Linked Care Implementation Guide
0.9.1 - ci-build

Resource Profile: LINCA Dispense (LINCAMedicationDispense)

Defining URL:http://fhir.hl7.at/linkedcare/StructureDefinition/linca-dipsense-documentation
Version:0.9.1
Name:LINCAMedicationDispense
Title:LINCA Dispense (LINCAMedicationDispense)
Status:Draft as of 2023-11-29 14:36:10+0000
Definition:

Linked Care Profile for dispense documentation. The dispense must be documented by the dispensing pharmacist and specify if an order was fulfilled completly or partially. The LINCA Dispense must have an LINCA Prescription as authorizingPrescription.

Publisher:The Linked Care Consortium. The Linked Care Consortium,
Source Resource:XML / JSON / Turtle

The official URL for this profile is: 

http://fhir.hl7.at/linkedcare/StructureDefinition/linca-dipsense-documentation

Formal Views of Profile Content

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

This structure is derived from MedicationDispense

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

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationDispense C0..*MedicationDispenseDispensing a medication to a named patient
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: AllLanguages (required): IETF language tag for a human language

Additional BindingsPurpose
CommonLanguagesStarter Set
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
... identifier 0..*IdentifierExternal identifier
... basedOn 0..*Reference(CarePlan)Plan that is fulfilled by this dispense
... partOf 0..*Reference(Procedure | MedicationAdministration)Event that dispense is part of
... status ?!Σ1..1codeA dispense ends the chain of the workflow. Therefore the status is fixed to 'completed'
Binding: MedicationDispenseStatusCodes (required): Describes the lifecycle of the dispense.


Required Pattern: completed
... notPerformedReason 0..1CodeableReference(DetectedIssue)Why a dispense was not performed
Binding: MedicationDispenseStatusReasonCodes (example)
... statusChanged 0..1dateTimeWhen the status changed
... category 0..*CodeableConceptType of medication dispense
Binding: MedicationDispenseAdministrationLocationCodes (example): A code describing where the dispensed medication is expected to be consumed or administered.


... medication Σ1..1CodeableReference(LINCA Medication (LINCAMeds))Medication that was dispensed, in conformance with ELGA CodeSystems (text-only, or text and number referencing one of the supported catalogs, as for example the PZN of the Austrian ASP).
Binding: https://termgit.elga.gv.at/CodeSystem-asp-liste (required)
... subject Σ1..1Reference(HL7® AT Core Patient Profile)Patient conform HL7 AT. Make sure the patient is identifiable somehow
... encounter 0..1Reference(Encounter)Encounter associated with event
... supportingInformation 0..*Reference(Resource)Information that supports the dispensing of the medication
... performer 0..*BackboneElementWho performed event
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... function 0..1CodeableConceptWho performed the dispense and what they did
Binding: MedicationDispensePerformerFunctionCodes (example): A code describing the role an individual played in dispensing a medication.

.... actor 1..1Reference(Organization)Reference to dispensing pharmacy (GDA index)
... location 0..1Reference(Location)Where the dispense occurred
... authorizingPrescription 1..1Reference(LINCA Prescription (LINCAPrescriptionMedicationRequest))Prescription that authorized dispense of this medication
... type 0..1CodeableConceptPossible values: FFC (First-fill complete for completly fulfilled orders), FFP (first-fill part fill, for pratially fulfilled orders)
Binding: ActPharmacySupplyType (example): ActPharmacySupplyType

... quantity 0..1SimpleQuantityAmount dispensed
... daysSupply 0..1SimpleQuantityAmount of medication expressed as a timing amount
... recorded 0..1dateTimeWhen the recording of the dispense started
... whenPrepared ΣC0..1dateTimeWhen product was packaged and reviewed
... whenHandedOver C0..1dateTimeWhen product was given out
... destination 0..1Reference(Location)Where the medication was/will be sent
... receiver 0..*Reference(Patient | Practitioner | RelatedPerson | Location | PractitionerRole)Who collected the medication or where the medication was delivered
... note 0..*AnnotationInformation about the dispense
... renderedDosageInstruction 0..1markdownFull representation of the dosage instructions
... dosageInstruction 0..*DosageHow the medication is to be used by the patient or administered by the caregiver
.... id 0..1idUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence Σ0..1integerThe order of the dosage instructions
.... text Σ0..1stringFree text dosage instructions e.g. SIG
.... additionalInstruction Σ0..*CodeableConceptSupplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".


