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11.3 Ресурс MedicationDispense - Назначение

Pharmacy Work GroupMaturity Level: 2 Trial UseSecurity Category: Patient Compartments: Patient, Practitioner

Обозначает, что лекарственный продукт был или должен быть выдан названному лицу/пациенту. Включает в себя описание и инструкции по применению поставляемого лекарственного продукта. Выдача лекарственного средства - это ответное действие фармацевтической системы на заказ лекарственного средства.

This resource covers the supply of medications to a patient. Examples include dispensing and pick-up from an outpatient or community pharmacy, dispensing patient-specific medications from inpatient pharmacy to ward, as well as issuing a single dose from ward stock to a patient for consumption. The medication dispense is the result of a pharmacy system responding to a medication order.

MedicationDispense is an event resource from a FHIR workflow perspective - see Workflow Event

The Medication domain includes a number of related resources

MedicationRequest An order for both supply of the medication and the instructions for administration of the medicine to a patient.
MedicationDispense Provision of a supply of a medication with the intention that it is subsequently consumed by a patient (usually in response to a prescription).
MedicationAdministration When a patient actually consumes a medicine, or the medication is otherwise administered to them
MedicationStatement This is a record of a medication being taken by a patient or that a medication has been given to a patient, where the record is the result of a report from the patient or another clinician. A medication statement is not a part of the prescribe->dispense->administer sequence, but is a report that such a sequence (or at least a part of it) did take place, resulting in a belief that the patient has received a particular medication.

This resource does not deal with the supply or transfer of non-medication related items to a patient.

The supply and the associated administration instructions might not exactly follow the original order (prescription), either because some details were left for completion at this point in the process or because the dispenser exercised their clinical judgment to make some appropriate modification.

На этот ресурс ссылаются ChargeItem, MedicationStatement и Observation

Структура

ИмяФлагиКард.ТипОписание и ограниченияdoco
.. MedicationDispense ITUDomainResourceВыдача лекарственного средства названному пациенту
+ Rule: Дата whenHandedOver не может быть меньше даты whenPrepared
Элементы, определённые в прародителе: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier 0..*IdentifierВнешний идентификатор
... partOf 0..*Reference(Procedure)Event that dispense is part of
... status ?!Σ1..1codepreparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | unknown
Medication dispense status codes (Required)
... statusReason[x] 0..1Why a dispense was not performed
Medication dispense status reason codes (Example)
.... statusReasonCodeableConceptCodeableConcept
.... statusReasonReferenceReference(DetectedIssue)
... category 0..1CodeableConceptType of medication dispense
Medication dispense category codes (Preferred)
... medication[x] Σ1..1Какое лекарственное средство было приготовлено
SNOMED CT Medication Codes (Example)
.... medicationCodeableConceptCodeableConcept
.... medicationReferenceReference(Medication)
... subject Σ0..1Reference(Patient | Group)Кому будет выдано
... context 0..1Reference(Encounter | EpisodeOfCare)Encounter / Episode associated with event
... supportingInformation 0..*Reference(Any)Information that supports the dispensing of the medication
... performer 0..*BackboneElementWho performed event
.... function 0..1CodeableConceptWho performed the dispense and what they did
Medication dispense performer function codes (Example)
.... actor 1..1Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson)Individual who was performing
... location 0..1Reference(Location)Where the dispense occurred
... authorizingPrescription 0..*Reference(MedicationRequest)Заказ на лекарственное средство, который санкционирует приготовление и распределение
... type 0..1CodeableConceptПробная выдача, частичная выдача, неотложная выдача и т. д
V3 Value SetActPharmacySupplyType (Example)
... quantity 0..1SimpleQuantityПриготовленное количество
... daysSupply 0..1SimpleQuantityКоличество лекарственного средства, выраженное в виде временного срока
... whenPrepared Σ0..1dateTimeWhen product was packaged and reviewed
... whenHandedOver 0..1dateTimeКогда продукт был выдан
... destination 0..1Reference(Location)Куда было отправлено лекарственное средство
... receiver 0..*Reference(Patient | Practitioner)Кто забрал лекарственное средство
... note 0..*AnnotationИнформация о приготовлении
... dosageInstruction 0..*DosageHow the medication is to be used by the patient or administered by the caregiver
... substitution 0..1BackboneElementWhether a substitution was performed on the dispense
.... wasSubstituted 1..1booleanWhether a substitution was or was not performed on the dispense
.... type 0..1CodeableConceptКод, означающий, был ли приготовлен другой препарат, а не тот, что указан в рецепте
V3 Value SetActSubstanceAdminSubstitutionCode (Example)
.... reason 0..*CodeableConceptПочему была сделана замена
V3 Value SetSubstanceAdminSubstitutionReason (Example)
.... responsibleParty 0..*Reference(Practitioner)Кто несет ответственность за замену
... detectedIssue 0..*Reference(DetectedIssue)Clinical issue with action
... eventHistory 0..*Reference(Provenance)A list of relevant lifecycle events

doco Документация по этому формату

UML-диаграмма (Legend)

