	MedicationDispense	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationDispense	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationDispense	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	MedicationDispense	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
mdd-1	error	MedicationDispense	whenHandedOver cannot be before whenPrepared	whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared
sqty-1	error	MedicationDispense.quantity, MedicationDispense.daysSupply	The comparator is not used on a SimpleQuantity	comparator.empty()
trxhub-inv-medication-request-ref-only	error	MedicationDispense.authorizingPrescription	Reference must point to a MedicationRequest resource	reference.exists() implies (reference.startsWith('MedicationRequest/') or reference.startsWith('urn:uuid:'))
trxhub-inv-patient-ref-only	error	MedicationDispense.subject	Reference must point to a Patient resource	reference.exists() implies (reference.startsWith('Patient/') or reference.startsWith('urn:uuid:'))
trxhub-inv-service-request-ref-only	error	MedicationDispense.supportingInformation	Reference must point to a ServiceRequest resource	reference.exists() implies (reference.startsWith('ServiceRequest/') or reference.startsWith('urn:uuid:'))
trxhub-md-1	error	MedicationDispense	statusReason must be present when status is declined	status = 'declined' implies statusReason.exists()
trxhub-md-2	error	MedicationDispense	statusReason must not be present when status is completed	status = 'completed' implies statusReason.empty()
trxhub-md-3	error	MedicationDispense	type, quantity, whenHandedOver and substitution are required when status is completed	status = 'completed' implies (type.exists() and quantity.exists() and whenHandedOver.exists() and substitution.exists())
trxhub-md-4	error	MedicationDispense	type, quantity, whenHandedOver and substitution must not be present when status is declined	status = 'declined' implies (type.empty() and quantity.empty() and whenHandedOver.empty() and substitution.empty())
trxhub-md-5	error	MedicationDispense	shipmentTrackingUrl is required when status is completed	status = 'completed' implies extension('https://trxhub.mediservice.ch/fhir/StructureDefinition/trxhub-shipment-tracking-url').exists()
trxhub-md-6	error	MedicationDispense	shipmentTrackingUrl must not be present when status is declined	status = 'declined' implies extension('https://trxhub.mediservice.ch/fhir/StructureDefinition/trxhub-shipment-tracking-url').empty()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
MedicationDispense	C	0..*	MedicationDispense	Dispensing a medication to a named patient Constraints: mdd-1, trxhub-md-1, trxhub-md-2, trxhub-md-3, trxhub-md-4, trxhub-md-5, trxhub-md-6
MedicationDispense.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
MedicationDispense.Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
MedicationDispense.Slices for extension.extension:shipmentTrackingUrl	S This element must be supported.	0..1	url	Shipment Tracking URL URL: https://trxhub.mediservice.ch/fhir/StructureDefinition/trxhub-shipment-tracking-url
MedicationDispense.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
MedicationDispense.status	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	1..1	code	preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown Binding: TRxHub MedicationDispense Status ValueSet (required)
MedicationDispense.statusReason[x]	S This element must be supported.	0..1	CodeableConcept	Why a dispense was not performed Binding: TRxHub MedicationDispense Status Reason ValueSet (required)
MedicationDispense.statusReason[x].coding	S This element must be supported. Σ This element is included in summaries.	1..1	Coding	Code defined by a terminology system
MedicationDispense.statusReason[x].coding.system	S This element must be supported. Σ This element is included in summaries.	1..1	uri	Identity of the terminology system Required Pattern: https://trxhub.mediservice.ch/fhir/CodeSystem/trxhub-medication-dispense-status-reason
MedicationDispense.statusReason[x].coding.code	S This element must be supported. Σ This element is included in summaries.	1..1	code	Symbol in syntax defined by the system
MedicationDispense.medication[x]	S This element must be supported. Σ This element is included in summaries.	1..1	CodeableConcept	The exact medication that has been dispensed, may differ from the requested medication if substituted; for a declined dispense, the medication that was requested but not dispensed Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying which substance or product can be dispensed.
