Amakomaya Nepal FHIR Implementation Guide
2.0.0 - ci-build Nepal

Amakomaya Nepal FHIR Implementation Guide - Local Development build (v2.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: AMK Core Medication Dispense Profile

Official URL: https://fhir.amakomaya.com/StructureDefinition/amk-core-medication-dispense Version: 2.0.0
Active as of 2026-08-21 Computable Name: AMKCoreMedicationDispenseProfile

Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License

The AMK Core MedicationDispense Profile inherits from the FHIR MedicationDispense resource; refer to it for scope and usage definitions. This profile sets minimum expectations for the MedicationDispense resource to record, search, and fetch information about medications dispensed to a patient within the Nepal health system. It specifies which core elements, extensions, vocabularies, and value sets SHALL be present and constrains how the elements are used.

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

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

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationDispense C 0..* MedicationDispense Dispensing a medication to a named patient
Constraints: mdd-1
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... contained 0..* Resource Contained, inline Resources
... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
Slice: Unordered, Open by value:url
... medication Σ 1..1 CodeableReference(Medication) What medication was (or was intended to be) supplied
Binding: Dietary Supplements (SNOMED) (required)
... subject Σ 1..1 Reference(AMK Core Patient Profile) Who the dispense is for
... quantity 1..1 SimpleQuantity(6.0.0-ballot5) Amount of medication
.... value Σ 1..1 decimal Numerical value (with implicit precision)
.... unit Σ 1..1 string Unit representation
.... system ΣC 1..1 uri System that defines coded unit form
.... code ΣC 1..1 code Coded form of the unit
... recorded 1..1 dateTime When the recording of the dispense started

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
MedicationDispense.status Base required MedicationDispense Status Codes 📍6.0.0-ballot5 FHIR Std.
MedicationDispense.medication Base required Dietary Supplements (SNOMED) 📦2.0.0 This IG

Constraints

Id Grade Path(s) Description Expression
dom-2 error MedicationDispense If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error MedicationDispense 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.trace('id') in %resource.descendants().select(reference | as(uri))) or descendants().where(reference='#' | as(uri)='#').exists()).not()).trace('unmatched', id).empty()
dom-4 error MedicationDispense 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 error MedicationDispense If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice MedicationDispense A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
mdd-1 error MedicationDispense whenHandedOver cannot be before whenPrepared (whenHandedOver.hasValue() and whenPrepared.hasValue()) implies whenHandedOver >= whenPrepared

This structure is derived from MedicationDispense

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationDispense 0..* MedicationDispense Dispensing a medication to a named patient
... medication 1..1 CodeableReference(Medication) What medication was (or was intended to be) supplied
Binding: Dietary Supplements (SNOMED) (required)
... subject 1..1 Reference(AMK Core Patient Profile) Who the dispense is for
... quantity 1..1 SimpleQuantity(6.0.0-ballot5) Amount of medication
.... value 1..1 decimal Numerical value (with implicit precision)
.... unit 1..1 string Unit representation
.... system 1..1 uri System that defines coded unit form
.... code 1..1 code Coded form of the unit