MedicationDispense (DomainResource)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 serveridentifier : Identifier [0..*]The procedure that trigger the dispensepartOf : Reference [0..*] « Procedure »Код состояния ряда событий по выдаче (this element modifies the meaning of other elements)status : code [1..1] « A coded concept specifying the state of the dispense event. (Strength=Required)MedicationDispense Status ! »Indicates the reason why a dispense was not performedstatusReason[x] : Type [0..1] « CodeableConcept|Reference( DetectedIssue); A code describing why a dispense was not performed. (Strength=Example)MedicationDispense Status Rea...?? »Indicates the type of medication dispense (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient))category : CodeableConcept [0..1] « A code describing where the dispensed medication is expected to be consumed or administered. (Strength=Preferred)MedicationDispense Category ? »Определяет вводимое лекарственное средство. Это либо ссылка на ресурс, представляющий детали лекарственного средства, либо простой атрибут с кодом лекарственного средства из известного списка медикаментовmedication[x] : Type [1..1] « CodeableConcept|Reference(Medication); A coded concept identifying which substance or product can be dispensed. (Strength=Example) SNOMEDCTMedicationCodes?? »A link to a resource representing the person or the group to whom the medication will be givensubject : Reference [0..1] « Patient|Group »The encounter or episode of care that establishes the context for this eventcontext : Reference [0..1] « Encounter|EpisodeOfCare »Additional information that supports the medication being dispensedsupportingInformation : Reference [0..*] « Any »The principal physical location where the dispense was performedlocation : Reference [0..1] « Location »Обозначает заказ на лекарственное средство, по которому выполняется приготовление и распределениеauthorizingPrescription : Reference [0..*] « MedicationRequest »Обозначает тип события выдачи. Например пробная выдача, завершение испытания, частичная выдача, неотложная выдача, образцы и т. пtype : CodeableConcept [0..1] « Обозначает тип события выдачи. Например пробная выдача, завершение испытания, частичная выдача, неотложная выдача, образцы и т. п. (Strength=Example)v3.ActPharmacySupplyType?? »Количество лекарственного средства, которое было приготовлено. Включает единицы измеренияquantity : Quantity(SimpleQuantity) [0..1]Количество лекарственного средства, выраженное в виде временного срокаdaysSupply : Quantity(SimpleQuantity) [0..1]Время, когда приготовленный продукт был упакован и проверенwhenPrepared : dateTime [0..1]Время, когда приготовленный продукт был выдан пациенту или его представителюwhenHandedOver : dateTime [0..1]Учреждение/место, куда было отгружено лекарственное средство в рамках события приготовленияdestination : Reference [0..1] « Location »Человек, который забрал лекарственное средство. Как правило, это пациент или тот, кто за ним ухаживает, но существуют случаи, когда это может быть и специалист по медицинскому обеспечениюreceiver : Reference [0..*] « Patient|Practitioner »Дополнительная информация о приготовлении, которая не может быть передана в других атрибутахnote : Annotation [0..*]Indicates how the medication is to be used by the patientdosageInstruction : Dosage [0..*]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 etcdetectedIssue : Reference [0..*] « DetectedIssue »A summary of the events of interest that have occurred, such as when the dispense was verifiedeventHistory : Reference [0..*] « Provenance »PerformerDistinguishes the type of performer in the dispense. For example, date enterer, packager, final checkerfunction : CodeableConcept [0..1] « A code describing the role an individual played in dispensing a medication. (Strength=Example)MedicationDispense Performer ...?? »The device, practitioner, etc. who performed the action. It should be assumed that the actor is the dispenser of the medicationactor : Reference [1..1] « Practitioner|PractitionerRole| Organization|Patient|Device|RelatedPerson »SubstitutionTrue if the dispenser dispensed a different drug or product from what was prescribedwasSubstituted : boolean [1..1]Код, означающий, был ли приготовлен другой препарат, а не тот, что указан в рецептеtype : CodeableConcept [0..1] « Закодированное понятие, описывающее, можно ли выдать другое лекарственное средство вместо продукта, указанного в рецепте. (Strength=Example)v3.ActSubstanceAdminSubstitut...?? »Причина замены (или отсутствия замены) того, что было предписаноreason : CodeableConcept [0..*] « Закодированное понятие, описывающее причину, по которой другое лекарственное средство следует (или не следует) выдать вместо указанного в рецепте. (Strength=Example)v3.SubstanceAdminSubstitution...?? »Человек или организация, несущая основную ответственность за эту заменуresponsibleParty : Reference [0..*] « Practitioner »Indicates who or what performed the eventperformer[0..*]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 donesubstitution[0..1]