MedicationDispense.medication[x].Slices for coding	S This element must be supported. Σ This element is included in summaries.	1..*	Coding	Code defined by a terminology system Slice: Unordered, Closed by value:system Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
MedicationDispense.medication[x].Slices for coding.coding:pharmacode	S This element must be supported. Σ This element is included in summaries.	0..1	Coding	Code defined by a terminology system
MedicationDispense.medication[x].Slices for coding.coding:pharmacode.system	S This element must be supported. Σ This element is included in summaries.	1..1	uri	Identity of the terminology system Fixed Value: urn:oid:2.51.1.3
MedicationDispense.medication[x].Slices for coding.coding:pharmacode.code	S This element must be supported. Σ This element is included in summaries.	1..1	code	Symbol in syntax defined by the system
MedicationDispense.medication[x].Slices for coding.coding:gtin	S This element must be supported. Σ This element is included in summaries.	0..1	Coding	Code defined by a terminology system
MedicationDispense.medication[x].Slices for coding.coding:gtin.system	S This element must be supported. Σ This element is included in summaries.	1..1	uri	Identity of the terminology system Fixed Value: urn:oid:1.3.160
MedicationDispense.medication[x].Slices for coding.coding:gtin.code	S This element must be supported. Σ This element is included in summaries.	1..1	code	Symbol in syntax defined by the system
MedicationDispense.medication[x].text	S This element must be supported. Σ This element is included in summaries.	0..1	string	Plain text representation of the concept
MedicationDispense.subject	S This element must be supported. Σ This element is included in summaries. C	1..1	Reference(Patient)	Who the dispense is for Constraints: trxhub-inv-patient-ref-only
MedicationDispense.supportingInformation	S This element must be supported. C	1..1	Reference(ServiceRequest)	order-medication ServiceRequest Constraints: trxhub-inv-service-request-ref-only
MedicationDispense.authorizingPrescription	S This element must be supported. C	1..1	Reference(MedicationRequest)	Medication order that authorizes the dispense Constraints: trxhub-inv-medication-request-ref-only
MedicationDispense.type	S This element must be supported.	0..1	CodeableConcept	Trial fill, partial fill, emergency fill, etc. Binding: TRxHub MedicationDispense Type ValueSet (required)
MedicationDispense.type.coding	S This element must be supported. Σ This element is included in summaries.	1..1	Coding	Code defined by a terminology system
MedicationDispense.type.coding.system	S This element must be supported. Σ This element is included in summaries.	1..1	uri	Identity of the terminology system Required Pattern: https://trxhub.mediservice.ch/fhir/CodeSystem/trxhub-medication-dispense-type
MedicationDispense.type.coding.code	S This element must be supported. Σ This element is included in summaries.	1..1	code	Symbol in syntax defined by the system
MedicationDispense.quantity	S This element must be supported. C	0..1	SimpleQuantity(4.0.1)	Amount dispensed Constraints: sqty-1
MedicationDispense.quantity.value	S This element must be supported. Σ This element is included in summaries.	1..1	decimal	Numerical value (with implicit precision)
MedicationDispense.whenHandedOver	S This element must be supported.	0..1	dateTime	When medicament was shipped
MedicationDispense.note	S This element must be supported.	0..1	Annotation	Information about the dispense
MedicationDispense.note.text	S This element must be supported. Σ This element is included in summaries.	1..1	markdown	The annotation - text content (as markdown)
MedicationDispense.substitution	S This element must be supported.	0..1	BackboneElement	Whether a substitution was performed on the dispense
MedicationDispense.substitution.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
MedicationDispense.substitution.wasSubstituted	S This element must be supported.	1..1	boolean	Whether a substitution was or was not performed on the dispense
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
MedicationDispense.status	Base	required	TRxHub MedicationDispense Status ValueSet	📦0.1.0	This IG
MedicationDispense.statusReason[x]	Base	required	TRxHub MedicationDispense Status Reason ValueSet	📦0.1.0	This IG
MedicationDispense.medication[x]	Base	example	SNOMED CT Medication Codes	📍4.0.1	FHIR Std.