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
MedicationDispense.medication Base required Dietary Supplements (SNOMED) 📦2.0.0 This IG
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationDispense C 0..* MedicationDispense Dispensing a medication to a named patient
Constraints: mdd-1
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: AllLanguages (required): IETF language tag for a human language
Additional BindingsPurpose
CommonLanguages Starter
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
Slice: Unordered, Open by value:url
... identifier 0..* Identifier External identifier
... basedOn 0..* Reference(CarePlan) Plan that is fulfilled by this dispense
... partOf 0..* Reference(Procedure | MedicationAdministration) Event that dispense is part of
... status ?!Σ 1..1 code preparation | in-progress | cancelled | on-hold | completed | entered-in-error | unfulfilled | declined | unknown
Binding: MedicationDispenseStatusCodes (required): Describes the lifecycle of the dispense.
... notPerformedReason 0..1 CodeableReference(DetectedIssue) Why a dispense was not performed
Binding: MedicationDispenseStatusReasonCodes (example)
... statusChanged 0..1 dateTime When the status changed
... category 0..* CodeableConcept Type of medication dispense
Binding: MedicationDispenseCategoryCodes (example): A code describing where the dispensed medication is expected to be consumed or administered.
... medication Σ 1..1 CodeableReference(Medication) What medication was (or was intended to be) supplied
Binding: Dietary Supplements (SNOMED) (required)
... subject Σ 1..1 Reference(AMK Core Patient Profile) Who the dispense is for
... encounter 0..1 Reference(Encounter) Encounter associated with event
... supportingInformation 0..* Reference(Resource) Information that supports the dispensing of the medication
... performer 0..* BackboneElement Who performed event
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Slice: Unordered, Open by value:url
.... function 0..1 CodeableConcept Who performed the dispense and what they did
Binding: MedicationDispensePerformerFunctionCodes (example): A code describing the role an individual played in dispensing a medication.
.... actor 1..1 Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam | Group) Individual who was performing
... location 0..1 Reference(Location) Where the dispense occurred
... authorizingPrescription 0..* Reference(MedicationRequest) Medication order that authorizes the dispense
... type 0..1 CodeableConcept Trial fill, partial fill, emergency fill, etc
Binding: ActPharmacySupplyType (example): ActPharmacySupplyType
... quantity 1..1 SimpleQuantity(6.0.0-ballot5) Amount of medication
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... value Σ 1..1 decimal Numerical value (with implicit precision)
.... unit Σ 1..1 string Unit representation
.... system ΣC 1..1 uri System that defines coded unit form
.... code ΣC 1..1 code Coded form of the unit
... daysSupply 0..1 SimpleQuantity(6.0.0-ballot5) Amount of medication expressed as a timing amount
... fillNumber 0..1 positiveInt A number that represents the known fill this dispense represents
... recorded 1..1 dateTime When the recording of the dispense started
... whenPrepared ΣC 0..1 dateTime When product was packaged and reviewed
... whenHandedOver C 0..1 dateTime When product was given out
... destination 0..1 Reference(Location) Where the medication was/will be sent
... receiver 0..* Reference(Patient | Practitioner | RelatedPerson | Location | PractitionerRole | Organization | Group) Who collected the medication or where the medication was delivered
... note 0..* Annotation Information about the dispense
... dosageInstruction 0..1 DosageDetails How the medication is to be used by the patient or administered by the caregiver
... doseAdministrationAid 0..1 CodeableConcept Type of adherence packaging to use for the dispense
Binding: MedicationDoseAids (example): DoseAdministrationAid
... substitution 0..1 BackboneElement Whether a substitution was performed on the dispense
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Slice: Unordered, Open by value:url
.... wasSubstituted 1..1 boolean Whether a substitution was or was not performed on the dispense
.... type 0..1 CodeableConcept Code signifying whether a different drug was dispensed from what was prescribed
Binding: ActSubstanceAdminSubstitutionCode (example): ActSubstanceAdminSubstitutionCode
.... reason 0..* CodeableConcept Why was substitution made
Binding: SubstanceAdminSubstitutionReason (example): SubstanceAdminSubstitutionReason
.... responsibleParty 0..1 Reference(Practitioner | PractitionerRole | Organization) Who is responsible for the substitution
... eventHistory 0..* Reference(Provenance) A list of relevant lifecycle events

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
MedicationDispense.language Base required All Languages 📍6.0.0-ballot5 FHIR Std.
MedicationDispense.status Base required MedicationDispense Status Codes 📍6.0.0-ballot5 FHIR Std.
MedicationDispense.notPerformedReason Base example MedicationDispense Status Reason Codes 📍6.0.0-ballot5 FHIR Std.
MedicationDispense.category Base example MedicationDispense Category Codes 📍6.0.0-ballot5 FHIR Std.
MedicationDispense.medication Base required Dietary Supplements (SNOMED) 📦2.0.0 This IG
MedicationDispense.performer.​function Base example MedicationDispense Performer Function Codes 📍6.0.0-ballot5 FHIR Std.
MedicationDispense.type Base example ActPharmacySupplyType 📦3.0.0 THO v7.3
MedicationDispense.doseAdministrationAid Base example Medication Dose Aids 📍6.0.0-ballot5 FHIR Std.
MedicationDispense.substitution.​type Base example ActSubstanceAdminSubstitutionCode 📦3.0.0 THO v7.3
MedicationDispense.substitution.​reason Base example SubstanceAdminSubstitutionReason 📦3.0.0 THO v7.3

Constraints

Id Grade Path(s) Description Expression
dom-2 error MedicationDispense If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error MedicationDispense 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.trace('id') in %resource.descendants().select(reference | as(uri))) or descendants().where(reference='#' | as(uri)='#').exists()).not()).trace('unmatched', id).empty()
dom-4 error MedicationDispense 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 error MedicationDispense If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice MedicationDispense A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
mdd-1 error MedicationDispense whenHandedOver cannot be before whenPrepared (whenHandedOver.hasValue() and whenPrepared.hasValue()) implies whenHandedOver >= whenPrepared