XML-шаблон

<MedicationDispense xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Внешний идентификатор --></identifier>
 <partOf><!-- 0..* Reference(Procedure) Event that dispense is part of --></partOf>
 <status value="[code]"/><!-- 1..1 preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | unknown -->
 <statusReason[x]><!-- 0..1 CodeableConcept|Reference(DetectedIssue) Why a dispense was not performed --></statusReason[x]>
 <category><!-- 0..1 CodeableConcept Type of medication dispense --></category>
 <medication[x]><!-- 1..1 CodeableConcept|Reference(Medication) Какое лекарственное средство было приготовлено --></medication[x]>
 <subject><!-- 0..1 Reference(Patient|Group) Кому будет выдано --></subject>
 <context><!-- 0..1 Reference(Encounter|EpisodeOfCare) Encounter / Episode associated with event --></context>
 <supportingInformation><!-- 0..* Reference(Any) Information that supports the dispensing of the medication --></supportingInformation>
 <performer>  <!-- 0..* Who performed event -->
  <function><!-- 0..1 CodeableConcept Who performed the dispense and what they did --></function>
  <actor><!-- 1..1 Reference(Practitioner|PractitionerRole|Organization|Patient|
    Device|RelatedPerson) Individual who was performing --></actor>
 </performer>
 <location><!-- 0..1 Reference(Location) Where the dispense occurred --></location>
 <authorizingPrescription><!-- 0..* Reference(MedicationRequest) Заказ на лекарственное средство, который санкционирует приготовление и распределение --></authorizingPrescription>
 <type><!-- 0..1 CodeableConcept Пробная выдача, частичная выдача, неотложная выдача и т. д --></type>
 <quantity><!-- 0..1 Quantity(SimpleQuantity) Приготовленное количество --></quantity>
 <daysSupply><!-- 0..1 Quantity(SimpleQuantity) Количество лекарственного средства, выраженное в виде временного срока --></daysSupply>
 <whenPrepared value="[dateTime]"/><!-- 0..1 When product was packaged and reviewed -->
 <whenHandedOver value="[dateTime]"/><!-- 0..1 Когда продукт был выдан -->
 <destination><!-- 0..1 Reference(Location) Куда было отправлено лекарственное средство --></destination>
 <receiver><!-- 0..* Reference(Patient|Practitioner) Кто забрал лекарственное средство --></receiver>
 <note><!-- 0..* Annotation Информация о приготовлении --></note>
 <dosageInstruction><!-- 0..* Dosage How the medication is to be used by the patient or administered by the caregiver --></dosageInstruction>
 <substitution>  <!-- 0..1 Whether a substitution was performed on the dispense -->
  <wasSubstituted value="[boolean]"/><!-- 1..1 Whether a substitution was or was not performed on the dispense -->
  <type><!-- 0..1 CodeableConcept Код, означающий, был ли приготовлен другой препарат, а не тот, что указан в рецепте --></type>
  <reason><!-- 0..* CodeableConcept Почему была сделана замена --></reason>
  <responsibleParty><!-- 0..* Reference(Practitioner) Кто несет ответственность за замену --></responsibleParty>
 </substitution>
 <detectedIssue><!-- 0..* Reference(DetectedIssue) Clinical issue with action --></detectedIssue>
 <eventHistory><!-- 0..* Reference(Provenance) A list of relevant lifecycle events --></eventHistory>
</MedicationDispense>

JSON-шаблон

{doco
  "resourceType" : "MedicationDispense",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Внешний идентификатор
  "partOf" : [{ Reference(Procedure) }], // Event that dispense is part of
  "status" : "<code>", // R!  preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | unknown
  // statusReason[x]: Why a dispense was not performed. One of these 2:
  "statusReasonCodeableConcept" : { CodeableConcept },
  "statusReasonReference" : { Reference(DetectedIssue) },
  "category" : { CodeableConcept }, // Type of medication dispense
  // medication[x]: Какое лекарственное средство было приготовлено. One of these 2:
  "medicationCodeableConcept" : { CodeableConcept },
  "medicationReference" : { Reference(Medication) },
  "subject" : { Reference(Patient|Group) }, // Кому будет выдано
  "context" : { Reference(Encounter|EpisodeOfCare) }, // Encounter / Episode associated with event
  "supportingInformation" : [{ Reference(Any) }], // Information that supports the dispensing of the medication
  "performer" : [{ // Who performed event
    "function" : { CodeableConcept }, // Who performed the dispense and what they did
    "actor" : { Reference(Practitioner|PractitionerRole|Organization|Patient|
    Device|RelatedPerson) } // R!  Individual who was performing
  }],
  "location" : { Reference(Location) }, // Where the dispense occurred
  "authorizingPrescription" : [{ Reference(MedicationRequest) }], // Заказ на лекарственное средство, который санкционирует приготовление и распределение
  "type" : { CodeableConcept }, // Пробная выдача, частичная выдача, неотложная выдача и т. д
  "quantity" : { Quantity(SimpleQuantity) }, // Приготовленное количество
  "daysSupply" : { Quantity(SimpleQuantity) }, // Количество лекарственного средства, выраженное в виде временного срока
  "whenPrepared" : "<dateTime>", // When product was packaged and reviewed
  "whenHandedOver" : "<dateTime>", // Когда продукт был выдан
  "destination" : { Reference(Location) }, // Куда было отправлено лекарственное средство
  "receiver" : [{ Reference(Patient|Practitioner) }], // Кто забрал лекарственное средство
  "note" : [{ Annotation }], // Информация о приготовлении
  "dosageInstruction" : [{ Dosage }], // How the medication is to be used by the patient or administered by the caregiver
  "substitution" : { // Whether a substitution was performed on the dispense
    "wasSubstituted" : <boolean>, // R!  Whether a substitution was or was not performed on the dispense
    "type" : { CodeableConcept }, // Код, означающий, был ли приготовлен другой препарат, а не тот, что указан в рецепте
    "reason" : [{ CodeableConcept }], // Почему была сделана замена
    "responsibleParty" : [{ Reference(Practitioner) }] // Кто несет ответственность за замену
  },
  "detectedIssue" : [{ Reference(DetectedIssue) }], // Clinical issue with action
  "eventHistory" : [{ Reference(Provenance) }] // A list of relevant lifecycle events
}