MedicationDispense.type	Base	required	TRxHub MedicationDispense Type ValueSet	📦0.1.0	This IG

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	MedicationDispense	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	MedicationDispense	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationDispense	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationDispense	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	MedicationDispense	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
mdd-1	error	MedicationDispense	whenHandedOver cannot be before whenPrepared	whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared
sqty-1	error	MedicationDispense.quantity	The comparator is not used on a SimpleQuantity	comparator.empty()
trxhub-inv-medication-request-ref-only	error	MedicationDispense.authorizingPrescription	Reference must point to a MedicationRequest resource	reference.exists() implies (reference.startsWith('MedicationRequest/') or reference.startsWith('urn:uuid:'))
trxhub-inv-patient-ref-only	error	MedicationDispense.subject	Reference must point to a Patient resource	reference.exists() implies (reference.startsWith('Patient/') or reference.startsWith('urn:uuid:'))
trxhub-inv-service-request-ref-only	error	MedicationDispense.supportingInformation	Reference must point to a ServiceRequest resource	reference.exists() implies (reference.startsWith('ServiceRequest/') or reference.startsWith('urn:uuid:'))
trxhub-md-1	error	MedicationDispense	statusReason must be present when status is declined	status = 'declined' implies statusReason.exists()
trxhub-md-2	error	MedicationDispense	statusReason must not be present when status is completed	status = 'completed' implies statusReason.empty()
trxhub-md-3	error	MedicationDispense	type, quantity, whenHandedOver and substitution are required when status is completed	status = 'completed' implies (type.exists() and quantity.exists() and whenHandedOver.exists() and substitution.exists())
trxhub-md-4	error	MedicationDispense	type, quantity, whenHandedOver and substitution must not be present when status is declined	status = 'declined' implies (type.empty() and quantity.empty() and whenHandedOver.empty() and substitution.empty())
trxhub-md-5	error	MedicationDispense	shipmentTrackingUrl is required when status is completed	status = 'completed' implies extension('https://trxhub.mediservice.ch/fhir/StructureDefinition/trxhub-shipment-tracking-url').exists()
trxhub-md-6	error	MedicationDispense	shipmentTrackingUrl must not be present when status is declined	status = 'declined' implies extension('https://trxhub.mediservice.ch/fhir/StructureDefinition/trxhub-shipment-tracking-url').empty()

Differential View

This structure is derived from MedicationDispense

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
MedicationDispense	C	0..*	MedicationDispense	Dispensing a medication to a named patient Constraints: trxhub-md-1, trxhub-md-2, trxhub-md-3, trxhub-md-4, trxhub-md-5, trxhub-md-6
MedicationDispense.Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
MedicationDispense.Slices for extension.extension:shipmentTrackingUrl	S This element must be supported.	0..1	url	Shipment Tracking URL URL: https://trxhub.mediservice.ch/fhir/StructureDefinition/trxhub-shipment-tracking-url
MedicationDispense.status	S This element must be supported.	1..1	code	preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown Binding: TRxHub MedicationDispense Status ValueSet (required)
MedicationDispense.statusReason[x]	S This element must be supported.	0..1	CodeableConcept	Why a dispense was not performed Binding: TRxHub MedicationDispense Status Reason ValueSet (required)
MedicationDispense.statusReason[x].coding	S This element must be supported.	1..1	Coding	Code defined by a terminology system
MedicationDispense.statusReason[x].coding.system	S This element must be supported.	1..1	uri	Identity of the terminology system Required Pattern: https://trxhub.mediservice.ch/fhir/CodeSystem/trxhub-medication-dispense-status-reason
MedicationDispense.statusReason[x].coding.code	S This element must be supported.	1..1	code	Symbol in syntax defined by the system
MedicationDispense.medication[x]	S This element must be supported.	1..1	CodeableConcept	The exact medication that has been dispensed, may differ from the requested medication if substituted; for a declined dispense, the medication that was requested but not dispensed
MedicationDispense.medication[x].Slices for coding	S This element must be supported.	1..*	Coding	Code defined by a terminology system Slice: Unordered, Closed by value:system Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
