Draft PH Core Implementation Guide
0.2.0 - ci-build Philippines flag

Draft PH Core Implementation Guide - Local Development build (v0.2.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: PHCoreMedicationDispense - Detailed Descriptions

Draft as of 2026-04-10

Definitions for the ph-core-medicationdispense resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. MedicationDispense
Definition

Indicates that a medication product is to be or has been dispensed for a named person/patient. This includes a description of the medication product (supply) provided and the instructions for administering the medication. The medication dispense is the result of a pharmacy system responding to a medication order.

ShortDispensing a medication to a named patient
Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
mdd-1: whenHandedOver cannot be before whenPrepared (whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared)
mdd-1: whenHandedOver cannot be before whenPrepared (whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared)
2. MedicationDispense.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. MedicationDispense.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored
Comments

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.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. MedicationDispense.status
Definition

A code specifying the state of the set of dispense events.

Shortpreparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown
Comments

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

Control1..1
BindingThe codes SHALL be taken from MedicationDispense Status Codeshttp://hl7.org/fhir/ValueSet/medicationdispense-status|4.0.1
(required to http://hl7.org/fhir/ValueSet/medicationdispense-status|4.0.1)

A coded concept specifying the state of the dispense event.

Typecode
Is Modifiertrue because 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
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. MedicationDispense.statusReason[x]
Definition

Indicates the reason why a dispense was not performed.

ShortWhy a dispense was not performed
Control0..1
BindingFor example codes, see MedicationDispense Status Reason Codeshttp://hl7.org/fhir/ValueSet/medicationdispense-status-reason|4.0.1
(example to http://hl7.org/fhir/ValueSet/medicationdispense-status-reason|4.0.1)

A code describing why a dispense was not performed.

TypeChoice of: CodeableConcept, Reference(DetectedIssue)
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on MedicationDispense.statusReason[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • type @ $this
  • 10. MedicationDispense.statusReason[x]:statusReasonCodeableConcept
    Slice NamestatusReasonCodeableConcept
    Definition

    Indicates the reason why a dispense was not performed.

    ShortWhy a dispense was not performed
    Control0..1
    BindingFor example codes, see MedicationDispense Status Reason Codeshttp://hl7.org/fhir/ValueSet/medicationdispense-status-reason|4.0.1
    (example to http://hl7.org/fhir/ValueSet/medicationdispense-status-reason|4.0.1)

    A code describing why a dispense was not performed.

    TypeCodeableConcept, Reference(DetectedIssue)
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifierfalse
    Must Supporttrue
    Obligations
      ObligationsActor
      SHALL:handlePH Core Server
      SHALL:handlePH Core Consumer
      MAY:able-to-populatePH Core Creator
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. MedicationDispense.statusReason[x]:statusReasonCodeableConcept.coding
      Definition

      A reference to a code defined by a terminology system.

      ShortCode defined by a terminology system
      Comments

      Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

      Control0..*
      TypeCoding
      Is Modifierfalse
      Must Supporttrue
      Obligations
        ObligationsActor
        SHALL:handlePH Core Server
        SHALL:handlePH Core Consumer
        MAY:able-to-populatePH Core Creator
        Summarytrue
        Requirements

        Allows for alternative encodings within a code system, and translations to other code systems.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        14. MedicationDispense.statusReason[x]:statusReasonCodeableConcept.text
        Definition

        A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

        ShortPlain text representation of the concept
        Comments

        Very often the text is the same as a displayName of one of the codings.

        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Obligations
          ObligationsActor
          SHALL:handlePH Core Server
          SHALL:handlePH Core Consumer
          MAY:able-to-populatePH Core Creator
          Summarytrue
          Requirements

          The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          16. MedicationDispense.category
          Definition

          Indicates the type of medication dispense (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)).

          ShortType of medication dispense
          Comments

          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.

          Control0..1
          BindingThe codes SHOULD be taken from MedicationDispense Category Codeshttp://hl7.org/fhir/ValueSet/medicationdispense-category|4.0.1
          (preferred to http://hl7.org/fhir/ValueSet/medicationdispense-category|4.0.1)

          A code describing where the dispensed medication is expected to be consumed or administered.

          TypeCodeableConcept
          Is Modifierfalse
          Must Supporttrue
          Obligations
            ObligationsActor
            SHALL:handlePH Core Server
            SHALL:handlePH Core Consumer
            MAY:able-to-populatePH Core Creator
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            18. MedicationDispense.category.coding
            Definition

            A reference to a code defined by a terminology system.

            ShortCode defined by a terminology system
            Comments

            Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

            Control0..*
            TypeCoding
            Is Modifierfalse
            Must Supporttrue
            Obligations
              ObligationsActor
              SHALL:handlePH Core Server
              SHALL:handlePH Core Consumer
              MAY:able-to-populatePH Core Creator
              Summarytrue
              Requirements

              Allows for alternative encodings within a code system, and translations to other code systems.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              20. MedicationDispense.category.text
              Definition

              A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

              ShortPlain text representation of the concept
              Comments

              Very often the text is the same as a displayName of one of the codings.

              Control0..1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Obligations
                ObligationsActor
                SHALL:handlePH Core Server
                SHALL:handlePH Core Consumer
                MAY:able-to-populatePH Core Creator
                Summarytrue
                Requirements

                The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                22. MedicationDispense.medication[x]
                Definition

                Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.

                ShortWhat medication was supplied
                Comments

                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.

                Control1..1
                BindingFor example codes, see SNOMEDCTMedicationCodeshttp://hl7.org/fhir/ValueSet/medication-codes|4.0.1
                (example to http://hl7.org/fhir/ValueSet/medication-codes|4.0.1)

                A coded concept identifying which substance or product can be dispensed.

                TypeChoice of: CodeableConcept, Reference(Medication)
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Is Modifierfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                SlicingThis element introduces a set of slices on MedicationDispense.medication[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                • type @ $this
                • 24. MedicationDispense.medication[x]:medicationReference
                  Slice NamemedicationReference
                  Definition

                  Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.

                  ShortWhat medication was supplied
                  Comments

                  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.

                  Control01..1
                  TypeReference(PH Core Medication, Medication), CodeableConcept
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  26. MedicationDispense.medication[x]:medicationCodeableConcept
                  Slice NamemedicationCodeableConcept
                  Definition

                  Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.

                  ShortWhat medication was supplied
                  Comments

                  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.

                  Control01..1
                  BindingThe codes SHOULD be taken from For example codes, see Drugshttp://hl7.org/fhir/ValueSet/medication-codes|4.0.1
                  (preferred to http://doh.gov.ph/fhir/ph-core/ValueSet/drugs-vs)
                  TypeCodeableConcept, Reference(Medication)
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Is Modifierfalse
                  Must Supporttrue
                  Obligations
                    ObligationsActor
                    SHALL:handlePH Core Server
                    SHALL:handlePH Core Consumer
                    MAY:able-to-populatePH Core Creator
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    28. MedicationDispense.medication[x]:medicationCodeableConcept.coding
                    Definition

                    A reference to a code defined by a terminology system.

                    ShortCode defined by a terminology system
                    Comments

                    Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                    Control0..*
                    TypeCoding
                    Is Modifierfalse
                    Must Supporttrue
                    Obligations
                      ObligationsActor
                      SHALL:handlePH Core Server
                      SHALL:handlePH Core Consumer
                      MAY:able-to-populatePH Core Creator
                      Summarytrue
                      Requirements

                      Allows for alternative encodings within a code system, and translations to other code systems.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      30. MedicationDispense.medication[x]:medicationCodeableConcept.text
                      Definition

                      A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                      ShortPlain text representation of the concept
                      Comments

                      Very often the text is the same as a displayName of one of the codings.

                      Control0..1
                      Typestring
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Obligations
                        ObligationsActor
                        SHALL:handlePH Core Server
                        SHALL:handlePH Core Consumer
                        MAY:able-to-populatePH Core Creator
                        Summarytrue
                        Requirements

                        The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        32. MedicationDispense.subject
                        Definition

                        A link to a resource representing the person or the group to whom the medication will be given.

                        ShortWho the dispense is for
                        Comments

                        SubstanceAdministration->subject->Patient.

                        Control0..1
                        TypeReference(PH Core Patient, Group, Patient, Group)
                        Is Modifierfalse
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        34. MedicationDispense.context
                        Definition

                        The encounter or episode of care that establishes the context for this event.

                        ShortEncounter / Episode associated with event
                        Control0..1
                        TypeReference(PH Core Encounter, EpisodeOfCare, Encounter, EpisodeOfCare)
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        36. MedicationDispense.performer
                        Definition

                        Indicates who or what performed the event.

