Medication Dispense FHIR Resource Proposal

medicationDispense

Owning committee name

Pharmacy

Interested Work Groups

• PHER (Immunizations)
• Patient Care

FHIR Resource Development Project Insight ID

855

Scope of coverage

Dispensing (or Supply) of Medicines to Humans across All Healthcare Disciplines in All Care Settings and All Regions.

The scope of "Medicines" is as defined by the medicines resource and at it's simplest can be taken to be an identified product. This allows very broad interpretation and can cover non-prescribed medication, herbal products, diet supplements, illicit drugs, and even some products that may be classified as devices. The key distinguishing characteristic is that the product is consumed during the process of medicationAdministration and cannot be reused.

An medicationDispense may be a single event or may be a series of events over a period of time. As such it is the mid point of a process of:

• prescription or ordering
• dispensing or supply
• administration or consumption

Separate resources have been created for medicationPrescription and medicationAdministration

RIM scope

medicationDispense corresponds to the RIM Acts of Substance Administration (SBADM) and Supply as constrained in the Pharmacy Domain model Medication Dispense PORX_RM020070UV

Resource appropriateness

Dispensing is one of the three core steps of use of medicines, the other two being Prescription and Administration. In many settings the three steps are performed by separate people, and are frequently recorded by separate software systems. Dispense records are a core part of knowing what medication a patient has been provided - having a standard format for this is essential. There is a well established set of attributes that are always required. The pharmacy group spent some time discussing the extent to which the attributes for Prescription, Dispensing and Administration overlapped and came to the conclusion that there is a need to express these attributes as part of distinct resources, not as part of some more abstract "Medicines Processing" resource.

Expected implementations

This is a key resource required by almost all Healthcare systems. As such it is key for any system scoped by CCDA.

Content sources

• Existing normative V3 Pharmacy RMIMs
• HL7 v2 specifications
• Existing specifications in Canada, The Netherlands and UK
• NCPDP specifications
• Developing specifications in Australia
• Some commercial systems

Resource Relationships

medicationDispense is one of a set of three (along with medicationPrescription and medicationAdministration) that describe the normal business lifecycle for point of care systems dealing with Medication. The business lifecycle will frequently be managed by the Order resource. medicationDispense will frequently be referred to by a carePlan resource.

Timelines

Ready for first ballot January 2013

gForge Users

hugh_glover, Jean-Henri Duteau