Turtle-шаблон

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:MedicationDispense;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:MedicationDispense.identifier [ Identifier ], ... ; # 0..* Внешний идентификатор
  fhir:MedicationDispense.partOf [ Reference(Procedure) ], ... ; # 0..* Event that dispense is part of
  fhir:MedicationDispense.status [ code ]; # 1..1 preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | unknown
  # MedicationDispense.statusReason[x] : 0..1 Why a dispense was not performed. One of these 2
    fhir:MedicationDispense.statusReasonCodeableConcept [ CodeableConcept ]
    fhir:MedicationDispense.statusReasonReference [ Reference(DetectedIssue) ]
  fhir:MedicationDispense.category [ CodeableConcept ]; # 0..1 Type of medication dispense
  # MedicationDispense.medication[x] : 1..1 Какое лекарственное средство было приготовлено. One of these 2
    fhir:MedicationDispense.medicationCodeableConcept [ CodeableConcept ]
    fhir:MedicationDispense.medicationReference [ Reference(Medication) ]
  fhir:MedicationDispense.subject [ Reference(Patient|Group) ]; # 0..1 Кому будет выдано
  fhir:MedicationDispense.context [ Reference(Encounter|EpisodeOfCare) ]; # 0..1 Encounter / Episode associated with event
  fhir:MedicationDispense.supportingInformation [ Reference(Any) ], ... ; # 0..* Information that supports the dispensing of the medication
  fhir:MedicationDispense.performer [ # 0..* Who performed event
    fhir:MedicationDispense.performer.function [ CodeableConcept ]; # 0..1 Who performed the dispense and what they did
    fhir:MedicationDispense.performer.actor [ Reference(Practitioner|PractitionerRole|Organization|Patient|Device|RelatedPerson) ]; # 1..1 Individual who was performing
  ], ...;
  fhir:MedicationDispense.location [ Reference(Location) ]; # 0..1 Where the dispense occurred
  fhir:MedicationDispense.authorizingPrescription [ Reference(MedicationRequest) ], ... ; # 0..* Заказ на лекарственное средство, который санкционирует приготовление и распределение
  fhir:MedicationDispense.type [ CodeableConcept ]; # 0..1 Пробная выдача, частичная выдача, неотложная выдача и т. д
  fhir:MedicationDispense.quantity [ Quantity(SimpleQuantity) ]; # 0..1 Приготовленное количество
  fhir:MedicationDispense.daysSupply [ Quantity(SimpleQuantity) ]; # 0..1 Количество лекарственного средства, выраженное в виде временного срока
  fhir:MedicationDispense.whenPrepared [ dateTime ]; # 0..1 When product was packaged and reviewed
  fhir:MedicationDispense.whenHandedOver [ dateTime ]; # 0..1 Когда продукт был выдан
  fhir:MedicationDispense.destination [ Reference(Location) ]; # 0..1 Куда было отправлено лекарственное средство
  fhir:MedicationDispense.receiver [ Reference(Patient|Practitioner) ], ... ; # 0..* Кто забрал лекарственное средство
  fhir:MedicationDispense.note [ Annotation ], ... ; # 0..* Информация о приготовлении
  fhir:MedicationDispense.dosageInstruction [ Dosage ], ... ; # 0..* How the medication is to be used by the patient or administered by the caregiver
  fhir:MedicationDispense.substitution [ # 0..1 Whether a substitution was performed on the dispense
    fhir:MedicationDispense.substitution.wasSubstituted [ boolean ]; # 1..1 Whether a substitution was or was not performed on the dispense
    fhir:MedicationDispense.substitution.type [ CodeableConcept ]; # 0..1 Код, означающий, был ли приготовлен другой препарат, а не тот, что указан в рецепте
    fhir:MedicationDispense.substitution.reason [ CodeableConcept ], ... ; # 0..* Почему была сделана замена
    fhir:MedicationDispense.substitution.responsibleParty [ Reference(Practitioner) ], ... ; # 0..* Кто несет ответственность за замену
  ];
  fhir:MedicationDispense.detectedIssue [ Reference(DetectedIssue) ], ... ; # 0..* Clinical issue with action
  fhir:MedicationDispense.eventHistory [ Reference(Provenance) ], ... ; # 0..* A list of relevant lifecycle events
]

Changes since R3

MedicationDispense
MedicationDispense.status
  • Min Cardinality changed from 0 to 1
  • Change value set from http://hl7.org/fhir/ValueSet/medication-dispense-status to http://hl7.org/fhir/ValueSet/medicationdispense-status
MedicationDispense.statusReason[x]
  • Added Element
MedicationDispense.performer.function
  • Added Element
MedicationDispense.performer.actor
  • Type Reference: Added Target Type PractitionerRole
MedicationDispense.location
  • Added Element
MedicationDispense.performer.onBehalfOf
  • deleted
MedicationDispense.notDone
  • deleted
MedicationDispense.notDoneReason[x]
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON.

See R3 <--> R4 Conversion Maps (status = 31 tests of which 31 fail to execute.)

