<status value="draft"/> <date value="2023-11-29T14:36:10+00:00"/> <publisher value="The Linked Care Consortium"/> <contact> <name value="The Linked Care Consortium"/> <telecom> <system value="url"/> <value value="https://www.linkedcare.at/"/> </telecom> </contact> <description value="Linked Care Profile for dispense documentation. The dispense must be documented by the dispensing pharmacist and specify if an order was fulfilled completly or partially. The LINCA Dispense must have an LINCA Prescription as authorizingPrescription. "/> <fhirVersion value="5.0.0"/> <mapping> <identity value="workflow"/> <uri value="http://hl7.org/fhir/workflow"/> <name value="Workflow Pattern"/> </mapping> <mapping> <identity value="w5"/> <uri value="http://hl7.org/fhir/fivews"/> <name value="FiveWs Pattern Mapping"/> </mapping> <mapping> <identity value="rim"/> <uri value="http://hl7.org/v3"/> <name value="RIM Mapping"/> </mapping> <mapping> <identity value="rx-dispense-rmim"/> <uri value="http://www.hl7.org/v3/PORX_RM020070UV"/> <name value="V3 Pharmacy Dispense RMIM"/> </mapping> <mapping> <identity value="v2"/> <uri value="http://hl7.org/v2"/> <name value="HL7 V2 Mapping"/> </mapping> <kind value="resource"/> <abstract value="false"/> <type value="MedicationDispense"/> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/MedicationDispense"/> <derivation value="constraint"/> <snapshot> <element id="MedicationDispense"> <path value="MedicationDispense"/> <short value="Dispensing a medication to a named patient"/> <definition value="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."/> <min value="0"/> <max value="*"/> <base> <path value="MedicationDispense"/> <min value="0"/> <max value="*"/> </base> <constraint> <key value="dom-2"/> <severity value="error"/> <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/> <expression value="contained.contained.empty()"/> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> </constraint> <constraint> <key value="dom-3"/> <severity value="error"/> <human value="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"/> <expression value="contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()"/> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> </constraint> <constraint> <key value="dom-4"/> <severity value="error"/> <human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated"/> <expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> </constraint> <constraint> <key value="dom-5"/> <severity value="error"/> <human value="If a resource is contained in another resource, it SHALL NOT have a security label"/> <expression value="contained.meta.security.empty()"/> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> </constraint> <constraint> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice"> <valueBoolean value="true"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation"> <valueMarkdown value="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."/> </extension> <key value="dom-6"/> <severity value="warning"/> <human value="A resource should have narrative for robust management"/> <expression value="text.`div`.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> </constraint> <constraint> <key value="mdd-1"/> <severity value="error"/> <human value="whenHandedOver cannot be before whenPrepared"/> <expression value="whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared"/> <source value="http://hl7.org/fhir/StructureDefinition/MedicationDispense"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="Entity, Role, or Act,Supply[moodCode=EVN]"/> </mapping> <mapping> <identity value="workflow"/> <map value="Event"/> </mapping> <mapping> <identity value="w5"/> <map value="clinical.medication"/> </mapping> </element> <element id="MedicationDispense.id"> <path value="MedicationDispense.id"/> <short value="Logical id of this artifact"/> <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/> <comment value="Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case."/> <min value="0"/> <max value="1"/> <base> <path value="Resource.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> </element> <element id="MedicationDispense.meta"> <path value="MedicationDispense.meta"/> <short value="Metadata about the resource"/> <definition value="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."/> <min value="0"/> <max value="1"/> <base> <path value="Resource.meta"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Meta"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> </element> <element id="MedicationDispense.implicitRules"> <path value="MedicationDispense.implicitRules"/> <short value="A set of rules under which this content was created"/> <definition value="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."/> <comment value="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 its narrative along with other profiles, value sets, etc."/> <min value="0"/> <max value="1"/> <base> <path value="Resource.implicitRules"/> <min value="0"/> <max value="1"/> </base> <type> <code value="uri"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="true"/> <isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation"/> <isSummary value="true"/> </element> <element id="MedicationDispense.language"> <path value="MedicationDispense.language"/> <short value="Language of the resource content"/> <definition value="The base language in which the resource is written."/> <comment value="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)."/> <min value="0"/> <max value="1"/> <base> <path value="Resource.language"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Language"/> </extension> <strength value="required"/> <description value="IETF language tag for a human language"/> <valueSet value="http://hl7.org/fhir/ValueSet/all-languages|5.0.0"/> <additional> <purpose value="starter"/> <valueSet value="http://hl7.org/fhir/ValueSet/languages"/> </additional> </binding> </element> <element id="MedicationDispense.text"> <path value="MedicationDispense.text"/> <short value="Text summary of the resource, for human interpretation"/> <definition value="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."/> <comment value="Contained resources do not have a 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."/> <alias value="narrative"/> <alias value="html"/> <alias value="xhtml"/> <alias value="display"/> <min value="0"/> <max value="1"/> <base> <path value="DomainResource.text"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Narrative"/> </type> <condition value="dom-6"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="Act.text?"/> </mapping> </element> <element id="MedicationDispense.contained"> <path value="MedicationDispense.contained"/> <short value="Contained, inline Resources"/> <definition value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning."/> <comment value="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."/> <alias value="inline resources"/> <alias value="anonymous resources"/> <alias value="contained resources"/> <min value="0"/> <max value="*"/> <base> <path value="DomainResource.contained"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Resource"/> </type> <condition value="dom-2"/> <condition value="dom-4"/> <condition value="dom-3"/> <condition value="dom-5"/> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="MedicationDispense.extension"> <path value="MedicationDispense.extension"/> <short value="Additional content defined by implementations"/> <definition value="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 managable, 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."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="DomainResource.