MedicationDispense.medication[x].Slices for coding.coding:pharmacode	S This element must be supported.	0..1	Coding	Code defined by a terminology system
MedicationDispense.medication[x].Slices for coding.coding:pharmacode.system	S This element must be supported.	1..1	uri	Identity of the terminology system Fixed Value: urn:oid:2.51.1.3
MedicationDispense.medication[x].Slices for coding.coding:pharmacode.code	S This element must be supported.	1..1	code	Symbol in syntax defined by the system
MedicationDispense.medication[x].Slices for coding.coding:gtin	S This element must be supported.	0..1	Coding	Code defined by a terminology system
MedicationDispense.medication[x].Slices for coding.coding:gtin.system	S This element must be supported.	1..1	uri	Identity of the terminology system Fixed Value: urn:oid:1.3.160
MedicationDispense.medication[x].Slices for coding.coding:gtin.code	S This element must be supported.	1..1	code	Symbol in syntax defined by the system
MedicationDispense.medication[x].text	S This element must be supported.	0..1	string	Plain text representation of the concept
MedicationDispense.subject	S This element must be supported. C	1..1	Reference(Patient)	Who the dispense is for Constraints: trxhub-inv-patient-ref-only
MedicationDispense.supportingInformation	S This element must be supported. C	1..1	Reference(ServiceRequest)	order-medication ServiceRequest Constraints: trxhub-inv-service-request-ref-only
MedicationDispense.authorizingPrescription	S This element must be supported. C	1..1	Reference(MedicationRequest)	Medication order that authorizes the dispense Constraints: trxhub-inv-medication-request-ref-only
MedicationDispense.type	S This element must be supported.	0..1	CodeableConcept	Trial fill, partial fill, emergency fill, etc. Binding: TRxHub MedicationDispense Type ValueSet (required)
MedicationDispense.type.coding	S This element must be supported.	1..1	Coding	Code defined by a terminology system
MedicationDispense.type.coding.system	S This element must be supported.	1..1	uri	Identity of the terminology system Required Pattern: https://trxhub.mediservice.ch/fhir/CodeSystem/trxhub-medication-dispense-type
MedicationDispense.type.coding.code	S This element must be supported.	1..1	code	Symbol in syntax defined by the system
MedicationDispense.quantity	S This element must be supported.	0..1	SimpleQuantity(4.0.1)	Amount dispensed
MedicationDispense.quantity.value	S This element must be supported.	1..1	decimal	Numerical value (with implicit precision)
MedicationDispense.whenHandedOver	S This element must be supported.	0..1	dateTime	When medicament was shipped
MedicationDispense.note	S This element must be supported.	0..1	Annotation	Information about the dispense
MedicationDispense.note.text	S This element must be supported.	1..1	markdown	The annotation - text content (as markdown)
MedicationDispense.substitution	S This element must be supported.	0..1	BackboneElement	Whether a substitution was performed on the dispense
MedicationDispense.substitution.wasSubstituted	S This element must be supported.	1..1	boolean	Whether a substitution was or was not performed on the dispense
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
MedicationDispense.status	Base	required	TRxHub MedicationDispense Status ValueSet	📦0.1.0	This IG
MedicationDispense.statusReason[x]	Base	required	TRxHub MedicationDispense Status Reason ValueSet	📦0.1.0	This IG
MedicationDispense.type	Base	required	TRxHub MedicationDispense Type ValueSet	📦0.1.0	This IG

Constraints

Id	Grade	Path(s)	Description	Expression
trxhub-inv-medication-request-ref-only	error	MedicationDispense.authorizingPrescription	Reference must point to a MedicationRequest resource	reference.exists() implies (reference.startsWith('MedicationRequest/') or reference.startsWith('urn:uuid:'))
trxhub-inv-patient-ref-only	error	MedicationDispense.subject	Reference must point to a Patient resource	reference.exists() implies (reference.startsWith('Patient/') or reference.startsWith('urn:uuid:'))
trxhub-inv-service-request-ref-only	error	MedicationDispense.supportingInformation	Reference must point to a ServiceRequest resource	reference.exists() implies (reference.startsWith('ServiceRequest/') or reference.startsWith('urn:uuid:'))
trxhub-md-1	error	MedicationDispense	statusReason must be present when status is declined	status = 'declined' implies statusReason.exists()
trxhub-md-2	error	MedicationDispense	statusReason must not be present when status is completed	status = 'completed' implies statusReason.empty()
trxhub-md-3	error	MedicationDispense	type, quantity, whenHandedOver and substitution are required when status is completed	status = 'completed' implies (type.exists() and quantity.exists() and whenHandedOver.exists() and substitution.exists())