.... patientInstruction Σ0..1stringPatient or consumer oriented instructions
.... timing Σ0..1TimingWhen medication should be administered
.... asNeeded ΣC0..1booleanTake "as needed"
.... asNeededFor ΣC0..*CodeableConceptTake "as needed" (for x)
Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.


.... site Σ0..1CodeableConceptBody site to administer to
Binding: SNOMEDCTAnatomicalStructureAdministrationSites (example): A coded concept describing the site location the medicine enters into or onto the body.

.... route Σ0..1CodeableConceptHow drug should enter body
Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

.... method Σ0..1CodeableConceptTechnique for administering medication
Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.

.... doseAndRate Σ0..*ElementAmount of medication administered, to be administered or typical amount to be administered
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... type Σ0..1CodeableConceptThe kind of dose or rate specified
Binding: DoseAndRateType (example): The kind of dose or rate specified.

..... Slices for dose[x] Σ0..1Amount of medication per dose
Slice: Unordered, Open by type:$this
...... doseRangeRange
...... doseQuantityQuantity(SimpleQuantity)
...... dose[x]:doseQuantity C0..1SimpleQuantityA fixed quantity (no comparator)
....... id 0..1idUnique id for inter-element referencing
....... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
....... value Σ0..1decimalNumerical value (with implicit precision)
....... unit Σ0..1stringUnit representation
....... system ΣC0..1uriSystem that defines coded unit form
....... code ΣC0..1codeCoded form of the unit
Binding: https://termgit.elga.gv.at/ValueSet/elga-medikationdarreichungsform (required)
..... rate[x] Σ0..1Amount of medication per unit of time
...... rateRatioRatio
...... rateRangeRange
...... rateQuantityQuantity(SimpleQuantity)
.... maxDosePerPeriod Σ0..*RatioUpper limit on medication per unit of time
.... maxDosePerAdministration Σ0..1SimpleQuantityUpper limit on medication per administration
.... maxDosePerLifetime Σ0..1SimpleQuantityUpper limit on medication per lifetime of the patient
... substitution 0..1BackboneElementWhether a substitution was performed on the dispense
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... wasSubstituted 1..1booleanWhether a substitution was or was not performed on the dispense
.... type 0..1CodeableConceptCode signifying whether a different drug was dispensed from what was prescribed
Binding: ActSubstanceAdminSubstitutionCode (example): ActSubstanceAdminSubstitutionCode

.... reason 0..*CodeableConceptWhy was substitution made
Binding: SubstanceAdminSubstitutionReason (example): SubstanceAdminSubstitutionReason


.... responsibleParty 0..1Reference(Practitioner | PractitionerRole | Organization)Who is responsible for the substitution
... eventHistory 0..*Reference(Provenance)A list of relevant lifecycle events

doco Documentation for this format

Differential View

This structure is derived from MedicationDispense

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

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationDispense C0..*MedicationDispenseDispensing a medication to a named patient
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: AllLanguages (required): IETF language tag for a human language

Additional BindingsPurpose
CommonLanguagesStarter Set
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
... identifier 0..*IdentifierExternal identifier
... basedOn 0..*Reference(CarePlan)Plan that is fulfilled by this dispense
... partOf 0..*Reference(Procedure | MedicationAdministration)Event that dispense is part of
... status ?!Σ1..1codeA dispense ends the chain of the workflow. Therefore the status is fixed to 'completed'
Binding: MedicationDispenseStatusCodes (required): Describes the lifecycle of the dispense.