This structure is derived from MedicationDispense

Summary

Mandatory: 6 elements

Structures

This structure refers to these other structures:

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationDispense C 0..* MedicationDispense Dispensing a medication to a named patient
Constraints: mdd-1
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... contained 0..* Resource Contained, inline Resources
... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
Slice: Unordered, Open by value:url
... medication Σ 1..1 CodeableReference(Medication) What medication was (or was intended to be) supplied
Binding: Dietary Supplements (SNOMED) (required)
... subject Σ 1..1 Reference(AMK Core Patient Profile) Who the dispense is for
... quantity 1..1 SimpleQuantity(6.0.0-ballot5) Amount of medication
.... value Σ 1..1 decimal Numerical value (with implicit precision)
.... unit Σ 1..1 string Unit representation
.... system ΣC 1..1 uri System that defines coded unit form
.... code ΣC 1..1 code Coded form of the unit
... recorded 1..1 dateTime When the recording of the dispense started

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
MedicationDispense.status Base required MedicationDispense Status Codes 📍6.0.0-ballot5 FHIR Std.
MedicationDispense.medication Base required Dietary Supplements (SNOMED) 📦2.0.0 This IG

Constraints

Id Grade Path(s) Description Expression
dom-2 error MedicationDispense If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error MedicationDispense 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.trace('id') in %resource.descendants().select(reference | as(uri))) or descendants().where(reference='#' | as(uri)='#').exists()).not()).trace('unmatched', id).empty()
dom-4 error MedicationDispense 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 error MedicationDispense If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice MedicationDispense A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
mdd-1 error MedicationDispense whenHandedOver cannot be before whenPrepared (whenHandedOver.hasValue() and whenPrepared.hasValue()) implies whenHandedOver >= whenPrepared

Differential View

This structure is derived from MedicationDispense

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationDispense 0..* MedicationDispense Dispensing a medication to a named patient
... medication 1..1 CodeableReference(Medication) What medication was (or was intended to be) supplied
Binding: Dietary Supplements (SNOMED) (required)
... subject 1..1 Reference(AMK Core Patient Profile) Who the dispense is for
... quantity 1..1 SimpleQuantity(6.0.0-ballot5) Amount of medication
.... value 1..1 decimal Numerical value (with implicit precision)
.... unit 1..1 string Unit representation
.... system 1..1 uri System that defines coded unit form
.... code 1..1 code Coded form of the unit

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
MedicationDispense.medication Base required Dietary Supplements (SNOMED) 📦2.0.0 This IG