trxhub-md-4	error	MedicationDispense	type, quantity, whenHandedOver and substitution must not be present when status is declined	status = 'declined' implies (type.empty() and quantity.empty() and whenHandedOver.empty() and substitution.empty())
trxhub-md-5	error	MedicationDispense	shipmentTrackingUrl is required when status is completed	status = 'completed' implies extension('https://trxhub.mediservice.ch/fhir/StructureDefinition/trxhub-shipment-tracking-url').exists()
trxhub-md-6	error	MedicationDispense	shipmentTrackingUrl must not be present when status is declined	status = 'declined' implies extension('https://trxhub.mediservice.ch/fhir/StructureDefinition/trxhub-shipment-tracking-url').empty()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
MedicationDispense	C	0..*	MedicationDispense	Dispensing a medication to a named patient Constraints: mdd-1, trxhub-md-1, trxhub-md-2, trxhub-md-3, trxhub-md-4, trxhub-md-5, trxhub-md-6
MedicationDispense.id	Σ This element is included in summaries.	0..1	id	Logical id of this artifact
MedicationDispense.meta	Σ This element is included in summaries.	0..1	Meta	Metadata about the resource
MedicationDispense.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
MedicationDispense.language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
MedicationDispense.text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
MedicationDispense.contained		0..*	Resource	Contained, inline Resources
MedicationDispense.Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
MedicationDispense.Slices for extension.extension:shipmentTrackingUrl	S This element must be supported.	0..1	url	Shipment Tracking URL URL: https://trxhub.mediservice.ch/fhir/StructureDefinition/trxhub-shipment-tracking-url
MedicationDispense.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
MedicationDispense.identifier		0..*	Identifier	External identifier
MedicationDispense.partOf		0..*	Reference(Procedure)	Event that dispense is part of
MedicationDispense.status	?! This element is a modifier element. S This element must be supported. Σ This element is included in summaries.	1..1	code	preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown Binding: TRxHub MedicationDispense Status ValueSet (required)
MedicationDispense.statusReason[x]	S This element must be supported.	0..1	CodeableConcept	Why a dispense was not performed Binding: TRxHub MedicationDispense Status Reason ValueSet (required)
MedicationDispense.statusReason[x].id		0..1	string	Unique id for inter-element referencing
MedicationDispense.statusReason[x].extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
MedicationDispense.statusReason[x].coding	S This element must be supported. Σ This element is included in summaries.	1..1	Coding	Code defined by a terminology system
MedicationDispense.statusReason[x].coding.id		0..1	string	Unique id for inter-element referencing
MedicationDispense.statusReason[x].coding.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
MedicationDispense.statusReason[x].coding.system	S This element must be supported. Σ This element is included in summaries.	1..1	uri	Identity of the terminology system Required Pattern: https://trxhub.mediservice.ch/fhir/CodeSystem/trxhub-medication-dispense-status-reason
MedicationDispense.statusReason[x].coding.version	Σ This element is included in summaries.	0..1	string	Version of the system - if relevant
MedicationDispense.statusReason[x].coding.code	S This element must be supported. Σ This element is included in summaries.	1..1	code	Symbol in syntax defined by the system
MedicationDispense.statusReason[x].coding.display	Σ This element is included in summaries.	0..1	string	Representation defined by the system
MedicationDispense.statusReason[x].coding.userSelected	Σ This element is included in summaries.	0..1	boolean	If this coding was chosen directly by the user
MedicationDispense.statusReason[x].text	Σ This element is included in summaries.	0..1	string	Plain text representation of the concept
MedicationDispense.category		0..1	CodeableConcept	Type of medication dispense Binding: MedicationDispense Category Codes (preferred): A code describing where the dispensed medication is expected to be consumed or administered.
MedicationDispense.medication[x]	S This element must be supported. Σ This element is included in summaries.	1..1	CodeableConcept	The exact medication that has been dispensed, may differ from the requested medication if substituted; for a declined dispense, the medication that was requested but not dispensed Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying which substance or product can be dispensed.