                        ShortWho performed event
                        Control0..*
                        TypeBackboneElement
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        38. MedicationDispense.performer.modifierExtension
                        Definition

                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                        ShortExtensions that cannot be ignored even if unrecognized
                        Comments

                        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.

                        Control0..*
                        TypeExtension
                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                        Summarytrue
                        Requirements

                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                        Alternate Namesextensions, user content, modifiers
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        40. MedicationDispense.performer.function
                        Definition

                        Distinguishes the type of performer in the dispense. For example, date enterer, packager, final checker.

                        ShortWho performed the dispense and what they did
                        Control0..1
                        BindingFor example codes, see MedicationDispense Performer Function Codeshttp://hl7.org/fhir/ValueSet/medicationdispense-performer-function|4.0.1
                        (example to http://hl7.org/fhir/ValueSet/medicationdispense-performer-function|4.0.1)

                        A code describing the role an individual played in dispensing a medication.

                        TypeCodeableConcept
                        Is Modifierfalse
                        Must Supporttrue
                        Obligations
                          ObligationsActor
                          SHALL:handlePH Core Server
                          SHALL:handlePH Core Consumer
                          MAY:able-to-populatePH Core Creator
                          Summaryfalse
                          Requirements

                          Allows disambiguation of the types of involvement of different performers.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          42. MedicationDispense.performer.function.coding
                          Definition

                          A reference to a code defined by a terminology system.

                          ShortCode defined by a terminology system
                          Comments

                          Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                          Control0..*
                          TypeCoding
                          Is Modifierfalse
                          Must Supporttrue
                          Obligations
                            ObligationsActor
                            SHALL:handlePH Core Server
                            SHALL:handlePH Core Consumer
                            MAY:able-to-populatePH Core Creator
                            Summarytrue
                            Requirements

                            Allows for alternative encodings within a code system, and translations to other code systems.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            44. MedicationDispense.performer.function.text
                            Definition

                            A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                            ShortPlain text representation of the concept
                            Comments

                            Very often the text is the same as a displayName of one of the codings.

                            Control0..1
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supporttrue
                            Obligations
                              ObligationsActor
                              SHALL:handlePH Core Server
                              SHALL:handlePH Core Consumer
                              MAY:able-to-populatePH Core Creator
                              Summarytrue
                              Requirements

                              The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              46. MedicationDispense.performer.actor
                              Definition

                              The device, practitioner, etc. who performed the action. It should be assumed that the actor is the dispenser of the medication.

                              ShortIndividual who was performing
                              Control1..1
                              TypeReference(PH Core Practitioner, PH Core PractitionerRole, PH Core Organization, PH Core Patient, Device, PH Core RelatedPerson, Practitioner, PractitionerRole, Organization, Patient, Device, RelatedPerson)
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              48. MedicationDispense.location
                              Definition

                              The principal physical location where the dispense was performed.

                              ShortWhere the dispense occurred
                              Control0..1
                              TypeReference(PH Core Location, Location)
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              50. MedicationDispense.authorizingPrescription
                              Definition

                              Indicates the medication order that is being dispensed against.

                              ShortMedication order that authorizes the dispense
                              Comments

                              Maps to basedOn in Event logical model.

                              Control0..*
                              TypeReference(PH Core Medication Request, MedicationRequest)
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              52. MedicationDispense.type
                              Definition

                              Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.

                              ShortTrial fill, partial fill, emergency fill, etc.
                              Control0..1
                              BindingFor example codes, see ActPharmacySupplyTypehttp://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType
                              (example to http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType)

                              Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supporttrue
                              Obligations
                                ObligationsActor
                                SHALL:handlePH Core Server
                                SHALL:handlePH Core Consumer
                                MAY:able-to-populatePH Core Creator
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                54. MedicationDispense.type.coding
                                Definition

                                A reference to a code defined by a terminology system.

                                ShortCode defined by a terminology system
                                Comments

                                Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                Control0..*
                                TypeCoding
                                Is Modifierfalse
                                Must Supporttrue
                                Obligations
                                  ObligationsActor
                                  SHALL:handlePH Core Server
                                  SHALL:handlePH Core Consumer
                                  MAY:able-to-populatePH Core Creator
                                  Summarytrue
                                  Requirements

                                  Allows for alternative encodings within a code system, and translations to other code systems.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  56. MedicationDispense.type.text
                                  Definition

                                  A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                  ShortPlain text representation of the concept
                                  Comments

                                  Very often the text is the same as a displayName of one of the codings.

                                  Control0..1
                                  Typestring
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Obligations
                                    ObligationsActor
                                    SHALL:handlePH Core Server
                                    SHALL:handlePH Core Consumer
                                    MAY:able-to-populatePH Core Creator
                                    Summarytrue
                                    Requirements

                                    The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    58. MedicationDispense.destination
                                    Definition

                                    Identification of the facility/location where the medication was shipped to, as part of the dispense event.

                                    ShortWhere the medication was sent
                                    Control0..1
                                    TypeReference(PH Core Location, Location)
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    60. MedicationDispense.receiver
                                    Definition

                                    Identifies the person who picked up the medication. This will usually be a patient or their caregiver, but some cases exist where it can be a healthcare professional.

                                    ShortWho collected the medication
                                    Control0..*
                                    TypeReference(PH Core Patient, PH Core Practitioner, Patient, Practitioner)
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    62. MedicationDispense.substitution
                                    Definition

                                    Indicates whether or not substitution was made as part of the dispense. In some cases, substitution will be expected but does not happen, in other cases substitution is not expected but does happen. This block explains what substitution did or did not happen and why. If nothing is specified, substitution was not done.

                                    ShortWhether a substitution was performed on the dispense
                                    Control0..1
                                    TypeBackboneElement
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    64. MedicationDispense.substitution.modifierExtension
                                    Definition

                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                    ShortExtensions that cannot be ignored even if unrecognized
                                    Comments

                                    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.

                                    Control0..*
                                    TypeExtension
                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                    Summarytrue
                                    Requirements

                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                    Alternate Namesextensions, user content, modifiers
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    66. MedicationDispense.substitution.wasSubstituted
                                    Definition

                                    True if the dispenser dispensed a different drug or product from what was prescribed.

                                    ShortWhether a substitution was or was not performed on the dispense
                                    Control1..1
                                    Typeboolean
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    68. MedicationDispense.substitution.type
                                    Definition

                                    A code signifying whether a different drug was dispensed from what was prescribed.

                                    ShortCode signifying whether a different drug was dispensed from what was prescribed
                                    Control0..1
                                    BindingFor example codes, see ActSubstanceAdminSubstitutionCodehttp://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
                                    (example to http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode)

                                    A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription.

                                    TypeCodeableConcept
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Obligations
                                      ObligationsActor
                                      SHALL:handlePH Core Server
                                      SHALL:handlePH Core Consumer
                                      MAY:able-to-populatePH Core Creator
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      70. MedicationDispense.substitution.type.coding
                                      Definition

                                      A reference to a code defined by a terminology system.

                                      ShortCode defined by a terminology system
                                      Comments

                                      Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                      Control0..*
                                      TypeCoding
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Obligations
                                        ObligationsActor
                                        SHALL:handlePH Core Server
                                        SHALL:handlePH Core Consumer
                                        MAY:able-to-populatePH Core Creator
                                        Summarytrue
                                        Requirements

                                        Allows for alternative encodings within a code system, and translations to other code systems.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        72. MedicationDispense.substitution.type.text
                                        Definition

                                        A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                        ShortPlain text representation of the concept
                                        Comments

                                        Very often the text is the same as a displayName of one of the codings.

                                        Control0..1
                                        Typestring
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supporttrue
                                        Obligations
                                          ObligationsActor
                                          SHALL:handlePH Core Server
                                          SHALL:handlePH Core Consumer
                                          MAY:able-to-populatePH Core Creator
                                          Summarytrue
                                          Requirements

                                          The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          74. MedicationDispense.substitution.reason
                                          Definition

                                          Indicates the reason for the substitution (or lack of substitution) from what was prescribed.

                                          ShortWhy was substitution made
                                          Control0..*
                                          BindingFor example codes, see SubstanceAdminSubstitutionReasonhttp://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason
                                          (example to http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason)

                                          A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.

                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Obligations
                                            ObligationsActor
                                            SHALL:handlePH Core Server
                                            SHALL:handlePH Core Consumer
                                            MAY:able-to-populatePH Core Creator
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            76. MedicationDispense.substitution.reason.coding
                                            Definition

                                            A reference to a code defined by a terminology system.