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. MedicationDispense C 0..* MedicationDispense Dispensing a medication to a named patient
Constraints: mdd-1
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: AllLanguages (required): IETF language tag for a human language
Additional BindingsPurpose
CommonLanguages Starter
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
Slice: Unordered, Open by value:url
... identifier 0..* Identifier External identifier
... basedOn 0..* Reference(CarePlan) Plan that is fulfilled by this dispense
... partOf 0..* Reference(Procedure | MedicationAdministration) Event that dispense is part of
... status ?!Σ 1..1 code preparation | in-progress | cancelled | on-hold | completed | entered-in-error | unfulfilled | declined | unknown
Binding: MedicationDispenseStatusCodes (required): Describes the lifecycle of the dispense.
... notPerformedReason 0..1 CodeableReference(DetectedIssue) Why a dispense was not performed
Binding: MedicationDispenseStatusReasonCodes (example)
... statusChanged 0..1 dateTime When the status changed
... category 0..* CodeableConcept Type of medication dispense
Binding: MedicationDispenseCategoryCodes (example): A code describing where the dispensed medication is expected to be consumed or administered.
... medication Σ 1..1 CodeableReference(Medication) What medication was (or was intended to be) supplied
Binding: Dietary Supplements (SNOMED) (required)
... subject Σ 1..1 Reference(AMK Core Patient Profile) Who the dispense is for
... encounter 0..1 Reference(Encounter) Encounter associated with event
... supportingInformation 0..* Reference(Resource) Information that supports the dispensing of the medication
... performer 0..* BackboneElement Who performed event
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Slice: Unordered, Open by value:url
.... function 0..1 CodeableConcept Who performed the dispense and what they did
Binding: MedicationDispensePerformerFunctionCodes (example): A code describing the role an individual played in dispensing a medication.
.... actor 1..1 Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam | Group) Individual who was performing
... location 0..1 Reference(Location) Where the dispense occurred
... authorizingPrescription 0..* Reference(MedicationRequest) Medication order that authorizes the dispense
... type 0..1 CodeableConcept Trial fill, partial fill, emergency fill, etc
Binding: ActPharmacySupplyType (example): ActPharmacySupplyType
... quantity 1..1 SimpleQuantity(6.0.0-ballot5) Amount of medication
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... value Σ 1..1 decimal Numerical value (with implicit precision)
.... unit Σ 1..1 string Unit representation
.... system ΣC 1..1 uri System that defines coded unit form
.... code ΣC 1..1 code Coded form of the unit
... daysSupply 0..1 SimpleQuantity(6.0.0-ballot5) Amount of medication expressed as a timing amount
... fillNumber 0..1 positiveInt A number that represents the known fill this dispense represents
... recorded 1..1 dateTime When the recording of the dispense started
... whenPrepared ΣC 0..1 dateTime When product was packaged and reviewed
... whenHandedOver C 0..1 dateTime When product was given out
... destination 0..1 Reference(Location) Where the medication was/will be sent
... receiver 0..* Reference(Patient | Practitioner | RelatedPerson | Location | PractitionerRole | Organization | Group) Who collected the medication or where the medication was delivered
... note 0..* Annotation Information about the dispense
... dosageInstruction 0..1 DosageDetails How the medication is to be used by the patient or administered by the caregiver
... doseAdministrationAid 0..1 CodeableConcept Type of adherence packaging to use for the dispense
Binding: MedicationDoseAids (example): DoseAdministrationAid
... substitution 0..1 BackboneElement Whether a substitution was performed on the dispense
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Slice: Unordered, Open by value:url
.... wasSubstituted 1..1 boolean Whether a substitution was or was not performed on the dispense
.... type 0..1 CodeableConcept Code signifying whether a different drug was dispensed from what was prescribed
Binding: ActSubstanceAdminSubstitutionCode (example): ActSubstanceAdminSubstitutionCode
.... reason 0..* CodeableConcept Why was substitution made
Binding: SubstanceAdminSubstitutionReason (example): SubstanceAdminSubstitutionReason
.... responsibleParty 0..1 Reference(Practitioner | PractitionerRole | Organization) Who is responsible for the substitution
... eventHistory 0..* Reference(Provenance) A list of relevant lifecycle events

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
MedicationDispense.language Base required All Languages 📍6.0.0-ballot5 FHIR Std.
MedicationDispense.status Base required MedicationDispense Status Codes 📍6.0.0-ballot5 FHIR Std.
MedicationDispense.notPerformedReason Base example MedicationDispense Status Reason Codes 📍6.0.0-ballot5 FHIR Std.
MedicationDispense.category Base example MedicationDispense Category Codes 📍6.0.0-ballot5 FHIR Std.
MedicationDispense.medication Base required Dietary Supplements (SNOMED) 📦2.0.0 This IG
MedicationDispense.performer.​function Base example MedicationDispense Performer Function Codes 📍6.0.0-ballot5 FHIR Std.
MedicationDispense.type Base example ActPharmacySupplyType 📦3.0.0 THO v7.3
MedicationDispense.doseAdministrationAid Base example Medication Dose Aids 📍6.0.0-ballot5 FHIR Std.
MedicationDispense.substitution.​type Base example ActSubstanceAdminSubstitutionCode 📦3.0.0 THO v7.3
MedicationDispense.substitution.​reason Base example SubstanceAdminSubstitutionReason 📦3.0.0 THO v7.3

Constraints

Id Grade Path(s) Description Expression
dom-2 error MedicationDispense If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error MedicationDispense 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.trace('id') in %resource.descendants().select(reference | as(uri))) or descendants().where(reference='#' | as(uri)='#').exists()).not()).trace('unmatched', id).empty()
dom-4 error MedicationDispense 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 error MedicationDispense If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice MedicationDispense A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
mdd-1 error MedicationDispense whenHandedOver cannot be before whenPrepared (whenHandedOver.hasValue() and whenPrepared.hasValue()) implies whenHandedOver >= whenPrepared

This structure is derived from MedicationDispense

Summary

Mandatory: 6 elements

Structures

This structure refers to these other structures:

 

Other representations of profile: CSV, Excel, Schematron