MedicationDispense.medication[x].id		0..1	string	Unique id for inter-element referencing
MedicationDispense.medication[x].extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
MedicationDispense.medication[x].Slices for coding	S This element must be supported. Σ This element is included in summaries.	1..*	Coding	Code defined by a terminology system Slice: Unordered, Closed by value:system Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
MedicationDispense.medication[x].Slices for coding.coding:pharmacode	S This element must be supported. Σ This element is included in summaries.	0..1	Coding	Code defined by a terminology system
MedicationDispense.medication[x].Slices for coding.coding:pharmacode.id		0..1	string	Unique id for inter-element referencing
MedicationDispense.medication[x].Slices for coding.coding:pharmacode.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
MedicationDispense.medication[x].Slices for coding.coding:pharmacode.system	S This element must be supported. Σ This element is included in summaries.	1..1	uri	Identity of the terminology system Fixed Value: urn:oid:2.51.1.3
MedicationDispense.medication[x].Slices for coding.coding:pharmacode.version	Σ This element is included in summaries.	0..1	string	Version of the system - if relevant
MedicationDispense.medication[x].Slices for coding.coding:pharmacode.code	S This element must be supported. Σ This element is included in summaries.	1..1	code	Symbol in syntax defined by the system
MedicationDispense.medication[x].Slices for coding.coding:pharmacode.display	Σ This element is included in summaries.	0..1	string	Representation defined by the system
MedicationDispense.medication[x].Slices for coding.coding:pharmacode.userSelected	Σ This element is included in summaries.	0..1	boolean	If this coding was chosen directly by the user
MedicationDispense.medication[x].Slices for coding.coding:gtin	S This element must be supported. Σ This element is included in summaries.	0..1	Coding	Code defined by a terminology system
MedicationDispense.medication[x].Slices for coding.coding:gtin.id		0..1	string	Unique id for inter-element referencing
MedicationDispense.medication[x].Slices for coding.coding:gtin.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
MedicationDispense.medication[x].Slices for coding.coding:gtin.system	S This element must be supported. Σ This element is included in summaries.	1..1	uri	Identity of the terminology system Fixed Value: urn:oid:1.3.160
MedicationDispense.medication[x].Slices for coding.coding:gtin.version	Σ This element is included in summaries.	0..1	string	Version of the system - if relevant
MedicationDispense.medication[x].Slices for coding.coding:gtin.code	S This element must be supported. Σ This element is included in summaries.	1..1	code	Symbol in syntax defined by the system
MedicationDispense.medication[x].Slices for coding.coding:gtin.display	Σ This element is included in summaries.	0..1	string	Representation defined by the system
MedicationDispense.medication[x].Slices for coding.coding:gtin.userSelected	Σ This element is included in summaries.	0..1	boolean	If this coding was chosen directly by the user
MedicationDispense.medication[x].text	S This element must be supported. Σ This element is included in summaries.	0..1	string	Plain text representation of the concept
MedicationDispense.subject	S This element must be supported. Σ This element is included in summaries. C	1..1	Reference(Patient)	Who the dispense is for Constraints: trxhub-inv-patient-ref-only
MedicationDispense.context		0..1	Reference(Encounter | EpisodeOfCare)	Encounter / Episode associated with event
MedicationDispense.supportingInformation	S This element must be supported. C	1..1	Reference(ServiceRequest)	order-medication ServiceRequest Constraints: trxhub-inv-service-request-ref-only
MedicationDispense.performer		0..*	BackboneElement	Who performed event
MedicationDispense.performer.id		0..1	string	Unique id for inter-element referencing
MedicationDispense.performer.extension		0..*	Extension	Additional content defined by implementations
MedicationDispense.performer.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
MedicationDispense.performer.function		0..1	CodeableConcept	Who performed the dispense and what they did Binding: MedicationDispense Performer Function Codes (example): A code describing the role an individual played in dispensing a medication.