                                            ShortCode defined by a terminology system
                                            Comments

                                            Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                            Control0..*
                                            TypeCoding
                                            Is Modifierfalse
                                            Must Supporttrue
                                            Obligations
                                              ObligationsActor
                                              SHALL:handlePH Core Server
                                              SHALL:handlePH Core Consumer
                                              MAY:able-to-populatePH Core Creator
                                              Summarytrue
                                              Requirements

                                              Allows for alternative encodings within a code system, and translations to other code systems.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              78. MedicationDispense.substitution.reason.text
                                              Definition

                                              A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                              ShortPlain text representation of the concept
                                              Comments

                                              Very often the text is the same as a displayName of one of the codings.

                                              Control0..1
                                              Typestring
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supporttrue
                                              Obligations
                                                ObligationsActor
                                                SHALL:handlePH Core Server
                                                SHALL:handlePH Core Consumer
                                                MAY:able-to-populatePH Core Creator
                                                Summarytrue
                                                Requirements

                                                The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                80. MedicationDispense.substitution.responsibleParty
                                                Definition

                                                The person or organization that has primary responsibility for the substitution.

                                                ShortWho is responsible for the substitution
                                                Control0..*
                                                TypeReference(PH Core Practitioner, PH Core PractitionerRole, Practitioner, PractitionerRole)
                                                Is Modifierfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

                                                Guidance on how to interpret the contents of this table can be foundhere

                                                0. MedicationDispense
                                                2. MedicationDispense.statusReason[x]
                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                SlicingThis element introduces a set of slices on MedicationDispense.statusReason[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                • type @ $this
                                                • 4. MedicationDispense.statusReason[x]:statusReasonCodeableConcept
                                                  Slice NamestatusReasonCodeableConcept
                                                  Control0..1
                                                  TypeCodeableConcept
                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                  Must Supporttrue
                                                  Obligations
                                                    ObligationsActor
                                                    SHALL:handlePH Core Server
                                                    SHALL:handlePH Core Consumer
                                                    MAY:able-to-populatePH Core Creator
                                                    6. MedicationDispense.statusReason[x]:statusReasonCodeableConcept.coding
                                                    Must Supporttrue
                                                    Obligations
                                                      ObligationsActor
                                                      SHALL:handlePH Core Server
                                                      SHALL:handlePH Core Consumer
                                                      MAY:able-to-populatePH Core Creator
                                                      8. MedicationDispense.statusReason[x]:statusReasonCodeableConcept.text
                                                      Must Supporttrue
                                                      Obligations
                                                        ObligationsActor
                                                        SHALL:handlePH Core Server
                                                        SHALL:handlePH Core Consumer
                                                        MAY:able-to-populatePH Core Creator
                                                        10. MedicationDispense.category
                                                        Must Supporttrue
                                                        Obligations
                                                          ObligationsActor
                                                          SHALL:handlePH Core Server
                                                          SHALL:handlePH Core Consumer
                                                          MAY:able-to-populatePH Core Creator
                                                          12. MedicationDispense.category.coding
                                                          Must Supporttrue
                                                          Obligations
                                                            ObligationsActor
                                                            SHALL:handlePH Core Server
                                                            SHALL:handlePH Core Consumer
                                                            MAY:able-to-populatePH Core Creator
                                                            14. MedicationDispense.category.text
                                                            Must Supporttrue
                                                            Obligations
                                                              ObligationsActor
                                                              SHALL:handlePH Core Server
                                                              SHALL:handlePH Core Consumer
                                                              MAY:able-to-populatePH Core Creator
                                                              16. MedicationDispense.medication[x]
                                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                              SlicingThis element introduces a set of slices on MedicationDispense.medication[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                              • type @ $this
                                                              • 18. MedicationDispense.medication[x]:medicationReference
                                                                Slice NamemedicationReference
                                                                Control0..1
                                                                TypeReference(PH Core Medication)
                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                20. MedicationDispense.medication[x]:medicationCodeableConcept
                                                                Slice NamemedicationCodeableConcept
                                                                Control0..1
                                                                BindingThe codes SHOULD be taken from Drugs
                                                                (preferred to http://doh.gov.ph/fhir/ph-core/ValueSet/drugs-vs)
                                                                TypeCodeableConcept
                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                Must Supporttrue
                                                                Obligations
                                                                  ObligationsActor
                                                                  SHALL:handlePH Core Server
                                                                  SHALL:handlePH Core Consumer
                                                                  MAY:able-to-populatePH Core Creator
                                                                  22. MedicationDispense.medication[x]:medicationCodeableConcept.coding
                                                                  Must Supporttrue
                                                                  Obligations
                                                                    ObligationsActor
                                                                    SHALL:handlePH Core Server
                                                                    SHALL:handlePH Core Consumer
                                                                    MAY:able-to-populatePH Core Creator
                                                                    24. MedicationDispense.medication[x]:medicationCodeableConcept.text
                                                                    Must Supporttrue
                                                                    Obligations
                                                                      ObligationsActor
                                                                      SHALL:handlePH Core Server
                                                                      SHALL:handlePH Core Consumer
                                                                      MAY:able-to-populatePH Core Creator
                                                                      26. MedicationDispense.subject
                                                                      TypeReference(PH Core Patient, Group)
                                                                      28. MedicationDispense.context
                                                                      TypeReference(PH Core Encounter, EpisodeOfCare)
                                                                      30. MedicationDispense.performer
                                                                      32. MedicationDispense.performer.function
                                                                      Must Supporttrue
                                                                      Obligations
                                                                        ObligationsActor
                                                                        SHALL:handlePH Core Server
                                                                        SHALL:handlePH Core Consumer
                                                                        MAY:able-to-populatePH Core Creator
                                                                        34. MedicationDispense.performer.function.coding
                                                                        Must Supporttrue
                                                                        Obligations
                                                                          ObligationsActor
                                                                          SHALL:handlePH Core Server
                                                                          SHALL:handlePH Core Consumer
                                                                          MAY:able-to-populatePH Core Creator
                                                                          36. MedicationDispense.performer.function.text
                                                                          Must Supporttrue
                                                                          Obligations
                                                                            ObligationsActor
                                                                            SHALL:handlePH Core Server
                                                                            SHALL:handlePH Core Consumer
                                                                            MAY:able-to-populatePH Core Creator
                                                                            38. MedicationDispense.performer.actor
                                                                            TypeReference(PH Core Practitioner, PH Core PractitionerRole, PH Core Organization, PH Core Patient, Device, PH Core RelatedPerson)
                                                                            40. MedicationDispense.location
                                                                            TypeReference(PH Core Location)
                                                                            42. MedicationDispense.authorizingPrescription
                                                                            TypeReference(PH Core Medication Request)
                                                                            44. MedicationDispense.type
                                                                            Must Supporttrue
                                                                            Obligations
                                                                              ObligationsActor
                                                                              SHALL:handlePH Core Server
                                                                              SHALL:handlePH Core Consumer
                                                                              MAY:able-to-populatePH Core Creator
                                                                              46. MedicationDispense.type.coding
                                                                              Must Supporttrue
                                                                              Obligations
                                                                                ObligationsActor
                                                                                SHALL:handlePH Core Server
                                                                                SHALL:handlePH Core Consumer
                                                                                MAY:able-to-populatePH Core Creator
                                                                                48. MedicationDispense.type.text
                                                                                Must Supporttrue
                                                                                Obligations
                                                                                  ObligationsActor
                                                                                  SHALL:handlePH Core Server
                                                                                  SHALL:handlePH Core Consumer
                                                                                  MAY:able-to-populatePH Core Creator
                                                                                  50. MedicationDispense.destination
                                                                                  TypeReference(PH Core Location)
                                                                                  52. MedicationDispense.receiver
                                                                                  TypeReference(PH Core Patient, PH Core Practitioner)
                                                                                  54. MedicationDispense.substitution
                                                                                  56. MedicationDispense.substitution.type
                                                                                  Must Supporttrue
                                                                                  Obligations
                                                                                    ObligationsActor
                                                                                    SHALL:handlePH Core Server
                                                                                    SHALL:handlePH Core Consumer
                                                                                    MAY:able-to-populatePH Core Creator
                                                                                    58. MedicationDispense.substitution.type.coding
                                                                                    Must Supporttrue
                                                                                    Obligations
                                                                                      ObligationsActor
                                                                                      SHALL:handlePH Core Server
                                                                                      SHALL:handlePH Core Consumer
                                                                                      MAY:able-to-populatePH Core Creator
                                                                                      60. MedicationDispense.substitution.type.text
                                                                                      Must Supporttrue
                                                                                      Obligations
                                                                                        ObligationsActor
                                                                                        SHALL:handlePH Core Server
                                                                                        SHALL:handlePH Core Consumer
                                                                                        MAY:able-to-populatePH Core Creator
                                                                                        62. MedicationDispense.substitution.reason
                                                                                        Must Supporttrue
                                                                                        Obligations
                                                                                          ObligationsActor
                                                                                          SHALL:handlePH Core Server
                                                                                          SHALL:handlePH Core Consumer
                                                                                          MAY:able-to-populatePH Core Creator
                                                                                          64. MedicationDispense.substitution.reason.coding
                                                                                          Must Supporttrue
                                                                                          Obligations
                                                                                            ObligationsActor
                                                                                            SHALL:handlePH Core Server
                                                                                            SHALL:handlePH Core Consumer
                                                                                            MAY:able-to-populatePH Core Creator
                                                                                            66. MedicationDispense.substitution.reason.text
                                                                                            Must Supporttrue
                                                                                            Obligations
                                                                                              ObligationsActor
                                                                                              SHALL:handlePH Core Server
                                                                                              SHALL:handlePH Core Consumer
                                                                                              MAY:able-to-populatePH Core Creator
                                                                                              68. MedicationDispense.substitution.responsibleParty
                                                                                              TypeReference(PH Core Practitioner, PH Core PractitionerRole)

