MedicationDispense

Records the dispensing of medication from a pharmacy to a patient or caregiver, documenting the fulfillment of a prescription order. Tracks the quantity dispensed, days of supply provided, any substitutions made, and the timing of preparation and handover to the recipient.

Overview

MedicationDispense documents the pharmacy fulfillment of a prescription. It captures the medication dispensed (which may differ from prescribed if substituted), quantity, days of supply, and the workflow timing from preparation to handover. The entity tracks generic substitutions with reasons, identifies the dispensing pharmacy and pharmacist, and supports supply chain and patient counseling documentation.

Key Concepts

Dispense Status

The status field tracks pharmacy workflow:

Status	Description	Workflow Stage
`preparation`	Being prepared	Filling in progress
`in-progress`	Ready, awaiting pickup	Verified, waiting
`completed`	Handed to patient	Fulfilled
`on-hold`	Paused for issue	Prior auth pending
`cancelled`	Order cancelled	Not dispensed
`declined`	Patient declined	Refused pickup
`stopped`	Partially fulfilled	Supply issue

Quantity and Supply

Dispensing quantities:

quantity - Amount dispensed
quantityUnit - Tablets, capsules, ml
daysSupply - Expected duration
Supports partial fills

Workflow Timing

Two timestamps track the process:

whenPrepared - Ready for pickup
whenHandedOver - Given to patient
Enables pharmacy efficiency metrics
processingTime calculated between them

Generic Substitution

When substituting medications:

substitution - Boolean flag
substitutionReason - Why substituted
Common reasons: generic equivalent, formulary, availability
Links to actual medication dispensed

Dispensing Location

The dispensingPharmacy links to Facility:

Retail pharmacy
Hospital pharmacy
Mail-order pharmacy
Specialty pharmacy

Dispenser

The dispenser links to Practitioner:

Pharmacist who verified
Pharmacy technician who filled
Accountability for accuracy

Use Cases

Retail Dispensing

Standard pharmacy fill:

Receive prescription (electronic or paper)
Create dispense record in preparation
Fill and verify medication
Record whenPrepared
Patient picks up, record whenHandedOver
Set status: "completed"

Generic Substitution

When substituting:

Check substitution permitted on prescription
Select generic equivalent
Set substitution: true
Document reason
Counsel patient on change
Record in notes

Partial Fill

For supply limitations:

Dispense available quantity
Document partial quantity
Calculate partial daysSupply
Set status: "stopped" if no more coming
Schedule remainder if available
Note partial fill reason

Hospital Discharge

For discharge medications:

Reconcile medications with inpatient list
Fill discharge prescriptions
Document counseling provided
Coordinate with care team
Ensure patient understanding
Record handover time

Prior Authorization Hold

When authorization pending:

Set status: "on-hold"
Note authorization requirement
Contact prescriber if needed
Update when resolved
Complete dispensing
Document delay reason

Related Entities

Entity	Relationship	Description
Patient	References	Recipient of medication
Prescription	References	Order being fulfilled
PrescriptionLine	References	Specific line item
Medication	References	Drug dispensed
Facility	References	Dispensing pharmacy
Practitioner	References	Dispensing pharmacist

Calculated Fields

Field	Type	Description
`isDispensed`	boolean	True when status is completed
`processingTime`	number	Minutes from whenPrepared to whenHandedOver

Enums

status

Value	Description
`preparation`	Medication is being prepared by pharmacy
`in-progress`	Medication prepared and ready for pickup
`cancelled`	Dispense order was cancelled
`on-hold`	Dispensing paused (prior auth, insurance issue)
`completed`	Medication successfully given to patient
`entered-in-error`	Record was created in error
`stopped`	Dispensing stopped before full completion
`declined`	Patient declined to pick up medication
`unknown`	Dispense status cannot be determined