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="MedicationDispense.modifierExtension"> <path value="MedicationDispense.modifierExtension"/> <short value="Extensions that cannot be ignored"/> <definition value="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 managable, 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/> <comment value="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."/> <requirements value="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](http://hl7.org/fhir/R5/extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="DomainResource.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <mustSupport value="false"/> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="MedicationDispense.identifier"> <path value="MedicationDispense.identifier"/> <short value="External identifier"/> <definition value="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."/> <comment value="This is a business identifier, not a resource identifier."/> <min value="0"/> <max value="*"/> <base> <path value="MedicationDispense.identifier"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Identifier"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="workflow"/> <map value="Event.identifier"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.identifier"/> </mapping> <mapping> <identity value="rim"/> <map value=".id"/> </mapping> <mapping> <identity value="rx-dispense-rmim"/> <map value="CombinedMedicationDispense.id"/> </mapping> </element> <element id="MedicationDispense.basedOn"> <path value="MedicationDispense.basedOn"/> <short value="Plan that is fulfilled by this dispense"/> <definition value="A plan that is fulfilled in whole or in part by this MedicationDispense."/> <min value="0"/> <max value="*"/> <base> <path value="MedicationDispense.basedOn"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/CarePlan"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".outboundRelationship[typeCode=FLFS].target"/> </mapping> </element> <element id="MedicationDispense.partOf"> <path value="MedicationDispense.partOf"/> <short value="Event that dispense is part of"/> <definition value="The procedure or medication administration that triggered the dispense."/> <comment value="While both a procedure and a medication administration may have triggered the dispense, but it is not expected that multiple procedures and/or multiple medication administrations would be triggers."/> <min value="0"/> <max value="*"/> <base> <path value="MedicationDispense.partOf"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Procedure"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationAdministration"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="workflow"/> <map value="Event.partOf"/> </mapping> <mapping> <identity value="rim"/> <map value=".outboundRelationship[typeCode=COMP]/target[classCode=PROC,moodCode=EVN]"/> </mapping> </element> <element id="MedicationDispense.status"> <path value="MedicationDispense.status"/> <short value="A dispense ends the chain of the workflow. Therefore the status is fixed to 'completed'"/> <definition value="A code specifying the state of the set of dispense events."/> <comment value="This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid."/> <min value="1"/> <max value="1"/> <base> <path value="MedicationDispense.status"/> <min value="1"/> <max value="1"/> </base> <type> <code value="code"/> </type> <patternCode value="completed"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="true"/> <isModifierReason value="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 value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MedicationDispenseStatus"/> </extension> <strength value="required"/> <description value="Describes the lifecycle of the dispense."/> <valueSet value="http://hl7.org/fhir/ValueSet/medicationdispense-status|5.0.0"/> </binding> <mapping> <identity value="workflow"/> <map value="Event.status"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.status"/> </mapping> <mapping> <identity value="rim"/> <map value=".statusCode"/> </mapping> <mapping> <identity value="rx-dispense-rmim"/> <map value="CombinedMedicationDispense.SupplyEvent.statusCode"/> </mapping> </element> <element id="MedicationDispense.notPerformedReason"> <path value="MedicationDispense.notPerformedReason"/> <short value="Why a dispense was not performed"/> <definition value="Indicates the reason why a dispense was not performed."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationDispense.notPerformedReason"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableReference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/DetectedIssue"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MedicationDispenseStatusReason"/> </extension> <strength value="example"/> <valueSet value="http://hl7.org/fhir/ValueSet/medicationdispense-status-reason"/> </binding> </element> <element id="MedicationDispense.statusChanged"> <path value="MedicationDispense.statusChanged"/> <short value="When the status changed"/> <definition value="The date (and maybe time) when the status of the dispense record changed."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationDispense.statusChanged"/> <min value="0"/> <max value="1"/> </base> <type> <code value="dateTime"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".subjectOf Observation[code = statusChange].value = date"/> </mapping> </element> <element id="MedicationDispense.category"> <path value="MedicationDispense.category"/> <short value="Type of medication dispense"/> <definition value="Indicates the type of medication dispense (for example, drug classification like ATC, where meds would be administered, legal category of the medication.)."/> <comment value="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."/> <min value="0"/> <max value="*"/> <base> <path value="MedicationDispense.category"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MedicationDispenseAdminLocation"/> </extension> <strength value="example"/> <description value="A code describing where the dispensed medication is expected to be consumed or administered."/> <valueSet value="http://hl7.org/fhir/ValueSet/medicationdispense-admin-location"/> </binding> <mapping> <identity value="rim"/> <map value=".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code="type of medication dispense"].value"/> </mapping> </element> <element id="MedicationDispense.medication"> <path value="MedicationDispense.medication"/> <short value="Medication that was dispensed, in conformance with ELGA CodeSystems (text-only, or text and number referencing one of the supported catalogs, as for example the PZN of the Austrian ASP)."/> <definition value="Identifies the medication supplied. 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."/> <comment value="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."/> <min value="1"/> <max value="1"/> <base> <path value="MedicationDispense.medication"/> <min value="1"/> <max value="1"/> </base> <type> <code value="CodeableReference"/> <targetProfile value="http://fhir.hl7.at/linkedcare/StructureDefinition/linca-medication"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <strength value="required"/> <valueSet value="https://termgit.elga.gv.at/CodeSystem-asp-liste"/> </binding> <mapping> <identity value="workflow"/> <map value="Event.code"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.what[x]"/> </mapping> <mapping> <identity value="v2"/> <map value="RXD-2 Dispense/Give Code"/> </mapping> <mapping> <identity value="rim"/> <map value=".participation[typeCode=PRD].role"/> </mapping> <mapping> <identity value="rx-dispense-rmim"/> <map value="CombinedMedicationRequest.component1.AdministrationRequest.consumable"/> </mapping> </element> <element id="MedicationDispense.subject"> <path value="MedicationDispense.subject"/> <short value="Patient conform HL7 AT. Make sure the patient is identifiable somehow"/> <definition value="A link to a resource representing the person or the group to whom the medication will be given."