Required Pattern: completed
... notPerformedReason 0..1CodeableReference(DetectedIssue)Why a dispense was not performed
Binding: MedicationDispenseStatusReasonCodes (example)
... statusChanged 0..1dateTimeWhen the status changed
... category 0..*CodeableConceptType of medication dispense
Binding: MedicationDispenseAdministrationLocationCodes (example): A code describing where the dispensed medication is expected to be consumed or administered.


... medication Σ1..1CodeableReference(LINCA Medication (LINCAMeds))Medication that was dispensed, in conformance with ELGA CodeSystems (text-only, or text and number referencing one of the supported catalogs, as for example the PZN of the Austrian ASP).
Binding: https://termgit.elga.gv.at/CodeSystem-asp-liste (required)
... subject Σ1..1Reference(HL7® AT Core Patient Profile)Patient conform HL7 AT. Make sure the patient is identifiable somehow
... encounter 0..1Reference(Encounter)Encounter associated with event
... supportingInformation 0..*Reference(Resource)Information that supports the dispensing of the medication
... performer 0..*BackboneElementWho performed event
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... function 0..1CodeableConceptWho performed the dispense and what they did
Binding: MedicationDispensePerformerFunctionCodes (example): A code describing the role an individual played in dispensing a medication.

.... actor 1..1Reference(Organization)Reference to dispensing pharmacy (GDA index)
... location 0..1Reference(Location)Where the dispense occurred
... authorizingPrescription 1..1Reference(LINCA Prescription (LINCAPrescriptionMedicationRequest))Prescription that authorized dispense of this medication
... type 0..1CodeableConceptPossible values: FFC (First-fill complete for completly fulfilled orders), FFP (first-fill part fill, for pratially fulfilled orders)
Binding: ActPharmacySupplyType (example): ActPharmacySupplyType

... quantity 0..1SimpleQuantityAmount dispensed
... daysSupply 0..1SimpleQuantityAmount of medication expressed as a timing amount
... recorded 0..1dateTimeWhen the recording of the dispense started
... whenPrepared ΣC0..1dateTimeWhen product was packaged and reviewed
... whenHandedOver C0..1dateTimeWhen product was given out
... destination 0..1Reference(Location)Where the medication was/will be sent
... receiver 0..*Reference(Patient | Practitioner | RelatedPerson | Location | PractitionerRole)Who collected the medication or where the medication was delivered
... note 0..*AnnotationInformation about the dispense
... renderedDosageInstruction 0..1markdownFull representation of the dosage instructions
... dosageInstruction 0..*DosageHow the medication is to be used by the patient or administered by the caregiver
.... id 0..1idUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence Σ0..1integerThe order of the dosage instructions
.... text Σ0..1stringFree text dosage instructions e.g. SIG
.... additionalInstruction Σ0..*CodeableConceptSupplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".


.... patientInstruction Σ0..1stringPatient or consumer oriented instructions
.... timing Σ0..1TimingWhen medication should be administered
.... asNeeded ΣC0..1booleanTake "as needed"
.... asNeededFor ΣC0..*CodeableConceptTake "as needed" (for x)
Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.


.... site Σ0..1CodeableConceptBody site to administer to
Binding: SNOMEDCTAnatomicalStructureAdministrationSites (example): A coded concept describing the site location the medicine enters into or onto the body.

.... route Σ0..1CodeableConceptHow drug should enter body
Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

.... method Σ0..1CodeableConceptTechnique for administering medication
Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.

.... doseAndRate Σ0..*ElementAmount of medication administered, to be administered or typical amount to be administered
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... type Σ0..1CodeableConceptThe kind of dose or rate specified
Binding: DoseAndRateType (example): The kind of dose or rate specified.