Структура

ИмяФлагиКард.ТипОписание и ограниченияdoco
.. MedicationDispense ITUDomainResourceВыдача лекарственного средства названному пациенту
+ Rule: Дата whenHandedOver не может быть меньше даты whenPrepared
Элементы, определённые в прародителе: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier 0..*IdentifierВнешний идентификатор
... partOf 0..*Reference(Procedure)Event that dispense is part of
... status ?!Σ1..1codepreparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | unknown
Medication dispense status codes (Required)
... statusReason[x] 0..1Why a dispense was not performed
Medication dispense status reason codes (Example)
.... statusReasonCodeableConceptCodeableConcept
.... statusReasonReferenceReference(DetectedIssue)
... category 0..1CodeableConceptType of medication dispense
Medication dispense category codes (Preferred)
... medication[x] Σ1..1Какое лекарственное средство было приготовлено
SNOMED CT Medication Codes (Example)
.... medicationCodeableConceptCodeableConcept
.... medicationReferenceReference(Medication)
... subject Σ0..1Reference(Patient | Group)Кому будет выдано
... context 0..1Reference(Encounter | EpisodeOfCare)Encounter / Episode associated with event
... supportingInformation 0..*Reference(Any)Information that supports the dispensing of the medication
... performer 0..*BackboneElementWho performed event
.... function 0..1CodeableConceptWho performed the dispense and what they did
Medication dispense performer function codes (Example)
.... actor 1..1Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson)Individual who was performing
... location 0..1Reference(Location)Where the dispense occurred
... authorizingPrescription 0..*Reference(MedicationRequest)Заказ на лекарственное средство, который санкционирует приготовление и распределение
... type 0..1CodeableConceptПробная выдача, частичная выдача, неотложная выдача и т. д
V3 Value SetActPharmacySupplyType (Example)
... quantity 0..1SimpleQuantityПриготовленное количество
... daysSupply 0..1SimpleQuantityКоличество лекарственного средства, выраженное в виде временного срока
... whenPrepared Σ0..1dateTimeWhen product was packaged and reviewed
... whenHandedOver 0..1dateTimeКогда продукт был выдан
... destination 0..1Reference(Location)Куда было отправлено лекарственное средство
... receiver 0..*Reference(Patient | Practitioner)Кто забрал лекарственное средство
... note 0..*AnnotationИнформация о приготовлении
... dosageInstruction 0..*DosageHow the medication is to be used by the patient or administered by the caregiver
... substitution 0..1BackboneElementWhether a substitution was performed on the dispense
.... wasSubstituted 1..1booleanWhether a substitution was or was not performed on the dispense
.... type 0..1CodeableConceptКод, означающий, был ли приготовлен другой препарат, а не тот, что указан в рецепте
V3 Value SetActSubstanceAdminSubstitutionCode (Example)
.... reason 0..*CodeableConceptПочему была сделана замена
V3 Value SetSubstanceAdminSubstitutionReason (Example)
.... responsibleParty 0..*Reference(Practitioner)Кто несет ответственность за замену
... detectedIssue 0..*Reference(DetectedIssue)Clinical issue with action
... eventHistory 0..*Reference(Provenance)A list of relevant lifecycle events

doco Документация по этому формату

UML-диаграмма (Legend)

MedicationDispense (DomainResource)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 serveridentifier : Identifier [0..*]The procedure that trigger the dispensepartOf : Reference [0..*] « Procedure »Код состояния ряда событий по выдаче (this element modifies the meaning of other elements)status : code [1..1] « A coded concept specifying the state of the dispense event. (Strength=Required)MedicationDispense Status ! »Indicates the reason why a dispense was not performedstatusReason[x] : Type [0..1] « CodeableConcept|Reference( DetectedIssue); A code describing why a dispense was not performed. (Strength=Example)MedicationDispense Status Rea...?? »Indicates the type of medication dispense (for example, where the medication is expected to be consumed or administered (i.e. inpatient or outpatient))category : CodeableConcept [0..1] « A code describing where the dispensed medication is expected to be consumed or administered. (Strength=Preferred)MedicationDispense Category ? »Определяет вводимое лекарственное средство. Это либо ссылка на ресурс, представляющий детали лекарственного средства, либо простой атрибут с кодом лекарственного средства из известного списка медикаментовmedication[x] : Type [1..1] « CodeableConcept|Reference(Medication); A coded concept identifying which substance or product can be dispensed. (Strength=Example) SNOMEDCTMedicationCodes?? »A link to a resource representing the person or the group to whom the medication will be givensubject : Reference [0..1] « Patient|Group »The encounter or episode of care that establishes the context for this eventcontext : Reference [0..1] « Encounter|EpisodeOfCare »Additional information that supports the medication being dispensedsupportingInformation : Reference [0..*] « Any »The principal physical location where the dispense was performedlocation : Reference [0..1] « Location »Обозначает заказ на лекарственное средство, по которому выполняется приготовление и распределениеauthorizingPrescription : Reference [0..*] « MedicationRequest »Обозначает тип события выдачи. Например пробная выдача, завершение испытания, частичная выдача, неотложная выдача, образцы и т. пtype : CodeableConcept [0..1] « Обозначает тип события выдачи. Например пробная выдача, завершение испытания, частичная выдача, неотложная выдача, образцы и т. п. (Strength=Example)v3.ActPharmacySupplyType?? »Количество лекарственного средства, которое было приготовлено. Включает единицы измеренияquantity : Quantity(SimpleQuantity) [0..1]Количество лекарственного средства, выраженное в виде временного срокаdaysSupply : Quantity(SimpleQuantity) [0..1]Время, когда приготовленный продукт был упакован и проверенwhenPrepared : dateTime [0..1]Время, когда приготовленный продукт был выдан пациенту или его представителюwhenHandedOver : dateTime [0..1]Учреждение/место, куда было отгружено лекарственное средство в рамках события приготовленияdestination : Reference [0..1] « Location »Человек, который забрал лекарственное средство. Как правило, это пациент или тот, кто за ним ухаживает, но существуют случаи, когда это может быть и специалист по медицинскому обеспечениюreceiver : Reference [0..*] « Patient|Practitioner »Дополнительная информация о приготовлении, которая не может быть передана в других атрибутахnote : Annotation [0..*]Indicates how the medication is to be used by the patientdosageInstruction : Dosage [0..*]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 etcdetectedIssue : Reference [0..*] « DetectedIssue »A summary of the events of interest that have occurred, such as when the dispense was verifiedeventHistory : Reference [0..*] « Provenance »PerformerDistinguishes the type of performer in the dispense. For example, date enterer, packager, final checkerfunction : CodeableConcept [0..1] « A code describing the role an individual played in dispensing a medication. (Strength=Example)MedicationDispense Performer ...?? »The device, practitioner, etc. who performed the action. It should be assumed that the actor is the dispenser of the medicationactor : Reference [1..1] « Practitioner|PractitionerRole| Organization|Patient|Device|RelatedPerson »SubstitutionTrue if the dispenser dispensed a different drug or product from what was prescribedwasSubstituted : boolean [1..1]Код, означающий, был ли приготовлен другой препарат, а не тот, что указан в рецептеtype : CodeableConcept [0..1] « Закодированное понятие, описывающее, можно ли выдать другое лекарственное средство вместо продукта, указанного в рецепте. (Strength=Example)v3.ActSubstanceAdminSubstitut...?? »Причина замены (или отсутствия замены) того, что было предписаноreason : CodeableConcept [0..*] « Закодированное понятие, описывающее причину, по которой другое лекарственное средство следует (или не следует) выдать вместо указанного в рецепте. (Strength=Example)v3.SubstanceAdminSubstitution...?? »Человек или организация, несущая основную ответственность за эту заменуresponsibleParty : Reference [0..*] « Practitioner »Indicates who or what performed the eventperformer[0..*]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 donesubstitution[0..1]