/> <comment value="SubstanceAdministration->subject->Patient."/> <min value="1"/> <max value="1"/> <base> <path value="MedicationDispense.subject"/> <min value="1"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://fhir.hl7.at/linkedcare/StructureDefinition/at-core-patient"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Event.subject"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.subject[x]"/> </mapping> <mapping> <identity value="v2"/> <map value="PID-3 Patient ID List"/> </mapping> <mapping> <identity value="rim"/> <map value=".participation[typeCode=SBJ].role[classCode=PAT]"/> </mapping> </element> <element id="MedicationDispense.encounter"> <path value="MedicationDispense.encounter"/> <short value="Encounter associated with event"/> <definition value="The encounter that establishes the context for this event."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationDispense.encounter"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="workflow"/> <map value="Event.encounter"/> </mapping> <mapping> <identity value="rim"/> <map value=".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN, code="type of encounter or episode"]"/> </mapping> </element> <element id="MedicationDispense.supportingInformation"> <path value="MedicationDispense.supportingInformation"/> <short value="Information that supports the dispensing of the medication"/> <definition value="Additional information that supports the medication being dispensed. For example, there may be requirements that a specific lab test has been completed prior to dispensing or the patient's weight at the time of dispensing is documented."/> <min value="0"/> <max value="*"/> <base> <path value="MedicationDispense.supportingInformation"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="w5"/> <map value="FiveWs.context"/> </mapping> <mapping> <identity value="rim"/> <map value=".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)]"/> </mapping> </element> <element id="MedicationDispense.performer"> <path value="MedicationDispense.performer"/> <short value="Who performed event"/> <definition value="Indicates who or what performed the event."/> <min value="0"/> <max value="*"/> <base> <path value="MedicationDispense.performer"/> <min value="0"/> <max value="*"/> </base> <type> <code value="BackboneElement"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="workflow"/> <map value="Event.performer"/> </mapping> <mapping> <identity value="rim"/> <map value=".participation[typeCode=PRF]"/> </mapping> </element> <element id="MedicationDispense.performer.id"> <path value="MedicationDispense.performer.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="MedicationDispense.performer.extension"> <path value="MedicationDispense.performer.extension"/> <short value="Additional content defined by implementations"/> <definition value="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 managable, 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."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="MedicationDispense.performer.modifierExtension"> <path value="MedicationDispense.performer.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="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 managable, 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/> <comment value="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."/> <requirements value="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](http://hl7.org/fhir/R5/extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneElement.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="MedicationDispense.performer.function"> <path value="MedicationDispense.performer.function"/> <short value="Who performed the dispense and what they did"/> <definition value="Distinguishes the type of performer in the dispense. For example, date enterer, packager, final checker."/> <requirements value="Allows disambiguation of the types of involvement of different performers."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationDispense.performer.function"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MedicationDispensePerformerFunction"/> </extension> <strength value="example"/> <description value="A code describing the role an individual played in dispensing a medication."/> <valueSet value="http://hl7.org/fhir/ValueSet/medicationdispense-performer-function"/> </binding> <mapping> <identity value="rim"/> <map value="participation[typeCode=PRF].functionCode"/> </mapping> </element> <element id="MedicationDispense.performer.actor"> <path value="MedicationDispense.performer.actor"/> <short value="Reference to dispensing pharmacy (GDA index)"/> <definition value="The device, practitioner, etc. who performed the action. It should be assumed that the actor is the dispenser of the medication."/> <min value="1"/> <max value="1"/> <base> <path value="MedicationDispense.performer.actor"/> <min value="1"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="workflow"/> <map value="Event.performer.actor"/> </mapping> <mapping> <identity value="rim"/> <map value=".role"/> </mapping> </element> <element id="MedicationDispense.location"> <path value="MedicationDispense.location"/> <short value="Where the dispense occurred"/> <definition value="The principal physical location where the dispense was performed."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationDispense.location"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Location"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".participation[typeCode=LOC].role"/> </mapping> </element> <element id="MedicationDispense.authorizingPrescription"> <path value="MedicationDispense.authorizingPrescription"/> <short value="Prescription that authorized dispense of this medication"/> <definition value="Indicates the medication order that is being dispensed against."/> <comment value="Maps to basedOn in Event logical model."/> <min value="1"/> <max value="1"/> <base> <path value="MedicationDispense.authorizingPrescription"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://fhir.hl7.at/linkedcare/StructureDefinition/linca-prescription-medication-request"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="workflow"/> <map value="Event.basedOn"/> </mapping> <mapping> <identity value="v2"/> <map value="ORC-2 Placer Order Number"/> </mapping> <mapping> <identity value="rim"/> <map value=".outboundRelationship[typeCode=FLFS].target[moodCode=RQO]"/> </mapping> <mapping> <identity value="rx-dispense-rmim"/> <map value="CombinedMedicationDispense.inFulfillmentOf"/> </mapping> </element> <element id="MedicationDispense.type"> <path value="MedicationDispense.type"/> <short value="Possible values: FFC (First-fill complete for completly fulfilled orders), FFP (first-fill part fill, for pratially fulfilled orders)"/> <definition value="Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationDispense.type"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MedicationDispenseType"/> </extension> <strength value="example"/> <description value="ActPharmacySupplyType"/> <valueSet value="http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType"/> </binding> <mapping> <identity value="v2"/> <map value="RXD-33 Dispense Type"/> </mapping> <mapping> <identity value="rim"/> <map value=".code"/> </mapping> <mapping> <identity value="rx-dispense-rmim"/> <map value="CombinedMedicationDispense.SupplyEvent.code"/> </mapping> </element> <element id="MedicationDispense.quantity"> <path value="MedicationDispense.quantity"/> <short value="Amount dispensed"/> <definition value="The amount of medication that has been dispensed. Includes unit of measure."