MedicationDispense.performer.actor		1..1	Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson)	Individual who was performing
MedicationDispense.location		0..1	Reference(Location)	Where the dispense occurred
MedicationDispense.authorizingPrescription	S This element must be supported. C	1..1	Reference(MedicationRequest)	Medication order that authorizes the dispense Constraints: trxhub-inv-medication-request-ref-only
MedicationDispense.type	S This element must be supported.	0..1	CodeableConcept	Trial fill, partial fill, emergency fill, etc. Binding: TRxHub MedicationDispense Type ValueSet (required)
MedicationDispense.type.id		0..1	string	Unique id for inter-element referencing
MedicationDispense.type.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
MedicationDispense.type.coding	S This element must be supported. Σ This element is included in summaries.	1..1	Coding	Code defined by a terminology system
MedicationDispense.type.coding.id		0..1	string	Unique id for inter-element referencing
MedicationDispense.type.coding.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
MedicationDispense.type.coding.system	S This element must be supported. Σ This element is included in summaries.	1..1	uri	Identity of the terminology system Required Pattern: https://trxhub.mediservice.ch/fhir/CodeSystem/trxhub-medication-dispense-type
MedicationDispense.type.coding.version	Σ This element is included in summaries.	0..1	string	Version of the system - if relevant
MedicationDispense.type.coding.code	S This element must be supported. Σ This element is included in summaries.	1..1	code	Symbol in syntax defined by the system
MedicationDispense.type.coding.display	Σ This element is included in summaries.	0..1	string	Representation defined by the system
MedicationDispense.type.coding.userSelected	Σ This element is included in summaries.	0..1	boolean	If this coding was chosen directly by the user
MedicationDispense.type.text	Σ This element is included in summaries.	0..1	string	Plain text representation of the concept
MedicationDispense.quantity	S This element must be supported. C	0..1	SimpleQuantity(4.0.1)	Amount dispensed Constraints: sqty-1
MedicationDispense.quantity.id		0..1	string	Unique id for inter-element referencing
MedicationDispense.quantity.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
MedicationDispense.quantity.value	S This element must be supported. Σ This element is included in summaries.	1..1	decimal	Numerical value (with implicit precision)
MedicationDispense.quantity.unit	Σ This element is included in summaries.	0..1	string	Unit representation
MedicationDispense.quantity.system	Σ This element is included in summaries. C	0..1	uri	System that defines coded unit form
MedicationDispense.quantity.code	Σ This element is included in summaries.	0..1	code	Coded form of the unit
MedicationDispense.daysSupply	C	0..1	SimpleQuantity(4.0.1)	Amount of medication expressed as a timing amount Constraints: sqty-1
MedicationDispense.whenPrepared	Σ This element is included in summaries.	0..1	dateTime	When product was packaged and reviewed
MedicationDispense.whenHandedOver	S This element must be supported.	0..1	dateTime	When medicament was shipped
MedicationDispense.destination		0..1	Reference(Location)	Where the medication was sent
MedicationDispense.receiver		0..*	Reference(Patient | Practitioner)	Who collected the medication
MedicationDispense.note	S This element must be supported.	0..1	Annotation	Information about the dispense
MedicationDispense.note.id		0..1	string	Unique id for inter-element referencing
MedicationDispense.note.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
MedicationDispense.note.author[x]	Σ This element is included in summaries.	0..1		Individual responsible for the annotation
MedicationDispense.note.author[x].authorReference			Reference(Practitioner | Patient | RelatedPerson | Organization)
MedicationDispense.note.author[x].authorString			string
MedicationDispense.note.time	Σ This element is included in summaries.	0..1	dateTime	When the annotation was made
MedicationDispense.note.text	S This element must be supported. Σ This element is included in summaries.	1..1	markdown	The annotation - text content (as markdown)
MedicationDispense.dosageInstruction		0..*	Dosage	How the medication is to be used by the patient or administered by the caregiver
MedicationDispense.substitution	S This element must be supported.	0..1	BackboneElement	Whether a substitution was performed on the dispense
MedicationDispense.substitution.id		0..1	string	Unique id for inter-element referencing
MedicationDispense.substitution.extension		0..*	Extension	Additional content defined by implementations
MedicationDispense.substitution.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
MedicationDispense.substitution.wasSubstituted	S This element must be supported.	1..1	boolean	Whether a substitution was or was not performed on the dispense
MedicationDispense.substitution.type		0..1	CodeableConcept	Code signifying whether a different drug was dispensed from what was prescribed Binding: ActSubstanceAdminSubstitutionCode (example): A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription.