                                                                                              Guidance on how to interpret the contents of this table can be foundhere

                                                                                              0. MedicationDispense
                                                                                              Definition

                                                                                              Indicates that a medication product is to be or has been dispensed for a named person/patient. This includes a description of the medication product (supply) provided and the instructions for administering the medication. The medication dispense is the result of a pharmacy system responding to a medication order.

                                                                                              ShortDispensing a medication to a named patient
                                                                                              Control0..*
                                                                                              Is Modifierfalse
                                                                                              Summaryfalse
                                                                                              Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                                                                                              dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
                                                                                              dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
                                                                                              dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                                                                                              dom-6: A resource should have narrative for robust management (text.`div`.exists())
                                                                                              mdd-1: whenHandedOver cannot be before whenPrepared (whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared)
                                                                                              2. MedicationDispense.id
                                                                                              Definition

                                                                                              The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

                                                                                              ShortLogical id of this artifact
                                                                                              Comments

                                                                                              The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

                                                                                              Control0..1
                                                                                              Typeid
                                                                                              Is Modifierfalse
                                                                                              Summarytrue
                                                                                              4. MedicationDispense.meta
                                                                                              Definition

                                                                                              The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

                                                                                              ShortMetadata about the resource
                                                                                              Control0..1
                                                                                              TypeMeta
                                                                                              Is Modifierfalse
                                                                                              Summarytrue
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              6. MedicationDispense.implicitRules
                                                                                              Definition

                                                                                              A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

                                                                                              ShortA set of rules under which this content was created
                                                                                              Comments

                                                                                              Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

                                                                                              Control0..1
                                                                                              Typeuri
                                                                                              Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                              Summarytrue
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              8. MedicationDispense.language
                                                                                              Definition

                                                                                              The base language in which the resource is written.

                                                                                              ShortLanguage of the resource content
                                                                                              Comments

                                                                                              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).

                                                                                              Control0..1
                                                                                              BindingThe codes SHOULD be taken from CommonLanguages
                                                                                              (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

                                                                                              A human language.

                                                                                              Additional BindingsPurpose
                                                                                              AllLanguagesMax Binding
                                                                                              Typecode
                                                                                              Is Modifierfalse
                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                              Summaryfalse
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              10. MedicationDispense.text
                                                                                              Definition

                                                                                              A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

                                                                                              ShortText summary of the resource, for human interpretation
                                                                                              Comments

                                                                                              Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

                                                                                              Control0..1
                                                                                              TypeNarrative
                                                                                              Is Modifierfalse
                                                                                              Summaryfalse
                                                                                              Alternate Namesnarrative, html, xhtml, display
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              12. MedicationDispense.contained
                                                                                              Definition

                                                                                              These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

                                                                                              ShortContained, inline Resources
                                                                                              Comments

                                                                                              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.

                                                                                              Control0..*
                                                                                              TypeResource
                                                                                              Is Modifierfalse
                                                                                              Summaryfalse
                                                                                              Alternate Namesinline resources, anonymous resources, contained resources
                                                                                              14. MedicationDispense.extension
                                                                                              Definition

                                                                                              May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                              ShortAdditional content defined by implementations
                                                                                              Comments

                                                                                              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.

                                                                                              Control0..*
                                                                                              TypeExtension
                                                                                              Is Modifierfalse
                                                                                              Summaryfalse
                                                                                              Alternate Namesextensions, user content
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                              16. MedicationDispense.modifierExtension
                                                                                              Definition

                                                                                              May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                              ShortExtensions that cannot be ignored
                                                                                              Comments

                                                                                              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.

                                                                                              Control0..*
                                                                                              TypeExtension
                                                                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                                                                                              Summaryfalse
                                                                                              Requirements

                                                                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                              Alternate Namesextensions, user content
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                              18. MedicationDispense.identifier
                                                                                              Definition

                                                                                              Identifiers associated with this Medication Dispense that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server.

                                                                                              ShortExternal identifier
                                                                                              Comments

                                                                                              This is a business identifier, not a resource identifier.

                                                                                              NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                                              Control0..*
                                                                                              TypeIdentifier
                                                                                              Is Modifierfalse
                                                                                              Summaryfalse
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              20. MedicationDispense.partOf
                                                                                              Definition

                                                                                              The procedure that trigger the dispense.

                                                                                              ShortEvent that dispense is part of
                                                                                              Control0..*
                                                                                              TypeReference(Procedure)
                                                                                              Is Modifierfalse
                                                                                              Summaryfalse
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              22. MedicationDispense.status
                                                                                              Definition

                                                                                              A code specifying the state of the set of dispense events.

                                                                                              Shortpreparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | declined | unknown
                                                                                              Comments

                                                                                              This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

                                                                                              Control1..1
                                                                                              BindingThe codes SHALL be taken from MedicationDispense Status Codes
                                                                                              (required to http://hl7.org/fhir/ValueSet/medicationdispense-status|4.0.1)

                                                                                              A coded concept specifying the state of the dispense event.

                                                                                              Typecode
                                                                                              Is Modifiertrue because 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
                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                              Summarytrue
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              24. MedicationDispense.statusReason[x]
                                                                                              Definition

                                                                                              Indicates the reason why a dispense was not performed.

                                                                                              ShortWhy a dispense was not performed
                                                                                              Control0..1
                                                                                              BindingFor example codes, see MedicationDispense Status Reason Codes
                                                                                              (example to http://hl7.org/fhir/ValueSet/medicationdispense-status-reason|4.0.1)

                                                                                              A code describing why a dispense was not performed.

                                                                                              TypeChoice of: CodeableConcept, Reference(DetectedIssue)
                                                                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                              Is Modifierfalse
                                                                                              Summaryfalse
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              SlicingThis element introduces a set of slices on MedicationDispense.statusReason[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                              • type @ $this
                                                                                              • 26. MedicationDispense.statusReason[x]:statusReasonCodeableConcept
                                                                                                Slice NamestatusReasonCodeableConcept
                                                                                                Definition

                                                                                                Indicates the reason why a dispense was not performed.

                                                                                                ShortWhy a dispense was not performed
                                                                                                Control0..1
                                                                                                BindingFor example codes, see MedicationDispense Status Reason Codes
                                                                                                (example to http://hl7.org/fhir/ValueSet/medicationdispense-status-reason|4.0.1)

                                                                                                A code describing why a dispense was not performed.

                                                                                                TypeCodeableConcept
                                                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                Is Modifierfalse
                                                                                                Must Supporttrue
                                                                                                Obligations
                                                                                                  ObligationsActor
                                                                                                  SHALL:handlePH Core Server
                                                                                                  SHALL:handlePH Core Consumer
                                                                                                  MAY:able-to-populatePH Core Creator
                                                                                                  Summaryfalse
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  28. MedicationDispense.statusReason[x]:statusReasonCodeableConcept.id
                                                                                                  Definition

                                                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                  ShortUnique id for inter-element referencing
                                                                                                  Control0..1
                                                                                                  Typestring
                                                                                                  Is Modifierfalse
                                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                  Summaryfalse
                                                                                                  30. MedicationDispense.statusReason[x]:statusReasonCodeableConcept.extension
                                                                                                  Definition

                                                                                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                  ShortAdditional content defined by implementations
                                                                                                  Comments

                                                                                                  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.

                                                                                                  Control0..*
                                                                                                  TypeExtension
                                                                                                  Is Modifierfalse
                                                                                                  Summaryfalse
                                                                                                  Alternate Namesextensions, user content
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                  SlicingThis element introduces a set of slices on MedicationDispense.statusReason[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                  • value @ url
                                                                                                  • 32. MedicationDispense.statusReason[x]:statusReasonCodeableConcept.coding
                                                                                                    Definition

                                                                                                    A reference to a code defined by a terminology system.