XML-шаблон

<MedicationDispense xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Внешний идентификатор --></identifier>
 <partOf><!-- 0..* Reference(Procedure) Event that dispense is part of --></partOf>
 <status value="[code]"/><!-- 1..1 preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | unknown -->
 <statusReason[x]><!-- 0..1 CodeableConcept|Reference(DetectedIssue) Why a dispense was not performed --></statusReason[x]>
 <category><!-- 0..1 CodeableConcept Type of medication dispense --></category>
 <medication[x]><!-- 1..1 CodeableConcept|Reference(Medication) Какое лекарственное средство было приготовлено --></medication[x]>
 <subject><!-- 0..1 Reference(Patient|Group) Кому будет выдано --></subject>
 <context><!-- 0..1 Reference(Encounter|EpisodeOfCare) Encounter / Episode associated with event --></context>
 <supportingInformation><!-- 0..* Reference(Any) Information that supports the dispensing of the medication --></supportingInformation>
 <performer>  <!-- 0..* Who performed event -->
  <function><!-- 0..1 CodeableConcept Who performed the dispense and what they did --></function>
  <actor><!-- 1..1 Reference(Practitioner|PractitionerRole|Organization|Patient|
    Device|RelatedPerson) Individual who was performing --></actor>
 </performer>
 <location><!-- 0..1 Reference(Location) Where the dispense occurred --></location>
 <authorizingPrescription><!-- 0..* Reference(MedicationRequest) Заказ на лекарственное средство, который санкционирует приготовление и распределение --></authorizingPrescription>
 <type><!-- 0..1 CodeableConcept Пробная выдача, частичная выдача, неотложная выдача и т. д --></type>
 <quantity><!-- 0..1 Quantity(SimpleQuantity) Приготовленное количество --></quantity>
 <daysSupply><!-- 0..1 Quantity(SimpleQuantity) Количество лекарственного средства, выраженное в виде временного срока --></daysSupply>
 <whenPrepared value="[dateTime]"/><!-- 0..1 When product was packaged and reviewed -->
 <whenHandedOver value="[dateTime]"/><!-- 0..1 Когда продукт был выдан -->
 <destination><!-- 0..1 Reference(Location) Куда было отправлено лекарственное средство --></destination>
 <receiver><!-- 0..* Reference(Patient|Practitioner) Кто забрал лекарственное средство --></receiver>
 <note><!-- 0..* Annotation Информация о приготовлении --></note>
 <dosageInstruction><!-- 0..* Dosage How the medication is to be used by the patient or administered by the caregiver --></dosageInstruction>
 <substitution>  <!-- 0..1 Whether a substitution was performed on the dispense -->
  <wasSubstituted value="[boolean]"/><!-- 1..1 Whether a substitution was or was not performed on the dispense -->
  <type><!-- 0..1 CodeableConcept Код, означающий, был ли приготовлен другой препарат, а не тот, что указан в рецепте --></type>
  <reason><!-- 0..* CodeableConcept Почему была сделана замена --></reason>
  <responsibleParty><!-- 0..* Reference(Practitioner) Кто несет ответственность за замену --></responsibleParty>
 </substitution>
 <detectedIssue><!-- 0..* Reference(DetectedIssue) Clinical issue with action --></detectedIssue>
 <eventHistory><!-- 0..* Reference(Provenance) A list of relevant lifecycle events --></eventHistory>
</MedicationDispense>