MedicationDispense.substitution.reason		0..*	CodeableConcept	Why was substitution made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
MedicationDispense.substitution.responsibleParty		0..*	Reference(Practitioner | PractitionerRole)	Who is responsible for the substitution
MedicationDispense.detectedIssue		0..*	Reference(DetectedIssue)	Clinical issue with action
MedicationDispense.eventHistory		0..*	Reference(Provenance)	A list of relevant lifecycle events
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
MedicationDispense.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
MedicationDispense.status	Base	required	TRxHub MedicationDispense Status ValueSet	📦0.1.0	This IG
MedicationDispense.statusReason[x]	Base	required	TRxHub MedicationDispense Status Reason ValueSet	📦0.1.0	This IG
MedicationDispense.category	Base	preferred	Medication dispense category codes	📍4.0.1	FHIR Std.
MedicationDispense.medication[x]	Base	example	SNOMED CT Medication Codes	📍4.0.1	FHIR Std.
MedicationDispense.performer.​function	Base	example	Medication dispense performer function codes	📍4.0.1	FHIR Std.
MedicationDispense.type	Base	required	TRxHub MedicationDispense Type ValueSet	📦0.1.0	This IG
MedicationDispense.substitution.​type	Base	example	ActSubstanceAdminSubstitutionCode	📦3.0.0	THO v7.4
MedicationDispense.substitution.​reason	Base	example	SubstanceAdminSubstitutionReason	📦3.0.0	THO v7.4

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	MedicationDispense	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	MedicationDispense	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationDispense	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationDispense	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	MedicationDispense	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
mdd-1	error	MedicationDispense	whenHandedOver cannot be before whenPrepared	whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared
sqty-1	error	MedicationDispense.quantity, MedicationDispense.daysSupply	The comparator is not used on a SimpleQuantity	comparator.empty()
trxhub-inv-medication-request-ref-only	error	MedicationDispense.authorizingPrescription	Reference must point to a MedicationRequest resource	reference.exists() implies (reference.startsWith('MedicationRequest/') or reference.startsWith('urn:uuid:'))
trxhub-inv-patient-ref-only	error	MedicationDispense.subject	Reference must point to a Patient resource	reference.exists() implies (reference.startsWith('Patient/') or reference.startsWith('urn:uuid:'))
trxhub-inv-service-request-ref-only	error	MedicationDispense.supportingInformation	Reference must point to a ServiceRequest resource	reference.exists() implies (reference.startsWith('ServiceRequest/') or reference.startsWith('urn:uuid:'))
trxhub-md-1	error	MedicationDispense	statusReason must be present when status is declined	status = 'declined' implies statusReason.exists()
trxhub-md-2	error	MedicationDispense	statusReason must not be present when status is completed	status = 'completed' implies statusReason.empty()
trxhub-md-3	error	MedicationDispense	type, quantity, whenHandedOver and substitution are required when status is completed	status = 'completed' implies (type.exists() and quantity.exists() and whenHandedOver.exists() and substitution.exists())
trxhub-md-4	error	MedicationDispense	type, quantity, whenHandedOver and substitution must not be present when status is declined	status = 'declined' implies (type.empty() and quantity.empty() and whenHandedOver.empty() and substitution.empty())
trxhub-md-5	error	MedicationDispense	shipmentTrackingUrl is required when status is completed	status = 'completed' implies extension('https://trxhub.mediservice.ch/fhir/StructureDefinition/trxhub-shipment-tracking-url').exists()
trxhub-md-6	error	MedicationDispense	shipmentTrackingUrl must not be present when status is declined	status = 'declined' implies extension('https://trxhub.mediservice.ch/fhir/StructureDefinition/trxhub-shipment-tracking-url').empty()

This structure is derived from MedicationDispense

Summary

Mandatory: 4 elements(11 nested mandatory elements)
Must-Support: 29 elements
Fixed: 2 elements

Extensions

This structure refers to these extensions:

• https://trxhub.mediservice.ch/fhir/StructureDefinition/trxhub-shipment-tracking-url

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of MedicationDispense.medication[x].coding (Closed)