                                                                                                    ShortCode defined by a terminology system
                                                                                                    Comments

                                                                                                    Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                                                    Control0..*
                                                                                                    TypeCoding
                                                                                                    Is Modifierfalse
                                                                                                    Must Supporttrue
                                                                                                    Obligations
                                                                                                      ObligationsActor
                                                                                                      SHALL:handlePH Core Server
                                                                                                      SHALL:handlePH Core Consumer
                                                                                                      MAY:able-to-populatePH Core Creator
                                                                                                      Summarytrue
                                                                                                      Requirements

                                                                                                      Allows for alternative encodings within a code system, and translations to other code systems.

                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      34. MedicationDispense.statusReason[x]:statusReasonCodeableConcept.text
                                                                                                      Definition

                                                                                                      A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                                                      ShortPlain text representation of the concept
                                                                                                      Comments

                                                                                                      Very often the text is the same as a displayName of one of the codings.

                                                                                                      Control0..1
                                                                                                      Typestring
                                                                                                      Is Modifierfalse
                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                      Must Supporttrue
                                                                                                      Obligations
                                                                                                        ObligationsActor
                                                                                                        SHALL:handlePH Core Server
                                                                                                        SHALL:handlePH Core Consumer
                                                                                                        MAY:able-to-populatePH Core Creator
                                                                                                        Summarytrue
                                                                                                        Requirements

                                                                                                        The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        36. MedicationDispense.category
                                                                                                        Definition

                                                                                                        Indicates the type of medication dispense (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient)).

                                                                                                        ShortType of medication dispense
                                                                                                        Comments

                                                                                                        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.

                                                                                                        Control0..1
                                                                                                        BindingThe codes SHOULD be taken from MedicationDispense Category Codes
                                                                                                        (preferred to http://hl7.org/fhir/ValueSet/medicationdispense-category|4.0.1)

                                                                                                        A code describing where the dispensed medication is expected to be consumed or administered.

                                                                                                        TypeCodeableConcept
                                                                                                        Is Modifierfalse
                                                                                                        Must Supporttrue
                                                                                                        Obligations
                                                                                                          ObligationsActor
                                                                                                          SHALL:handlePH Core Server
                                                                                                          SHALL:handlePH Core Consumer
                                                                                                          MAY:able-to-populatePH Core Creator
                                                                                                          Summaryfalse
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          38. MedicationDispense.category.id
                                                                                                          Definition

                                                                                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                          ShortUnique id for inter-element referencing
                                                                                                          Control0..1
                                                                                                          Typestring
                                                                                                          Is Modifierfalse
                                                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                          Summaryfalse
                                                                                                          40. MedicationDispense.category.extension
                                                                                                          Definition

                                                                                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                          ShortAdditional content defined by implementations
                                                                                                          Comments

                                                                                                          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.

                                                                                                          Control0..*
                                                                                                          TypeExtension
                                                                                                          Is Modifierfalse
                                                                                                          Summaryfalse
                                                                                                          Alternate Namesextensions, user content
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                          SlicingThis element introduces a set of slices on MedicationDispense.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                          • value @ url
                                                                                                          • 42. MedicationDispense.category.coding
                                                                                                            Definition

                                                                                                            A reference to a code defined by a terminology system.

                                                                                                            ShortCode defined by a terminology system
                                                                                                            Comments

                                                                                                            Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                                                            Control0..*
                                                                                                            TypeCoding
                                                                                                            Is Modifierfalse
                                                                                                            Must Supporttrue
                                                                                                            Obligations
                                                                                                              ObligationsActor
                                                                                                              SHALL:handlePH Core Server
                                                                                                              SHALL:handlePH Core Consumer
                                                                                                              MAY:able-to-populatePH Core Creator
                                                                                                              Summarytrue
                                                                                                              Requirements

                                                                                                              Allows for alternative encodings within a code system, and translations to other code systems.

                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              44. MedicationDispense.category.text
                                                                                                              Definition

                                                                                                              A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                                                              ShortPlain text representation of the concept
                                                                                                              Comments

                                                                                                              Very often the text is the same as a displayName of one of the codings.

                                                                                                              Control0..1
                                                                                                              Typestring
                                                                                                              Is Modifierfalse
                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                              Must Supporttrue
                                                                                                              Obligations
                                                                                                                ObligationsActor
                                                                                                                SHALL:handlePH Core Server
                                                                                                                SHALL:handlePH Core Consumer
                                                                                                                MAY:able-to-populatePH Core Creator
                                                                                                                Summarytrue
                                                                                                                Requirements

                                                                                                                The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                46. MedicationDispense.medication[x]
                                                                                                                Definition

                                                                                                                Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.

                                                                                                                ShortWhat medication was supplied
                                                                                                                Comments

                                                                                                                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.

                                                                                                                Control1..1
                                                                                                                BindingFor example codes, see SNOMEDCTMedicationCodes
                                                                                                                (example to http://hl7.org/fhir/ValueSet/medication-codes|4.0.1)

                                                                                                                A coded concept identifying which substance or product can be dispensed.

                                                                                                                TypeChoice of: CodeableConcept, Reference(Medication)
                                                                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                Is Modifierfalse
                                                                                                                Summarytrue
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                SlicingThis element introduces a set of slices on MedicationDispense.medication[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                                                                                • type @ $this
                                                                                                                • 48. MedicationDispense.medication[x]:medicationReference
                                                                                                                  Slice NamemedicationReference
                                                                                                                  Definition

                                                                                                                  Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.

                                                                                                                  ShortWhat medication was supplied
                                                                                                                  Comments

                                                                                                                  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.

                                                                                                                  Control0..1
                                                                                                                  TypeReference(PH Core Medication)
                                                                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                  Is Modifierfalse
                                                                                                                  Summarytrue
                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  50. MedicationDispense.medication[x]:medicationCodeableConcept
                                                                                                                  Slice NamemedicationCodeableConcept
                                                                                                                  Definition

                                                                                                                  Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications.

                                                                                                                  ShortWhat medication was supplied
                                                                                                                  Comments

                                                                                                                  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.

                                                                                                                  Control0..1
                                                                                                                  BindingThe codes SHOULD be taken from Drugs
                                                                                                                  (preferred to http://doh.gov.ph/fhir/ph-core/ValueSet/drugs-vs)
                                                                                                                  TypeCodeableConcept
                                                                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                  Is Modifierfalse
                                                                                                                  Must Supporttrue
                                                                                                                  Obligations
                                                                                                                    ObligationsActor
                                                                                                                    SHALL:handlePH Core Server
                                                                                                                    SHALL:handlePH Core Consumer
                                                                                                                    MAY:able-to-populatePH Core Creator
                                                                                                                    Summarytrue
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    52. MedicationDispense.medication[x]:medicationCodeableConcept.id
                                                                                                                    Definition

                                                                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                    ShortUnique id for inter-element referencing
                                                                                                                    Control0..1
                                                                                                                    Typestring
                                                                                                                    Is Modifierfalse
                                                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                    Summaryfalse
                                                                                                                    54. MedicationDispense.medication[x]:medicationCodeableConcept.extension
                                                                                                                    Definition

                                                                                                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                    ShortAdditional content defined by implementations
                                                                                                                    Comments

                                                                                                                    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.

                                                                                                                    Control0..*
                                                                                                                    TypeExtension
                                                                                                                    Is Modifierfalse
                                                                                                                    Summaryfalse
                                                                                                                    Alternate Namesextensions, user content
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                    SlicingThis element introduces a set of slices on MedicationDispense.medication[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                    • value @ url
                                                                                                                    • 56. MedicationDispense.medication[x]:medicationCodeableConcept.coding
                                                                                                                      Definition

                                                                                                                      A reference to a code defined by a terminology system.

                                                                                                                      ShortCode defined by a terminology system
                                                                                                                      Comments

                                                                                                                      Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                                                                      Control0..*
                                                                                                                      TypeCoding
                                                                                                                      Is Modifierfalse
                                                                                                                      Must Supporttrue
                                                                                                                      Obligations
                                                                                                                        ObligationsActor
                                                                                                                        SHALL:handlePH Core Server
                                                                                                                        SHALL:handlePH Core Consumer
                                                                                                                        MAY:able-to-populatePH Core Creator
                                                                                                                        Summarytrue
                                                                                                                        Requirements

                                                                                                                        Allows for alternative encodings within a code system, and translations to other code systems.