JSON-шаблон

{doco
  "resourceType" : "MedicationDispense",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Внешний идентификатор
  "partOf" : [{ Reference(Procedure) }], // Event that dispense is part of
  "status" : "<code>", // R!  preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | unknown
  // statusReason[x]: Why a dispense was not performed. One of these 2:
  "statusReasonCodeableConcept" : { CodeableConcept },
  "statusReasonReference" : { Reference(DetectedIssue) },
  "category" : { CodeableConcept }, // Type of medication dispense
  // medication[x]: Какое лекарственное средство было приготовлено. One of these 2:
  "medicationCodeableConcept" : { CodeableConcept },
  "medicationReference" : { Reference(Medication) },
  "subject" : { Reference(Patient|Group) }, // Кому будет выдано
  "context" : { Reference(Encounter|EpisodeOfCare) }, // Encounter / Episode associated with event
  "supportingInformation" : [{ Reference(Any) }], // Information that supports the dispensing of the medication
  "performer" : [{ // Who performed event
    "function" : { CodeableConcept }, // Who performed the dispense and what they did
    "actor" : { Reference(Practitioner|PractitionerRole|Organization|Patient|
    Device|RelatedPerson) } // R!  Individual who was performing
  }],
  "location" : { Reference(Location) }, // Where the dispense occurred
  "authorizingPrescription" : [{ Reference(MedicationRequest) }], // Заказ на лекарственное средство, который санкционирует приготовление и распределение
  "type" : { CodeableConcept }, // Пробная выдача, частичная выдача, неотложная выдача и т. д
  "quantity" : { Quantity(SimpleQuantity) }, // Приготовленное количество
  "daysSupply" : { Quantity(SimpleQuantity) }, // Количество лекарственного средства, выраженное в виде временного срока
  "whenPrepared" : "<dateTime>", // When product was packaged and reviewed
  "whenHandedOver" : "<dateTime>", // Когда продукт был выдан
  "destination" : { Reference(Location) }, // Куда было отправлено лекарственное средство
  "receiver" : [{ Reference(Patient|Practitioner) }], // Кто забрал лекарственное средство
  "note" : [{ Annotation }], // Информация о приготовлении
  "dosageInstruction" : [{ Dosage }], // How the medication is to be used by the patient or administered by the caregiver
  "substitution" : { // Whether a substitution was performed on the dispense
    "wasSubstituted" : <boolean>, // R!  Whether a substitution was or was not performed on the dispense
    "type" : { CodeableConcept }, // Код, означающий, был ли приготовлен другой препарат, а не тот, что указан в рецепте
    "reason" : [{ CodeableConcept }], // Почему была сделана замена
    "responsibleParty" : [{ Reference(Practitioner) }] // Кто несет ответственность за замену
  },
  "detectedIssue" : [{ Reference(DetectedIssue) }], // Clinical issue with action
  "eventHistory" : [{ Reference(Provenance) }] // A list of relevant lifecycle events
}

Turtle-шаблон

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:MedicationDispense;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:MedicationDispense.identifier [ Identifier ], ... ; # 0..* Внешний идентификатор
  fhir:MedicationDispense.partOf [ Reference(Procedure) ], ... ; # 0..* Event that dispense is part of
  fhir:MedicationDispense.status [ code ]; # 1..1 preparation | in-progress | cancelled | on-hold | completed | entered-in-error | stopped | unknown
  # MedicationDispense.statusReason[x] : 0..1 Why a dispense was not performed. One of these 2
    fhir:MedicationDispense.statusReasonCodeableConcept [ CodeableConcept ]
    fhir:MedicationDispense.statusReasonReference [ Reference(DetectedIssue) ]
  fhir:MedicationDispense.category [ CodeableConcept ]; # 0..1 Type of medication dispense
  # MedicationDispense.medication[x] : 1..1 Какое лекарственное средство было приготовлено. One of these 2
    fhir:MedicationDispense.medicationCodeableConcept [ CodeableConcept ]
    fhir:MedicationDispense.medicationReference [ Reference(Medication) ]
  fhir:MedicationDispense.subject [ Reference(Patient|Group) ]; # 0..1 Кому будет выдано
  fhir:MedicationDispense.context [ Reference(Encounter|EpisodeOfCare) ]; # 0..1 Encounter / Episode associated with event
  fhir:MedicationDispense.supportingInformation [ Reference(Any) ], ... ; # 0..* Information that supports the dispensing of the medication
  fhir:MedicationDispense.performer [ # 0..* Who performed event
    fhir:MedicationDispense.performer.function [ CodeableConcept ]; # 0..1 Who performed the dispense and what they did
    fhir:MedicationDispense.performer.actor [ Reference(Practitioner|PractitionerRole|Organization|Patient|Device|RelatedPerson) ]; # 1..1 Individual who was performing
  ], ...;
  fhir:MedicationDispense.location [ Reference(Location) ]; # 0..1 Where the dispense occurred
  fhir:MedicationDispense.authorizingPrescription [ Reference(MedicationRequest) ], ... ; # 0..* Заказ на лекарственное средство, который санкционирует приготовление и распределение
  fhir:MedicationDispense.type [ CodeableConcept ]; # 0..1 Пробная выдача, частичная выдача, неотложная выдача и т. д
  fhir:MedicationDispense.quantity [ Quantity(SimpleQuantity) ]; # 0..1 Приготовленное количество
  fhir:MedicationDispense.daysSupply [ Quantity(SimpleQuantity) ]; # 0..1 Количество лекарственного средства, выраженное в виде временного срока
  fhir:MedicationDispense.whenPrepared [ dateTime ]; # 0..1 When product was packaged and reviewed
  fhir:MedicationDispense.whenHandedOver [ dateTime ]; # 0..1 Когда продукт был выдан
  fhir:MedicationDispense.destination [ Reference(Location) ]; # 0..1 Куда было отправлено лекарственное средство
  fhir:MedicationDispense.receiver [ Reference(Patient|Practitioner) ], ... ; # 0..* Кто забрал лекарственное средство
  fhir:MedicationDispense.note [ Annotation ], ... ; # 0..* Информация о приготовлении
  fhir:MedicationDispense.dosageInstruction [ Dosage ], ... ; # 0..* How the medication is to be used by the patient or administered by the caregiver
  fhir:MedicationDispense.substitution [ # 0..1 Whether a substitution was performed on the dispense
    fhir:MedicationDispense.substitution.wasSubstituted [ boolean ]; # 1..1 Whether a substitution was or was not performed on the dispense
    fhir:MedicationDispense.substitution.type [ CodeableConcept ]; # 0..1 Код, означающий, был ли приготовлен другой препарат, а не тот, что указан в рецепте
    fhir:MedicationDispense.substitution.reason [ CodeableConcept ], ... ; # 0..* Почему была сделана замена
    fhir:MedicationDispense.substitution.responsibleParty [ Reference(Practitioner) ], ... ; # 0..* Кто несет ответственность за замену
  ];
  fhir:MedicationDispense.detectedIssue [ Reference(DetectedIssue) ], ... ; # 0..* Clinical issue with action
  fhir:MedicationDispense.eventHistory [ Reference(Provenance) ], ... ; # 0..* A list of relevant lifecycle events
]