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationDispense.quantity"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="v2"/> <map value="RXD-4 Actual Dispense Amount / RXD-5.1 Actual Dispense Units.code / RXD-5.3 Actual Dispense Units.name of coding system"/> </mapping> <mapping> <identity value="rim"/> <map value=".quantity"/> </mapping> <mapping> <identity value="rx-dispense-rmim"/> <map value="CombinedMedicationDispense.SupplyEvent.quantity"/> </mapping> </element> <element id="MedicationDispense.daysSupply"> <path value="MedicationDispense.daysSupply"/> <short value="Amount of medication expressed as a timing amount"/> <definition value="The amount of medication expressed as a timing amount."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationDispense.daysSupply"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="v2"/> <map value="TQ1.6 Timing/Quantity Segment Service Duration. Prior 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” From v2.5 on, TQ1.6 Timing/Quantity Segment / Service Duration. This is a CQ data type (<Quantity (NM)> ^ <Units (CWE)>), thus for days supply, assuming the unit of measure is “days”, the numeric value is TQ1.6.1 (…|14^ For 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"/> </mapping> <mapping> <identity value="rim"/> <map value="effectiveUseTime"/> </mapping> </element> <element id="MedicationDispense.recorded"> <path value="MedicationDispense.recorded"/> <short value="When the recording of the dispense started"/> <definition value="The date (and maybe time) when the dispense activity started if whenPrepared or whenHandedOver is not populated."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationDispense.recorded"/> <min value="0"/> <max value="1"/> </base> <type> <code value="dateTime"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".MedicationDispense.dataEnterer..time"/> </mapping> </element> <element id="MedicationDispense.whenPrepared"> <path value="MedicationDispense.whenPrepared"/> <short value="When product was packaged and reviewed"/> <definition value="The time when the dispensed product was packaged and reviewed."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationDispense.whenPrepared"/> <min value="0"/> <max value="1"/> </base> <type> <code value="dateTime"/> </type> <condition value="mdd-1"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="RXD-3 Date/Time Dispensed"/> </mapping> <mapping> <identity value="rim"/> <map value=".effectiveTime[xmi:type=IVL_TS].low"/> </mapping> <mapping> <identity value="rx-dispense-rmim"/> <map value="CombinedMedicationDispense.SupplyEvent.effectiveTime"/> </mapping> </element> <element id="MedicationDispense.whenHandedOver"> <path value="MedicationDispense.whenHandedOver"/> <short value="When product was given out"/> <definition value="The time the dispensed product was provided to the patient or their representative."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationDispense.whenHandedOver"/> <min value="0"/> <max value="1"/> </base> <type> <code value="dateTime"/> </type> <condition value="mdd-1"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="workflow"/> <map value="Event.occurrence[x]"/> </mapping> <mapping> <identity value="v2"/> <map value="RXD-3 Date/Time Dispensed"/> </mapping> <mapping> <identity value="rim"/> <map value=".effectiveTime[xmi:type=IVL_TS].high"/> </mapping> <mapping> <identity value="rx-dispense-rmim"/> <map value="CombinedMedicationDispense.SupplyEvent.effectiveTime"/> </mapping> </element> <element id="MedicationDispense.destination"> <path value="MedicationDispense.destination"/> <short value="Where the medication was/will be sent"/> <definition value="Identification of the facility/location where the medication was/will be shipped to, as part of the dispense event."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationDispense.destination"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Location"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="v2"/> <map value="RXD-13 Dispense-to Location; RXD-30 Dispense to Pharmacy; RXD-31 Dispense to Pharmacy Address"/> </mapping> <mapping> <identity value="rim"/> <map value=".participation[typeCode=DST].role"/> </mapping> <mapping> <identity value="rx-dispense-rmim"/> <map value="CombinedMedicationDispense.SupplyEvent.destination"/> </mapping> </element> <element id="MedicationDispense.receiver"> <path value="MedicationDispense.receiver"/> <short value="Who collected the medication or where the medication was delivered"/> <definition value="Identifies the person who picked up the medication or the location of where the medication was delivered. This will usually be a patient or their caregiver, but some cases exist where it can be a healthcare professional or a location."/> <min value="0"/> <max value="*"/> <base> <path value="MedicationDispense.receiver"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Location"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".participation[typeCode=RCV].role"/> </mapping> <mapping> <identity value="rx-dispense-rmim"/> <map value="CombinedMedicationDispense.SupplyEvent.receiver"/> </mapping> </element> <element id="MedicationDispense.note"> <path value="MedicationDispense.note"/> <short value="Information about the dispense"/> <definition value="Extra information about the dispense that could not be conveyed in the other attributes."/> <min value="0"/> <max value="*"/> <base> <path value="MedicationDispense.note"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Annotation"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="workflow"/> <map value="Event.note"/> </mapping> <mapping> <identity value="v2"/> <map value="RXD-9 Dispense Notes"/> </mapping> <mapping> <identity value="rim"/> <map value=".inboundRelationship[typeCode=SUBJ]/source[classCode=ACT,moodCode=EVN]"/> </mapping> </element> <element id="MedicationDispense.renderedDosageInstruction"> <path value="MedicationDispense.renderedDosageInstruction"/> <short value="Full representation of the dosage instructions"/> <definition value="The full representation of the dose of the medication included in all dosage instructions. To be used when multiple dosage instructions are included to represent complex dosing such as increasing or tapering doses."/> <comment value="The content of the renderedDosageInstructions must not be different than the dose represented in the dosageInstruction content."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationDispense.renderedDosageInstruction"/> <min value="0"/> <max value="1"/> </base> <type> <code value="markdown"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="SubstanceAdministration.text"/> </mapping> </element> <element id="MedicationDispense.dosageInstruction"> <path value="MedicationDispense.dosageInstruction"/> <short value="How the medication is to be used by the patient or administered by the caregiver"/> <definition value="Indicates how the medication is to be used by the patient."/> <comment value="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. The pharmacist reviews the medication order prior to dispense and updates the dosageInstruction based on the actual product being dispensed."/> <min value="0"/> <max value="*"/> <base> <path value="MedicationDispense.dosageInstruction"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Dosage"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=INT]"/> </mapping> </element> <element id="MedicationDispense.dosageInstruction.id"> <path value="MedicationDispense.dosageInstruction.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="MedicationDispense.dosageInstruction.extension"> <path value="MedicationDispense.dosageInstruction.extension"/> <slicing> <discriminator> <type value="value"/> <path value="url"/> </discriminator> <description value="Extensions are always sliced by (at least) url"/> <rules value="open"/> </slicing> <short value="Additional content defined by implementations"/> <definition value="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 managable, 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."