17 properties

Schema

Properties

Property	Type	Mode	Description	Required
patient	Patient	stored	Reference to the patient receiving the dispensed medication, establishing the recipient of the medication supply Example: `"patient-67890"`	Required
prescription	Prescription	stored	Reference to the prescription order being fulfilled by this dispensing event Example: `"prescription-12345"`	Required
prescriptionLine	PrescriptionLine	stored	Reference to the specific prescription line item being dispensed when a prescription contains multiple medications Example: `"prescription-line-54321"`	Optional
status	string	stored	Current state of the dispensing process in the pharmacy workflow Values: `preparation, in-progress, cancelled, on-hold, completed, entered-in-error, stopped, declined, unknown` Example: `"completed"`	Required
medication	Medication	stored	Reference to the specific medication product dispensed, which may differ from the prescribed medication if substitution occurred Example: `"health-ref-medication-789"`	Required
quantity	number	stored	Amount of medication dispensed expressed as a numeric value, used in conjunction with quantity unit Example: `90`	Optional
quantityUnit	string	stored	Unit of measure for the dispensed quantity such as tablets, capsules, milliliters, grams, or other pharmaceutical units Example: `"tablets"`	Optional
daysSupply	number	stored	Expected number of days the dispensed medication supply will last based on the prescribed dosing instructions Example: `30`	Optional
whenPrepared	DateTime	stored	Timestamp when the medication was prepared and verified by the pharmacy, ready for pickup or delivery Example: `"2025-01-15T14:30:00Z"`	Optional
whenHandedOver	DateTime	stored	Timestamp when the medication was physically given to the patient or authorized representative Example: `"2025-01-15T16:45:00Z"`	Optional
dispensingPharmacy	Facility	stored	Reference to the pharmacy facility location where the medication was dispensed Example: `"facility-pharmacy-001"`	Optional
dispenser	Practitioner	stored	Reference to the pharmacist or pharmacy technician responsible for dispensing and verifying the medication Example: `"practitioner-pharmacist-456"`	Optional
substitution	boolean	stored	Indicates whether a therapeutic or generic substitution was made from the originally prescribed medication Example: `true`	Optional
substitutionReason	string	stored	Explanation for why a substitution was made, such as generic equivalent, formulary requirement, availability, or cost considerations Example: `"Generic equivalent dispensed per patient request and insurance formulary"`	Optional
note	string	stored	Additional notes about the dispensing event including special handling instructions, patient counseling provided, or other relevant information Example: `"Patient counseled on taking with food. Refrigeration required."`	Optional
isDispensed	boolean	calculated	Calculated indicator showing whether the medication has been successfully dispensed to the patient, true when status is completed	Optional
processingTime	number	calculated	Calculated duration in minutes from when the medication was prepared to when it was handed over to the patient, useful for pharmacy efficiency metrics	Optional

Examples

Example 1

{
  "@type": "MedicationDispense",
  "patient": "patient-retail-001",
  "prescription": "prescription-amb-789",
  "prescriptionLine": "prescription-line-amb-789-1",
  "status": "completed",
  "medication": "health-ref-medication-lisinopril-10mg",
  "quantity": 90,
  "quantityUnit": "tablets",
  "daysSupply": 90,
  "whenPrepared": "2025-01-15T14:30:00Z",
  "whenHandedOver": "2025-01-15T16:45:00Z",
  "dispensingPharmacy": "facility-retail-pharmacy-downtown",
  "dispenser": "practitioner-pharmacist-jones",
  "substitution": false,
  "substitutionReason": null,
  "note": "Patient counseled on monitoring blood pressure. Follow-up with physician in 3 months.",
  "_comment": "isDispensed: true, processingTime: 135"
}

Example 2

{
  "@type": "MedicationDispense",
  "patient": "patient-hospital-456",
  "prescription": "prescription-inpatient-234",
  "prescriptionLine": "prescription-line-inpatient-234-2",
  "status": "completed",
  "medication": "health-ref-medication-atorvastatin-generic-20mg",
  "quantity": 30,
  "quantityUnit": "tablets",
  "daysSupply": 30,
  "whenPrepared": "2025-01-16T09:15:00Z",
  "whenHandedOver": "2025-01-16T10:00:00Z",
  "dispensingPharmacy": "facility-hospital-pharmacy-main",
  "dispenser": "practitioner-pharmacist-chen",
  "substitution": true,
  "substitutionReason": "Generic equivalent dispensed per hospital formulary requirements and insurance coverage",
  "note": "Patient discharged. Medication reconciliation completed. Generic substitution explained and accepted.",
  "_comment": "isDispensed: true, processingTime: 45"
}

Example 3

{
  "@type": "MedicationDispense",
  "patient": "patient-chronic-789",
  "prescription": "prescription-specialty-567",
  "prescriptionLine": "prescription-line-specialty-567-1",
  "status": "completed",
  "medication": "health-ref-medication-insulin-glargine-100units",
  "quantity": 3,
  "quantityUnit": "vials",
  "daysSupply": 15,
  "whenPrepared": "2025-01-17T11:00:00Z",
  "whenHandedOver": "2025-01-17T14:30:00Z",
  "dispensingPharmacy": "facility-specialty-pharmacy-diabetes",
  "dispenser": "practitioner-pharmacist-rodriguez",
  "substitution": false,
  "substitutionReason": null,
  "note": "Partial fill - patient requested half supply due to financial constraints. Insurance authorization pending for full quantity. Counseled on proper refrigeration and injection technique. Patient to return in 2 weeks for remainder.",
  "_comment": "isDispensed: true, processingTime: 210"
}