                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        58. MedicationDispense.medication[x]:medicationCodeableConcept.text
                                                                                                                        Definition

                                                                                                                        A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                                                                        ShortPlain text representation of the concept
                                                                                                                        Comments

                                                                                                                        Very often the text is the same as a displayName of one of the codings.

                                                                                                                        Control0..1
                                                                                                                        Typestring
                                                                                                                        Is Modifierfalse
                                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                        Must Supporttrue
                                                                                                                        Obligations
                                                                                                                          ObligationsActor
                                                                                                                          SHALL:handlePH Core Server
                                                                                                                          SHALL:handlePH Core Consumer
                                                                                                                          MAY:able-to-populatePH Core Creator
                                                                                                                          Summarytrue
                                                                                                                          Requirements

                                                                                                                          The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          60. MedicationDispense.subject
                                                                                                                          Definition

                                                                                                                          A link to a resource representing the person or the group to whom the medication will be given.

                                                                                                                          ShortWho the dispense is for
                                                                                                                          Comments

                                                                                                                          SubstanceAdministration->subject->Patient.

                                                                                                                          Control0..1
                                                                                                                          TypeReference(PH Core Patient, Group)
                                                                                                                          Is Modifierfalse
                                                                                                                          Summarytrue
                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          62. MedicationDispense.context
                                                                                                                          Definition

                                                                                                                          The encounter or episode of care that establishes the context for this event.

                                                                                                                          ShortEncounter / Episode associated with event
                                                                                                                          Control0..1
                                                                                                                          TypeReference(PH Core Encounter, EpisodeOfCare)
                                                                                                                          Is Modifierfalse
                                                                                                                          Summaryfalse
                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          64. MedicationDispense.supportingInformation
                                                                                                                          Definition

                                                                                                                          Additional information that supports the medication being dispensed.

                                                                                                                          ShortInformation that supports the dispensing of the medication
                                                                                                                          Control0..*
                                                                                                                          TypeReference(Resource)
                                                                                                                          Is Modifierfalse
                                                                                                                          Summaryfalse
                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          66. MedicationDispense.performer
                                                                                                                          Definition

                                                                                                                          Indicates who or what performed the event.

                                                                                                                          ShortWho performed event
                                                                                                                          Control0..*
                                                                                                                          TypeBackboneElement
                                                                                                                          Is Modifierfalse
                                                                                                                          Summaryfalse
                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          68. MedicationDispense.performer.id
                                                                                                                          Definition

                                                                                                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                          ShortUnique id for inter-element referencing
                                                                                                                          Control0..1
                                                                                                                          Typestring
                                                                                                                          Is Modifierfalse
                                                                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                          Summaryfalse
                                                                                                                          70. MedicationDispense.performer.extension
                                                                                                                          Definition

                                                                                                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                          ShortAdditional content defined by implementations
                                                                                                                          Comments

                                                                                                                          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.

                                                                                                                          Control0..*
                                                                                                                          TypeExtension
                                                                                                                          Is Modifierfalse
                                                                                                                          Summaryfalse
                                                                                                                          Alternate Namesextensions, user content
                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                          72. MedicationDispense.performer.modifierExtension
                                                                                                                          Definition

                                                                                                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                          ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                          Comments

                                                                                                                          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.

                                                                                                                          Control0..*
                                                                                                                          TypeExtension
                                                                                                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                          Summarytrue
                                                                                                                          Requirements

                                                                                                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                          Alternate Namesextensions, user content, modifiers
                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                          74. MedicationDispense.performer.function
                                                                                                                          Definition

                                                                                                                          Distinguishes the type of performer in the dispense. For example, date enterer, packager, final checker.

                                                                                                                          ShortWho performed the dispense and what they did
                                                                                                                          Control0..1
                                                                                                                          BindingFor example codes, see MedicationDispense Performer Function Codes
                                                                                                                          (example to http://hl7.org/fhir/ValueSet/medicationdispense-performer-function|4.0.1)

                                                                                                                          A code describing the role an individual played in dispensing a medication.

                                                                                                                          TypeCodeableConcept
                                                                                                                          Is Modifierfalse
                                                                                                                          Must Supporttrue
                                                                                                                          Obligations
                                                                                                                            ObligationsActor
                                                                                                                            SHALL:handlePH Core Server
                                                                                                                            SHALL:handlePH Core Consumer
                                                                                                                            MAY:able-to-populatePH Core Creator
                                                                                                                            Summaryfalse
                                                                                                                            Requirements

                                                                                                                            Allows disambiguation of the types of involvement of different performers.

                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            76. MedicationDispense.performer.function.id
                                                                                                                            Definition

                                                                                                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                            ShortUnique id for inter-element referencing
                                                                                                                            Control0..1
                                                                                                                            Typestring
                                                                                                                            Is Modifierfalse
                                                                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                            Summaryfalse
                                                                                                                            78. MedicationDispense.performer.function.extension
                                                                                                                            Definition

                                                                                                                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                            ShortAdditional content defined by implementations
                                                                                                                            Comments

                                                                                                                            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.

                                                                                                                            Control0..*
                                                                                                                            TypeExtension
                                                                                                                            Is Modifierfalse
                                                                                                                            Summaryfalse
                                                                                                                            Alternate Namesextensions, user content
                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                            SlicingThis element introduces a set of slices on MedicationDispense.performer.function.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                            • value @ url
                                                                                                                            • 80. MedicationDispense.performer.function.coding
                                                                                                                              Definition

                                                                                                                              A reference to a code defined by a terminology system.

                                                                                                                              ShortCode defined by a terminology system
                                                                                                                              Comments

                                                                                                                              Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                                                                              Control0..*
                                                                                                                              TypeCoding
                                                                                                                              Is Modifierfalse
                                                                                                                              Must Supporttrue
                                                                                                                              Obligations
                                                                                                                                ObligationsActor
                                                                                                                                SHALL:handlePH Core Server
                                                                                                                                SHALL:handlePH Core Consumer
                                                                                                                                MAY:able-to-populatePH Core Creator
                                                                                                                                Summarytrue
                                                                                                                                Requirements

                                                                                                                                Allows for alternative encodings within a code system, and translations to other code systems.

                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                82. MedicationDispense.performer.function.text
                                                                                                                                Definition

                                                                                                                                A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                                                                                ShortPlain text representation of the concept
                                                                                                                                Comments

                                                                                                                                Very often the text is the same as a displayName of one of the codings.

                                                                                                                                Control0..1
                                                                                                                                Typestring
                                                                                                                                Is Modifierfalse
                                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                Must Supporttrue
                                                                                                                                Obligations
                                                                                                                                  ObligationsActor
                                                                                                                                  SHALL:handlePH Core Server
                                                                                                                                  SHALL:handlePH Core Consumer
                                                                                                                                  MAY:able-to-populatePH Core Creator
                                                                                                                                  Summarytrue
                                                                                                                                  Requirements

                                                                                                                                  The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                  84. MedicationDispense.performer.actor
                                                                                                                                  Definition

                                                                                                                                  The device, practitioner, etc. who performed the action. It should be assumed that the actor is the dispenser of the medication.

                                                                                                                                  ShortIndividual who was performing
                                                                                                                                  Control1..1
                                                                                                                                  TypeReference(PH Core Practitioner, PH Core PractitionerRole, PH Core Organization, PH Core Patient, Device, PH Core RelatedPerson)
                                                                                                                                  Is Modifierfalse
                                                                                                                                  Summaryfalse
                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                  86. MedicationDispense.location
                                                                                                                                  Definition

                                                                                                                                  The principal physical location where the dispense was performed.

                                                                                                                                  ShortWhere the dispense occurred
                                                                                                                                  Control0..1
                                                                                                                                  TypeReference(PH Core Location)
                                                                                                                                  Is Modifierfalse
                                                                                                                                  Summaryfalse
                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                  88. MedicationDispense.authorizingPrescription
                                                                                                                                  Definition

                                                                                                                                  Indicates the medication order that is being dispensed against.

                                                                                                                                  ShortMedication order that authorizes the dispense
                                                                                                                                  Comments

                                                                                                                                  Maps to basedOn in Event logical model.

                                                                                                                                  Control0..*
                                                                                                                                  TypeReference(PH Core Medication Request)
                                                                                                                                  Is Modifierfalse
                                                                                                                                  Summaryfalse
                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                  90. MedicationDispense.type
                                                                                                                                  Definition

                                                                                                                                  Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.

                                                                                                                                  ShortTrial fill, partial fill, emergency fill, etc.
                                                                                                                                  Control0..1
                                                                                                                                  BindingFor example codes, see ActPharmacySupplyType
                                                                                                                                  (example to http://terminology.hl7.org/ValueSet/v3-ActPharmacySupplyType)

                                                                                                                                  Indicates the type of dispensing event that is performed. For example, Trial Fill, Completion of Trial, Partial Fill, Emergency Fill, Samples, etc.