Changes since Release 3

MedicationDispense
MedicationDispense.status
  • Min Cardinality changed from 0 to 1
  • Change value set from http://hl7.org/fhir/ValueSet/medication-dispense-status to http://hl7.org/fhir/ValueSet/medicationdispense-status
MedicationDispense.statusReason[x]
  • Added Element
MedicationDispense.performer.function
  • Added Element
MedicationDispense.performer.actor
  • Type Reference: Added Target Type PractitionerRole
MedicationDispense.location
  • Added Element
MedicationDispense.performer.onBehalfOf
  • deleted
MedicationDispense.notDone
  • deleted
MedicationDispense.notDoneReason[x]
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON.

See R3 <--> R4 Conversion Maps (status = 31 tests of which 31 fail to execute.)

 

See the Profiles & Extensions and the Альтернативные определения: Основное определение XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions & the Анализ зависимостей

PathОписаниеТипСсылка
MedicationDispense.status A coded concept specifying the state of the dispense event.RequiredMedicationDispense Status Codes
MedicationDispense.statusReason[x] A code describing why a dispense was not performed.ExampleMedicationDispense Status Reason Codes
MedicationDispense.category A code describing where the dispensed medication is expected to be consumed or administered.PreferredMedicationDispense Category Codes
MedicationDispense.medication[x] A coded concept identifying which substance or product can be dispensed.ExampleSNOMEDCTMedicationCodes
MedicationDispense.performer.function A code describing the role an individual played in dispensing a medication.ExampleMedicationDispense Performer Function Codes
MedicationDispense.type Обозначает тип события выдачи. Например пробная выдача, завершение испытания, частичная выдача, неотложная выдача, образцы и т. п.Examplev3.ActPharmacySupplyType
MedicationDispense.substitution.type Закодированное понятие, описывающее, можно ли выдать другое лекарственное средство вместо продукта, указанного в рецепте.Examplev3.ActSubstanceAdminSubstitutionCode
MedicationDispense.substitution.reason Закодированное понятие, описывающее причину, по которой другое лекарственное средство следует (или не следует) выдать вместо указанного в рецепте.Examplev3.SubstanceAdminSubstitutionReason

idLevelLocationОпределениеExpression
mdd-1Rule (base)Дата whenHandedOver не может быть меньше даты whenPreparedwhenHandedOver.empty() or whenPrepared.empty() or whenHandedOver >= whenPrepared

Параметры поиска для этого ресурса. Также к нему применяются общие параметры. Более подробную информацию о поиске в REST, обмене сообщениями и сервисах см. в разделе Поиск.

ИмяТипОпределениеВыражениеIn Common
codetokenReturns dispenses of this medicine code(MedicationDispense.medication as CodeableConcept)13 Resources
contextreferenceReturns dispenses with a specific context (episode or episode of care)MedicationDispense.context
(EpisodeOfCare, Encounter)
destinationreferenceReturns dispenses that should be sent to a specific destinationMedicationDispense.destination
(Location)
identifiertokenReturns dispenses with this external identifierMedicationDispense.identifier30 Resources
medicationreferenceReturns dispenses of this medicine resource(MedicationDispense.medication as Reference)
(Medication)
3 Resources
patientreferenceИдентификатор пациента, для которого необходимо вывести список dispensesMedicationDispense.subject.where(resolve() is Patient)
(Patient)
performerreferenceReturns dispenses performed by a specific individualMedicationDispense.performer.actor
(Practitioner, Organization, Device, Patient, PractitionerRole, RelatedPerson)
prescriptionreferenceИдентификатор назначения, из которого необходимо перечислить dispensesMedicationDispense.authorizingPrescription
(MedicationRequest)
1 Resources
receiverreferenceThe identity of a receiver to list dispenses forMedicationDispense.receiver
(Practitioner, Patient)
responsiblepartyreferenceReturns dispenses with the specified responsible partyMedicationDispense.substitution.responsibleParty
(Practitioner)
statustokenReturns dispenses with a specified dispense statusMedicationDispense.status3 Resources
subjectreferenceThe identity of a patient for whom to list dispensesMedicationDispense.subject
(Group, Patient)
typetokenReturns dispenses of a specific typeMedicationDispense.type
whenhandedoverdateReturns dispenses handed over on this dateMedicationDispense.whenHandedOver
whenprepareddateReturns dispenses prepared on this dateMedicationDispense.whenPrepared