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="MedicationDispense.dosageInstruction.modifierExtension"> <path value="MedicationDispense.dosageInstruction.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="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 managable, 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/> <comment value="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."/> <requirements value="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](http://hl7.org/fhir/R5/extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneType.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="MedicationDispense.dosageInstruction.sequence"> <path value="MedicationDispense.dosageInstruction.sequence"/> <short value="The order of the dosage instructions"/> <definition value="Indicates the order in which the dosage instructions should be applied or interpreted."/> <requirements value="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 value="0"/> <max value="1"/> <base> <path value="Dosage.sequence"/> <min value="0"/> <max value="1"/> </base> <type> <code value="integer"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="TQ1-1"/> </mapping> <mapping> <identity value="rim"/> <map value=".text"/> </mapping> </element> <element id="MedicationDispense.dosageInstruction.text"> <path value="MedicationDispense.dosageInstruction.text"/> <short value="Free text dosage instructions e.g. SIG"/> <definition value="Free text dosage instructions e.g. SIG."/> <requirements value="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 value="0"/> <max value="1"/> <base> <path value="Dosage.text"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="RXO-6; RXE-21"/> </mapping> <mapping> <identity value="rim"/> <map value=".text"/> </mapping> </element> <element id="MedicationDispense.dosageInstruction.additionalInstruction"> <path value="MedicationDispense.dosageInstruction.additionalInstruction"/> <short value="Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness""/> <definition value="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")."/> <comment value="Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or take "immediately following drug x") should be populated in dosage.text."/> <requirements value="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 value="0"/> <max value="*"/> <base> <path value="Dosage.additionalInstruction"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="AdditionalInstruction"/> </extension> <strength value="example"/> <description value="A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery"."/> <valueSet value="http://hl7.org/fhir/ValueSet/additional-instruction-codes"/> </binding> <mapping> <identity value="v2"/> <map value="RXO-7"/> </mapping> <mapping> <identity value="rim"/> <map value=".text"/> </mapping> </element> <element id="MedicationDispense.dosageInstruction.patientInstruction"> <path value="MedicationDispense.dosageInstruction.patientInstruction"/> <short value="Patient or consumer oriented instructions"/> <definition value="Instructions in terms that are understood by the patient or consumer."/> <min value="0"/> <max value="1"/> <base> <path value="Dosage.patientInstruction"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="RXO-7"/> </mapping> <mapping> <identity value="rim"/> <map value=".text"/> </mapping> </element> <element id="MedicationDispense.dosageInstruction.timing"> <path value="MedicationDispense.dosageInstruction.timing"/> <short value="When medication should be administered"/> <definition value="When medication should be administered."/> <comment value="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."/> <requirements value="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 value="0"/> <max value="1"/> <base> <path value="Dosage.timing"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Timing"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value=".effectiveTime"/> </mapping> </element> <element id="MedicationDispense.dosageInstruction.asNeeded"> <path value="MedicationDispense.dosageInstruction.asNeeded"/> <short value="Take "as needed""/> <definition value="Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option)."/> <comment value="Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated."/> <min value="0"/> <max value="1"/> <base> <path value="Dosage.asNeeded"/> <min value="0"/> <max value="1"/> </base> <type> <code value="boolean"/> </type> <condition value="dos-1"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="TQ1-9"/> </mapping> <mapping> <identity value="rim"/> <map value=".outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept"/> </mapping> </element> <element id="MedicationDispense.dosageInstruction.asNeededFor"> <path value="MedicationDispense.dosageInstruction.asNeededFor"/> <short value="Take "as needed" (for x)"/> <definition value="Indicates whether the Medication is only taken based on a precondition for taking the Medication (CodeableConcept)."/> <comment value="Can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be False, then the dose is given according to the schedule and is not "prn" or "as needed"."/> <min value="0"/> <max value="*"/> <base> <path value="Dosage.asNeededFor"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> <condition value="dos-1"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MedicationAsNeededReason"/> </extension> <strength value="example"/> <description value="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."/> <valueSet value="http://hl7.org/fhir/ValueSet/medication-as-needed-reason"/> </binding> <mapping> <identity value="v2"/> <map value="TQ1-9"/> </mapping> <mapping> <identity value="rim"/> <map value=".outboundRelationship[typeCode=PRCN].target[classCode=OBS, moodCode=EVN, code="as needed"].value=boolean or codable concept"/> </mapping> </element> <element id="MedicationDispense.dosageInstruction.site"> <path value="MedicationDispense.dosageInstruction.site"/> <short value="Body site to administer to"/> <definition value="Body site to administer to."/> <comment value="If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [http://hl7.org/fhir/StructureDefinition/bodySite](http://hl7.org/fhir/extensions/StructureDefinition-bodySite.html). May be a summary code, or a reference to a very precise definition of the location, or both."/> <requirements value="A coded specification of the anatomic site where the medication first enters the body."/> <min value="0"/> <max value="1"/> <base> <path value="Dosage.site"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MedicationAdministrationSite"/> </extension> <strength value="example"/> <description value="A coded concept describing the site location the medicine enters into or onto the body."/> <valueSet value="http://hl7.org/fhir/ValueSet/approach-site-codes"/> </binding> <mapping> <identity value="v2"/> <map value="RXR-2"/> </mapping> <mapping> <identity value="rim"/> <map value=".approachSiteCode"/> </mapping> </element> <element id="MedicationDispense.dosageInstruction.route"> <path value="MedicationDispense.dosageInstruction.route"/> <short value="How drug should enter body"/> <definition value="How drug should enter body."/> <requirements value="A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body."/> <min value="0"/> <max value="1"/> <base> <path value="Dosage.route"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="RouteOfAdministration"/> </extension> <strength value="example"/> <description value="A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject."/> <valueSet value="http://hl7.org/fhir/ValueSet/route-codes"/> </binding> <mapping> <identity value="v2"/> <map value="RXR-1"/> </mapping> <mapping> <identity value="rim"/> <map value=".routeCode"/> </mapping> </element> <element id="MedicationDispense.dosageInstruction.method"> <path value="MedicationDispense.dosageInstruction.method"/> <short value="Technique for administering medication"/> <definition value="Technique for administering medication."/> <comment value="Terminologies used often pre-coordinate this term with the route and or form of administration."/> <requirements value="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 value="0"/> <max value="1"/> <base> <path value="Dosage.method"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MedicationAdministrationMethod"/> </extension> <strength value="example"/> <description value="A coded concept describing the technique by which the medicine is administered."/> <valueSet value="http://hl7.org/fhir/ValueSet/administration-method-codes"/> </binding> <mapping> <identity value="v2"/> <map value="RXR-4"/> </mapping> <mapping> <identity value="rim"/> <map value="SubstanceAdministration.methodCode"/> </mapping> </element> <element id="MedicationDispense.dosageInstruction.doseAndRate"> <path value="MedicationDispense.dosageInstruction.doseAndRate"/> <short value="Amount of medication administered, to be administered or typical amount to be administered"/> <definition value="Depending on the resource,this is the amount of medication administered, to be administered or typical amount to be administered."/> <min value="0"/> <max value="*"/> <base> <path value="Dosage.doseAndRate"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Element"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="TQ1-2"/> </mapping> <mapping> <identity value="rim"/> <map value="SubstanceAdministration.doseQuantity; SubstanceAdministration.RateQuantity"/> </mapping> </element> <element id="MedicationDispense.dosageInstruction.doseAndRate.id"> <path value="MedicationDispense.dosageInstruction.doseAndRate.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="MedicationDispense.dosageInstruction.doseAndRate.extension"> <path value="MedicationDispense.dosageInstruction.doseAndRate.extension"/> <slicing> <discriminator> <type value="value"/> <path value="url"/> </discriminator> <description value="Extensions are always sliced by (at least) url"/> <rules value="open"/> </slicing> <short value="Additional content defined by implementations"/> <definition value="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 managable, 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."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="MedicationDispense.dosageInstruction.doseAndRate.type"> <path value="MedicationDispense.dosageInstruction.doseAndRate.type"/> <short value="The kind of dose or rate specified"/> <definition value="The kind of dose or rate specified, for example, ordered or calculated."/> <requirements value="If the type is not populated, assume to be "ordered"."/> <min value="0"/> <max value="1"/> <base> <path value="Dosage.doseAndRate.type"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DoseAndRateType"/> </extension> <strength value="example"/> <description value="The kind of dose or rate specified."/> <valueSet value="http://terminology.hl7.org/ValueSet/dose-rate-type"/> </binding> <mapping> <identity value="v2"/> <map value="RXO-21; RXE-23"/> </mapping> </element> <element id="MedicationDispense.dosageInstruction.doseAndRate.dose[x]"> <path value="MedicationDispense.dosageInstruction.doseAndRate.dose[x]"/> <slicing> <discriminator> <type value="type"/> <path value="$this"/> </discriminator> <ordered value="false"/> <rules value="open"/> </slicing> <short value="Amount of medication per dose"/> <definition value="Amount of medication per dose."/> <comment value="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."/> <requirements value="The amount of therapeutic or other substance given at one administration event."/> <min value="0"/> <max value="1"/> <base> <path value="Dosage.doseAndRate.dose[x]"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Range"/> </type> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="RXO-2, RXE-3"/> </mapping> <mapping> <identity value="rim"/> <map value=".doseQuantity"/> </mapping> </element> <element id="MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity"> <path value="MedicationDispense.dosageInstruction.doseAndRate.dose[x]"/> <sliceName value="doseQuantity"/> <short value="A fixed quantity (no comparator)"/> <definition value="The comparator is not used on a SimpleQuantity"/> <comment value="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."/> <requirements value="The amount of therapeutic or other substance given at one administration event."/> <min value="0"/> <max value="1"/> <base> <path value="Dosage.doseAndRate.dose[x]"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="qty-3"/> <severity value="error"/> <human value="If a code for the unit is present, the system SHALL also be present"/> <expression value="code.empty() or system.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Quantity"/> </constraint> <constraint> <key value="sqty-1"/> <severity value="error"/> <human value="The comparator is not used on a SimpleQuantity"/> <expression value="comparator.empty()"/> <source value="http://hl7.org/fhir/StructureDefinition/MedicationDispense"/> </constraint> <isModifier value="false"/> <mapping> <identity value="rim"/> <map value="n/a,PQ, IVL<PQ>, MO, CO, depending on the values"/> </mapping> <mapping> <identity value="v2"/> <map value="SN (see also Range) or CQ"/> </mapping> </element> <element id="MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.id"> <path value="MedicationDispense.dosageInstruction.doseAndRate.dose[x].id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.extension"> <path value="MedicationDispense.dosageInstruction.doseAndRate.dose[x].extension"/> <slicing> <discriminator> <type value="value"/> <path value="url"/> </discriminator> <description value="Extensions are always sliced by (at least) url"/> <rules value="open"/> </slicing> <short value="Additional content defined by implementations"/> <definition value="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 managable, 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."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.value"> <path value="MedicationDispense.dosageInstruction.doseAndRate.dose[x].value"/> <short value="Numerical value (with implicit precision)"/> <definition value="The value of the measured amount. The value includes an implicit precision in the presentation of the value."/> <comment value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)."/> <requirements value="Precision is handled implicitly in almost all cases of measurement."/> <min value="0"/> <max value="1"/> <base> <path value="Quantity.value"/> <min value="0"/> <max value="1"/> </base> <type> <code value="decimal"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="SN.2 / CQ - N/A"/> </mapping> <mapping> <identity value="rim"/> <map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value"/> </mapping> </element> <element id="MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.comparator"> <path value="MedicationDispense.dosageInstruction.doseAndRate.dose[x].comparator"/> <short value="< | <= | >= | > | ad - how to understand the value"/> <definition value="Not allowed to be used in this context"/> <requirements value="Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology."/> <min value="0"/> <max value="0"/> <base> <path value="Quantity.comparator"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <meaningWhenMissing value="If there is no comparator, then there is no modification of the value"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="true"/> <isModifierReason value="This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="QuantityComparator"/> </extension> <strength value="required"/> <description value="How the Quantity should be understood and represented."/> <valueSet value="http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0"/> </binding> <mapping> <identity value="v2"/> <map value="SN.1 / CQ.1"/> </mapping> <mapping> <identity value="rim"/> <map value="IVL properties"/> </mapping> </element> <element id="MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.unit"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="MedicationDispense.dosageInstruction.doseAndRate.dose[x].unit"/> <short value="Unit representation"/> <definition value="A human-readable form of the unit."/> <requirements value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms."/> <min value="0"/> <max value="1"/> <base> <path value="Quantity.unit"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="(see OBX.6 etc.) / CQ.2"/> </mapping> <mapping> <identity value="rim"/> <map value="PQ.unit"/> </mapping> </element> <element id="MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.system"> <path value="MedicationDispense.dosageInstruction.doseAndRate.dose[x].system"/> <short value="System that defines coded unit form"/> <definition value="The identification of the system that provides the coded form of the unit."/> <requirements value="Need to know the system that defines the coded form of the unit."/> <min value="0"/> <max value="1"/> <base> <path value="Quantity.system"/> <min value="0"/> <max value="1"/> </base> <type> <code value="uri"/> </type> <condition value="qty-3"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="(see OBX.6 etc.) / CQ.2"/> </mapping> <mapping> <identity value="rim"/> <map value="CO.codeSystem, PQ.translation.codeSystem"/> </mapping> </element> <element id="MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.code"> <path value="MedicationDispense.dosageInstruction.doseAndRate.dose[x].code"/> <short value="Coded form of the unit"/> <definition value="A computer processable form of the unit in some unit representation system."/> <comment value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system."/> <requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest."/> <min value="0"/> <max value="1"/> <base> <path value="Quantity.code"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <condition value="qty-3"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <binding> <strength value="required"/> <valueSet value="https://termgit.elga.gv.at/ValueSet/elga-medikationdarreichungsform"/> </binding> <mapping> <identity value="v2"/> <map value="(see OBX.6 etc.) / CQ.2"/> </mapping> <mapping> <identity value="rim"/> <map value="PQ.code, MO.currency, PQ.translation.code"/> </mapping> </element> <element id="MedicationDispense.dosageInstruction.doseAndRate.rate[x]"> <path value="MedicationDispense.dosageInstruction.doseAndRate.rate[x]"/> <short value="Amount of medication per unit of time"/> <definition value="Amount of medication per unit of time."/> <comment value="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. It 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 grammar 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."/> <requirements value="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 value="0"/> <max value="1"/> <base> <path value="Dosage.doseAndRate.rate[x]"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Ratio"/> </type> <type> <code value="Range"/> </type> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="RXE22, RXE23, RXE-24"/> </mapping> <mapping> <identity value="rim"/> <map value=".rateQuantity"/> </mapping> </element> <element id="MedicationDispense.dosageInstruction.maxDosePerPeriod"> <path value="MedicationDispense.dosageInstruction.maxDosePerPeriod"/> <short value="Upper limit on medication per unit of time"/> <definition value="Upper limit on medication per unit of time."/> <comment value="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"."/> <requirements value="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 value="0"/> <max value="*"/> <base> <path value="Dosage.maxDosePerPeriod"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Ratio"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="RXO-23, RXE-19"/> </mapping> <mapping> <identity value="rim"/> <map value=".maxDoseQuantity"/> </mapping> </element> <element id="MedicationDispense.dosageInstruction.maxDosePerAdministration"> <path value="MedicationDispense.dosageInstruction.maxDosePerAdministration"/> <short value="Upper limit on medication per administration"/> <definition value="Upper limit on medication per administration."/> <comment value="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."/> <requirements value="The maximum total quantity of a therapeutic substance that may be administered to a subject per administration."/> <min value="0"/> <max value="1"/> <base> <path value="Dosage.maxDosePerAdministration"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="not supported"/> </mapping> </element> <element id="MedicationDispense.dosageInstruction.maxDosePerLifetime"> <path value="MedicationDispense.dosageInstruction.maxDosePerLifetime"/> <short value="Upper limit on medication per lifetime of the patient"/> <definition value="Upper limit on medication per lifetime of the patient."/> <requirements value="The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject."/> <min value="0"/> <max value="1"/> <base> <path value="Dosage.maxDosePerLifetime"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="not supported"/> </mapping> </element> <element id="MedicationDispense.substitution"> <path value="MedicationDispense.substitution"/> <short value="Whether a substitution was performed on the dispense"/> <definition value="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."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationDispense.substitution"/> <min value="0"/> <max value="1"/> </base> <type> <code value="BackboneElement"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".outboundRelationship[typeCode=COMP].target[classCode=SUBST, moodCode=EVN]"/> </mapping> <mapping> <identity value="rx-dispense-rmim"/> <map value="CombinedMedicationDispense.substitutionMade"/> </mapping> </element> <element id="MedicationDispense.substitution.id"> <path value="MedicationDispense.substitution.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="MedicationDispense.substitution.extension"> <path value="MedicationDispense.substitution.extension"/> <short value="Additional content defined by implementations"/> <definition value="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 managable, 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."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="MedicationDispense.substitution.modifierExtension"> <path value="MedicationDispense.substitution.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="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 managable, 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/> <comment value="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."/> <requirements value="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](http://hl7.org/fhir/R5/extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneElement.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="MedicationDispense.substitution.wasSubstituted"> <path value="MedicationDispense.substitution.wasSubstituted"/> <short value="Whether a substitution was or was not performed on the dispense"/> <definition value="True if the dispenser dispensed a different drug or product from what was prescribed."