..... Slices for dose[x] Σ0..1Amount of medication per dose
Slice: Unordered, Open by type:$this
...... doseRangeRange
...... doseQuantityQuantity(SimpleQuantity)
...... dose[x]:doseQuantity C0..1SimpleQuantityA fixed quantity (no comparator)
....... id 0..1idUnique id for inter-element referencing
....... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
....... value Σ0..1decimalNumerical value (with implicit precision)
....... unit Σ0..1stringUnit representation
....... system ΣC0..1uriSystem that defines coded unit form
....... code ΣC0..1codeCoded form of the unit
Binding: https://termgit.elga.gv.at/ValueSet/elga-medikationdarreichungsform (required)
..... rate[x] Σ0..1Amount of medication per unit of time
...... rateRatioRatio
...... rateRangeRange
...... rateQuantityQuantity(SimpleQuantity)
.... maxDosePerPeriod Σ0..*RatioUpper limit on medication per unit of time
.... maxDosePerAdministration Σ0..1SimpleQuantityUpper limit on medication per administration
.... maxDosePerLifetime Σ0..1SimpleQuantityUpper limit on medication per lifetime of the patient
... substitution 0..1BackboneElementWhether a substitution was performed on the dispense
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... wasSubstituted 1..1booleanWhether a substitution was or was not performed on the dispense
.... type 0..1CodeableConceptCode signifying whether a different drug was dispensed from what was prescribed
Binding: ActSubstanceAdminSubstitutionCode (example): ActSubstanceAdminSubstitutionCode

.... reason 0..*CodeableConceptWhy was substitution made
Binding: SubstanceAdminSubstitutionReason (example): SubstanceAdminSubstitutionReason


.... responsibleParty 0..1Reference(Practitioner | PractitionerRole | Organization)Who is responsible for the substitution
... eventHistory 0..*Reference(Provenance)A list of relevant lifecycle events

doco Documentation for this format

 

Other representations of profile: CSV, Excel, Schematron

Terminology Bindings

PathConformanceValueSet / Code
MedicationDispense.languagerequiredAllLanguages
MedicationDispense.statusrequiredPattern: completed
MedicationDispense.notPerformedReasonexampleMedicationDispenseStatusReasonCodes
MedicationDispense.categoryexampleMedicationDispenseAdministrationLocationCodes
MedicationDispense.medicationrequiredhttps://termgit.elga.gv.at/CodeSystem-asp-liste
MedicationDispense.performer.functionexampleMedicationDispensePerformerFunctionCodes
MedicationDispense.typeexampleActPharmacySupplyType
MedicationDispense.dosageInstruction.additionalInstructionexampleSNOMEDCTAdditionalDosageInstructions
MedicationDispense.dosageInstruction.asNeededForexampleSNOMEDCTMedicationAsNeededReasonCodes
MedicationDispense.dosageInstruction.siteexampleSNOMEDCTAnatomicalStructureAdministrationSites
MedicationDispense.dosageInstruction.routeexampleSNOMEDCTRouteCodes
MedicationDispense.dosageInstruction.methodexampleSNOMEDCTAdministrationMethodCodes
MedicationDispense.dosageInstruction.doseAndRate.typeexampleDoseAndRateType
MedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantity.coderequiredhttps://termgit.elga.gv.at/ValueSet/elga-medikationdarreichungsform
MedicationDispense.substitution.typeexampleActSubstanceAdminSubstitutionCode
MedicationDispense.substitution.reasonexampleSubstanceAdminSubstitutionReason

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorMedicationDispenseIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorMedicationDispenseIf 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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorMedicationDispenseIf 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-5errorMedicationDispenseIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceMedicationDispenseA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
mdd-1errorMedicationDispensewhenHandedOver cannot be before whenPrepared
: whenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared
qty-3errorMedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantityIf a code for the unit is present, the system SHALL also be present
: code.empty() or system.exists()
sqty-1errorMedicationDispense.dosageInstruction.doseAndRate.dose[x]:doseQuantityThe comparator is not used on a SimpleQuantity
: comparator.empty()