                                                                                                                                  TypeCodeableConcept
                                                                                                                                  Is Modifierfalse
                                                                                                                                  Must Supporttrue
                                                                                                                                  Obligations
                                                                                                                                    ObligationsActor
                                                                                                                                    SHALL:handlePH Core Server
                                                                                                                                    SHALL:handlePH Core Consumer
                                                                                                                                    MAY:able-to-populatePH Core Creator
                                                                                                                                    Summaryfalse
                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                    92. MedicationDispense.type.id
                                                                                                                                    Definition

                                                                                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                    ShortUnique id for inter-element referencing
                                                                                                                                    Control0..1
                                                                                                                                    Typestring
                                                                                                                                    Is Modifierfalse
                                                                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                    Summaryfalse
                                                                                                                                    94. MedicationDispense.type.extension
                                                                                                                                    Definition

                                                                                                                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                                    ShortAdditional content defined by implementations
                                                                                                                                    Comments

                                                                                                                                    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.

                                                                                                                                    Control0..*
                                                                                                                                    TypeExtension
                                                                                                                                    Is Modifierfalse
                                                                                                                                    Summaryfalse
                                                                                                                                    Alternate Namesextensions, user content
                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                    SlicingThis element introduces a set of slices on MedicationDispense.type.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                    • value @ url
                                                                                                                                    • 96. MedicationDispense.type.coding
                                                                                                                                      Definition

                                                                                                                                      A reference to a code defined by a terminology system.

                                                                                                                                      ShortCode defined by a terminology system
                                                                                                                                      Comments

                                                                                                                                      Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                                                                                      Control0..*
                                                                                                                                      TypeCoding
                                                                                                                                      Is Modifierfalse
                                                                                                                                      Must Supporttrue
                                                                                                                                      Obligations
                                                                                                                                        ObligationsActor
                                                                                                                                        SHALL:handlePH Core Server
                                                                                                                                        SHALL:handlePH Core Consumer
                                                                                                                                        MAY:able-to-populatePH Core Creator
                                                                                                                                        Summarytrue
                                                                                                                                        Requirements

                                                                                                                                        Allows for alternative encodings within a code system, and translations to other code systems.

                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                        98. MedicationDispense.type.text
                                                                                                                                        Definition

                                                                                                                                        A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                                                                                        ShortPlain text representation of the concept
                                                                                                                                        Comments

                                                                                                                                        Very often the text is the same as a displayName of one of the codings.

                                                                                                                                        Control0..1
                                                                                                                                        Typestring
                                                                                                                                        Is Modifierfalse
                                                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                        Must Supporttrue
                                                                                                                                        Obligations
                                                                                                                                          ObligationsActor
                                                                                                                                          SHALL:handlePH Core Server
                                                                                                                                          SHALL:handlePH Core Consumer
                                                                                                                                          MAY:able-to-populatePH Core Creator
                                                                                                                                          Summarytrue
                                                                                                                                          Requirements

                                                                                                                                          The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                          100. MedicationDispense.quantity
                                                                                                                                          Definition

                                                                                                                                          The amount of medication that has been dispensed. Includes unit of measure.

                                                                                                                                          ShortAmount dispensed
                                                                                                                                          Control0..1
                                                                                                                                          TypeQuantity(SimpleQuantity)
                                                                                                                                          Is Modifierfalse
                                                                                                                                          Summaryfalse
                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                          102. MedicationDispense.daysSupply
                                                                                                                                          Definition

                                                                                                                                          The amount of medication expressed as a timing amount.

                                                                                                                                          ShortAmount of medication expressed as a timing amount
                                                                                                                                          Control0..1
                                                                                                                                          TypeQuantity(SimpleQuantity)
                                                                                                                                          Is Modifierfalse
                                                                                                                                          Summaryfalse
                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                          104. MedicationDispense.whenPrepared
                                                                                                                                          Definition

                                                                                                                                          The time when the dispensed product was packaged and reviewed.

                                                                                                                                          ShortWhen product was packaged and reviewed
                                                                                                                                          Control0..1
                                                                                                                                          TypedateTime
                                                                                                                                          Is Modifierfalse
                                                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                          Summarytrue
                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                          106. MedicationDispense.whenHandedOver
                                                                                                                                          Definition

                                                                                                                                          The time the dispensed product was provided to the patient or their representative.

                                                                                                                                          ShortWhen product was given out
                                                                                                                                          Control0..1
                                                                                                                                          TypedateTime
                                                                                                                                          Is Modifierfalse
                                                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                          Summaryfalse
                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                          108. MedicationDispense.destination
                                                                                                                                          Definition

                                                                                                                                          Identification of the facility/location where the medication was shipped to, as part of the dispense event.

                                                                                                                                          ShortWhere the medication was sent
                                                                                                                                          Control0..1
                                                                                                                                          TypeReference(PH Core Location)
                                                                                                                                          Is Modifierfalse
                                                                                                                                          Summaryfalse
                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                          110. MedicationDispense.receiver
                                                                                                                                          Definition

                                                                                                                                          Identifies the person who picked up the medication. This will usually be a patient or their caregiver, but some cases exist where it can be a healthcare professional.

                                                                                                                                          ShortWho collected the medication
                                                                                                                                          Control0..*
                                                                                                                                          TypeReference(PH Core Patient, PH Core Practitioner)
                                                                                                                                          Is Modifierfalse
                                                                                                                                          Summaryfalse
                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                          112. MedicationDispense.note
                                                                                                                                          Definition

                                                                                                                                          Extra information about the dispense that could not be conveyed in the other attributes.

                                                                                                                                          ShortInformation about the dispense
                                                                                                                                          Control0..*
                                                                                                                                          TypeAnnotation
                                                                                                                                          Is Modifierfalse
                                                                                                                                          Summaryfalse
                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                          114. MedicationDispense.dosageInstruction
                                                                                                                                          Definition

                                                                                                                                          Indicates how the medication is to be used by the patient.

                                                                                                                                          ShortHow the medication is to be used by the patient or administered by the caregiver
                                                                                                                                          Comments

                                                                                                                                          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.

                                                                                                                                          Control0..*
                                                                                                                                          TypeDosage
                                                                                                                                          Is Modifierfalse
                                                                                                                                          Summaryfalse
                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                          116. MedicationDispense.substitution
                                                                                                                                          Definition

                                                                                                                                          Indicates whether or not substitution was made as part of the dispense. In some cases, substitution will be expected but does not happen, in other cases substitution is not expected but does happen. This block explains what substitution did or did not happen and why. If nothing is specified, substitution was not done.

                                                                                                                                          ShortWhether a substitution was performed on the dispense
                                                                                                                                          Control0..1
                                                                                                                                          TypeBackboneElement
                                                                                                                                          Is Modifierfalse
                                                                                                                                          Summaryfalse
                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                          118. MedicationDispense.substitution.id
                                                                                                                                          Definition

                                                                                                                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                          ShortUnique id for inter-element referencing
                                                                                                                                          Control0..1
                                                                                                                                          Typestring
                                                                                                                                          Is Modifierfalse
                                                                                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                          Summaryfalse
                                                                                                                                          120. MedicationDispense.substitution.extension
                                                                                                                                          Definition

                                                                                                                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                                          ShortAdditional content defined by implementations
                                                                                                                                          Comments

                                                                                                                                          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.

                                                                                                                                          Control0..*
                                                                                                                                          TypeExtension
                                                                                                                                          Is Modifierfalse
                                                                                                                                          Summaryfalse
                                                                                                                                          Alternate Namesextensions, user content
                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                          122. MedicationDispense.substitution.modifierExtension
                                                                                                                                          Definition

                                                                                                                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                                          ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                          Comments

                                                                                                                                          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.

                                                                                                                                          Control0..*
                                                                                                                                          TypeExtension
                                                                                                                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                                          Summarytrue
                                                                                                                                          Requirements

                                                                                                                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                                          Alternate Namesextensions, user content, modifiers
                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                          124. MedicationDispense.substitution.wasSubstituted
                                                                                                                                          Definition

                                                                                                                                          True if the dispenser dispensed a different drug or product from what was prescribed.

                                                                                                                                          ShortWhether a substitution was or was not performed on the dispense
                                                                                                                                          Control1..1
                                                                                                                                          Typeboolean
                                                                                                                                          Is Modifierfalse
                                                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                          Summaryfalse
                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                          126. MedicationDispense.substitution.type
                                                                                                                                          Definition

                                                                                                                                          A code signifying whether a different drug was dispensed from what was prescribed.