/> <min value="1"/> <max value="1"/> <base> <path value="MedicationDispense.substitution.wasSubstituted"/> <min value="1"/> <max value="1"/> </base> <type> <code value="boolean"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".actionNegationInd"/> </mapping> </element> <element id="MedicationDispense.substitution.type"> <path value="MedicationDispense.substitution.type"/> <short value="Code signifying whether a different drug was dispensed from what was prescribed"/> <definition value="A code signifying whether a different drug was dispensed from what was prescribed."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationDispense.substitution.type"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MedicationIntendedSubstitutionType"/> </extension> <strength value="example"/> <description value="ActSubstanceAdminSubstitutionCode"/> <valueSet value="http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode"/> </binding> <mapping> <identity value="v2"/> <map value="RXO-9 Allow Substitutions / RXE-9 Substitution Status"/> </mapping> <mapping> <identity value="rim"/> <map value=".code"/> </mapping> <mapping> <identity value="rx-dispense-rmim"/> <map value="CombinedMedicationDispense.substitutionMade.code"/> </mapping> </element> <element id="MedicationDispense.substitution.reason"> <path value="MedicationDispense.substitution.reason"/> <short value="Why was substitution made"/> <definition value="Indicates the reason for the substitution (or lack of substitution) from what was prescribed."/> <min value="0"/> <max value="*"/> <base> <path value="MedicationDispense.substitution.reason"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MedicationIntendedSubstitutionReason"/> </extension> <strength value="example"/> <description value="SubstanceAdminSubstitutionReason"/> <valueSet value="http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason"/> </binding> <mapping> <identity value="rim"/> <map value=".reasonCode"/> </mapping> <mapping> <identity value="rx-dispense-rmim"/> <map value="CombinedMedicationDispense.substitutionMade.reasonCode"/> </mapping> </element> <element id="MedicationDispense.substitution.responsibleParty"> <path value="MedicationDispense.substitution.responsibleParty"/> <short value="Who is responsible for the substitution"/> <definition value="The person or organization that has primary responsibility for the substitution."/> <min value="0"/> <max value="1"/> <base> <path value="MedicationDispense.substitution.responsibleParty"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".participation[typeCode=PFM].role[classCode=ASSIGN]"/> </mapping> <mapping> <identity value="rx-dispense-rmim"/> <map value="CombinedMedicationDispense.substitutionMade.ResponsibleParty"/> </mapping> </element> <element id="MedicationDispense.eventHistory"> <path value="MedicationDispense.eventHistory"/> <short value="A list of relevant lifecycle events"/> <definition value="A summary of the events of interest that have occurred, such as when the dispense was verified."/> <comment value="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.)."/> <min value="0"/> <max value="*"/> <base> <path value="MedicationDispense.eventHistory"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Provenance"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]"/> </mapping> </element> </snapshot> <differential> <element id="MedicationDispense"> <path value="MedicationDispense"/> </element> <element id="MedicationDispense.status"> <path value="MedicationDispense.status"/> <short value="A dispense ends the chain of the workflow. Therefore the status is fixed to 'completed'"/> <patternCode value="completed"/> </element> <element id="MedicationDispense.medication"> <path value="MedicationDispense.medication"/> <short value="Medication that was dispensed, in conformance with ELGA CodeSystems (text-only, or text and number referencing one of the supported catalogs, as for example the PZN of the Austrian ASP)."/> <type> <code value="CodeableReference"/> <targetProfile value="http://fhir.hl7.at/linkedcare/StructureDefinition/linca-medication"/> </type> <binding> <strength value="required"/> <valueSet value="https://termgit.elga.gv.at/CodeSystem-asp-liste"/> </binding> </element> <element id="MedicationDispense.subject"> <path value="MedicationDispense.subject"/> <short value="Patient conform HL7 AT. Make sure the patient is identifiable somehow"/> <type> <code value="Reference"/> <targetProfile value="http://fhir.hl7.at/linkedcare/StructureDefinition/at-core-patient"/> </type> </element> <element id="MedicationDispense.performer.actor"> <path value="MedicationDispense.performer.actor"/> <short value="Reference to dispensing pharmacy (GDA index)"/> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization"/> </type> </element> <element id="MedicationDispense.authorizingPrescription"> <path value="MedicationDispense.authorizingPrescription"/> <short value="Prescription that authorized dispense of this medication"/> <min value="1"/> <max value="1"/> <type> <code value="Reference"/> <targetProfile value="http://fhir.hl7.at/linkedcare/StructureDefinition/linca-prescription-medication-request"/> </type> </element> <element id="MedicationDispense.type"> <path value="MedicationDispense.type"/> <short value="Possible values: FFC (First-fill complete for completly fulfilled orders), FFP (first-fill part fill, for pratially fulfilled orders)"/> </element> <element id="MedicationDispense.dosageInstruction.doseAndRate.dose[x]"> <path value="MedicationDispense.dosageInstruction.doseAndRate.dose[x]"/> <slicing> <discriminator> <type value="type"/> <path value="$this"/> </discriminator> <ordered value="false"/> <rules value="open"/> </slicing> </element> <element id="MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity"> <path value="MedicationDispense.dosageInstruction.doseAndRate.dose[x]"/> <sliceName value="doseQuantity"/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity"/> </type> </element> <element id="MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.code"> <path value="MedicationDispense.dosageInstruction.doseAndRate.dose[x].code"/> <binding> <strength value="required"/> <valueSet value="https://termgit.elga.gv.at/ValueSet/elga-medikationdarreichungsform"/> </binding> </element> </differential> </StructureDefinition>

Name	Card.	Type	Description & Constraints
MedicationDispense	0..*	MedicationDispense	Dispensing a medication to a named patient
status	1..1	code	A dispense ends the chain of the workflow. Therefore the status is fixed to 'completed' Required Pattern: completed
medication	1..1	CodeableReference(LINCA Medication (LINCAMeds))	Medication that was dispensed, in conformance with ELGA CodeSystems (text-only, or text and number referencing one of the supported catalogs, as for example the PZN of the Austrian ASP). Binding: https://termgit.elga.gv.at/CodeSystem-asp-liste (required)
subject	1..1	Reference(HL7® AT Core Patient Profile)	Patient conform HL7 AT. Make sure the patient is identifiable somehow
performer
actor	1..1	Reference(Organization)	Reference to dispensing pharmacy (GDA index)
authorizingPrescription	1..1	Reference(LINCA Prescription (LINCAPrescriptionMedicationRequest))	Prescription that authorized dispense of this medication
type	0..1	CodeableConcept	Possible values: FFC (First-fill complete for completly fulfilled orders), FFP (first-fill part fill, for pratially fulfilled orders)
dosageInstruction
doseAndRate
Slices for dose[x]	0..1	Range, SimpleQuantity	Amount of medication per dose Slice: Unordered, Open by type:$this
dose[x]:doseQuantity	0..1	SimpleQuantity	A fixed quantity (no comparator)
code	0..1	code	Coded form of the unit Binding: https://termgit.elga.gv.at/ValueSet/elga-medikationdarreichungsform (required)
Documentation for this format