                                                                                                                                          ShortCode signifying whether a different drug was dispensed from what was prescribed
                                                                                                                                          Control0..1
                                                                                                                                          BindingFor example codes, see ActSubstanceAdminSubstitutionCode
                                                                                                                                          (example to http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode)

                                                                                                                                          A coded concept describing whether a different medicinal product may be dispensed other than the product as specified exactly in the prescription.

                                                                                                                                          TypeCodeableConcept
                                                                                                                                          Is Modifierfalse
                                                                                                                                          Must Supporttrue
                                                                                                                                          Obligations
                                                                                                                                            ObligationsActor
                                                                                                                                            SHALL:handlePH Core Server
                                                                                                                                            SHALL:handlePH Core Consumer
                                                                                                                                            MAY:able-to-populatePH Core Creator
                                                                                                                                            Summaryfalse
                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                            128. MedicationDispense.substitution.type.id
                                                                                                                                            Definition

                                                                                                                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                            ShortUnique id for inter-element referencing
                                                                                                                                            Control0..1
                                                                                                                                            Typestring
                                                                                                                                            Is Modifierfalse
                                                                                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                            Summaryfalse
                                                                                                                                            130. MedicationDispense.substitution.type.extension
                                                                                                                                            Definition

                                                                                                                                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                                            ShortAdditional content defined by implementations
                                                                                                                                            Comments

                                                                                                                                            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.

                                                                                                                                            Control0..*
                                                                                                                                            TypeExtension
                                                                                                                                            Is Modifierfalse
                                                                                                                                            Summaryfalse
                                                                                                                                            Alternate Namesextensions, user content
                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                            SlicingThis element introduces a set of slices on MedicationDispense.substitution.type.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                            • value @ url
                                                                                                                                            • 132. MedicationDispense.substitution.type.coding
                                                                                                                                              Definition

                                                                                                                                              A reference to a code defined by a terminology system.

                                                                                                                                              ShortCode defined by a terminology system
                                                                                                                                              Comments

                                                                                                                                              Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                                                                                              Control0..*
                                                                                                                                              TypeCoding
                                                                                                                                              Is Modifierfalse
                                                                                                                                              Must Supporttrue
                                                                                                                                              Obligations
                                                                                                                                                ObligationsActor
                                                                                                                                                SHALL:handlePH Core Server
                                                                                                                                                SHALL:handlePH Core Consumer
                                                                                                                                                MAY:able-to-populatePH Core Creator
                                                                                                                                                Summarytrue
                                                                                                                                                Requirements

                                                                                                                                                Allows for alternative encodings within a code system, and translations to other code systems.

                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                134. MedicationDispense.substitution.type.text
                                                                                                                                                Definition

                                                                                                                                                A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                                                                                                ShortPlain text representation of the concept
                                                                                                                                                Comments

                                                                                                                                                Very often the text is the same as a displayName of one of the codings.

                                                                                                                                                Control0..1
                                                                                                                                                Typestring
                                                                                                                                                Is Modifierfalse
                                                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                Must Supporttrue
                                                                                                                                                Obligations
                                                                                                                                                  ObligationsActor
                                                                                                                                                  SHALL:handlePH Core Server
                                                                                                                                                  SHALL:handlePH Core Consumer
                                                                                                                                                  MAY:able-to-populatePH Core Creator
                                                                                                                                                  Summarytrue
                                                                                                                                                  Requirements

                                                                                                                                                  The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                  136. MedicationDispense.substitution.reason
                                                                                                                                                  Definition

                                                                                                                                                  Indicates the reason for the substitution (or lack of substitution) from what was prescribed.

                                                                                                                                                  ShortWhy was substitution made
                                                                                                                                                  Control0..*
                                                                                                                                                  BindingFor example codes, see SubstanceAdminSubstitutionReason
                                                                                                                                                  (example to http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason)

                                                                                                                                                  A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.

                                                                                                                                                  TypeCodeableConcept
                                                                                                                                                  Is Modifierfalse
                                                                                                                                                  Must Supporttrue
                                                                                                                                                  Obligations
                                                                                                                                                    ObligationsActor
                                                                                                                                                    SHALL:handlePH Core Server
                                                                                                                                                    SHALL:handlePH Core Consumer
                                                                                                                                                    MAY:able-to-populatePH Core Creator
                                                                                                                                                    Summaryfalse
                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                    138. MedicationDispense.substitution.reason.id
                                                                                                                                                    Definition

                                                                                                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                                    ShortUnique id for inter-element referencing
                                                                                                                                                    Control0..1
                                                                                                                                                    Typestring
                                                                                                                                                    Is Modifierfalse
                                                                                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                    Summaryfalse
                                                                                                                                                    140. MedicationDispense.substitution.reason.extension
                                                                                                                                                    Definition

                                                                                                                                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                                                    ShortAdditional content defined by implementations
                                                                                                                                                    Comments

                                                                                                                                                    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.

                                                                                                                                                    Control0..*
                                                                                                                                                    TypeExtension
                                                                                                                                                    Is Modifierfalse
                                                                                                                                                    Summaryfalse
                                                                                                                                                    Alternate Namesextensions, user content
                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                    SlicingThis element introduces a set of slices on MedicationDispense.substitution.reason.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                    • value @ url
                                                                                                                                                    • 142. MedicationDispense.substitution.reason.coding
                                                                                                                                                      Definition

                                                                                                                                                      A reference to a code defined by a terminology system.

                                                                                                                                                      ShortCode defined by a terminology system
                                                                                                                                                      Comments

                                                                                                                                                      Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                                                                                                      Control0..*
                                                                                                                                                      TypeCoding
                                                                                                                                                      Is Modifierfalse
                                                                                                                                                      Must Supporttrue
                                                                                                                                                      Obligations
                                                                                                                                                        ObligationsActor
                                                                                                                                                        SHALL:handlePH Core Server
                                                                                                                                                        SHALL:handlePH Core Consumer
                                                                                                                                                        MAY:able-to-populatePH Core Creator
                                                                                                                                                        Summarytrue
                                                                                                                                                        Requirements

                                                                                                                                                        Allows for alternative encodings within a code system, and translations to other code systems.

                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                        144. MedicationDispense.substitution.reason.text
                                                                                                                                                        Definition

                                                                                                                                                        A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                                                                                                        ShortPlain text representation of the concept
                                                                                                                                                        Comments

                                                                                                                                                        Very often the text is the same as a displayName of one of the codings.

                                                                                                                                                        Control0..1
                                                                                                                                                        Typestring
                                                                                                                                                        Is Modifierfalse
                                                                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                        Must Supporttrue
                                                                                                                                                        Obligations
                                                                                                                                                          ObligationsActor
                                                                                                                                                          SHALL:handlePH Core Server
                                                                                                                                                          SHALL:handlePH Core Consumer
                                                                                                                                                          MAY:able-to-populatePH Core Creator
                                                                                                                                                          Summarytrue
                                                                                                                                                          Requirements

                                                                                                                                                          The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                          146. MedicationDispense.substitution.responsibleParty
                                                                                                                                                          Definition

                                                                                                                                                          The person or organization that has primary responsibility for the substitution.

                                                                                                                                                          ShortWho is responsible for the substitution
                                                                                                                                                          Control0..*
                                                                                                                                                          TypeReference(PH Core Practitioner, PH Core PractitionerRole)
                                                                                                                                                          Is Modifierfalse
                                                                                                                                                          Summaryfalse
                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                          148. MedicationDispense.detectedIssue
                                                                                                                                                          Definition

                                                                                                                                                          Indicates an actual or potential clinical issue with or between one or more active or proposed clinical actions for a patient; e.g. drug-drug interaction, duplicate therapy, dosage alert etc.

                                                                                                                                                          ShortClinical issue with action
                                                                                                                                                          Comments

                                                                                                                                                          This element can include a detected issue that has been identified either by a decision support system or by a clinician and may include information on the steps that were taken to address the issue.

                                                                                                                                                          Control0..*
                                                                                                                                                          TypeReference(DetectedIssue)
                                                                                                                                                          Is Modifierfalse
                                                                                                                                                          Summaryfalse
                                                                                                                                                          Alternate NamesContraindication, Drug Utilization Review (DUR), Alert
                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                          150. MedicationDispense.eventHistory
                                                                                                                                                          Definition

                                                                                                                                                          A summary of the events of interest that have occurred, such as when the dispense was verified.

                                                                                                                                                          ShortA list of relevant lifecycle events
                                                                                                                                                          Comments

                                                                                                                                                          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.).

                                                                                                                                                          Control0..*
                                                                                                                                                          TypeReference(Provenance)
                                                                                                                                                          Is Modifierfalse
                                                                                                                                                          Summaryfalse
                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))