Dose syntax implementation guidance for FHIR STU3

This guidance is under active development by NHS Digital and content may be added or updated on a regular basis.

Diprobase ointment, 1 application, Topical, 3 times a day

Product-based instruction using an AMP. Where no dose quantity. 
<MedicationRequest xmlns="http://hl7.org/fhir">
    <id value="dad3ae68-f7d7-4bad-8d6d-09e114842b53" />
    <contained>
        <Medication>
            <id value="med1" />
            <code>
                <coding>
                    <system value="http://snomed.info/sct" />
                    <code value="3491511000001101" />
                    <display value="Diprobase ointment (Bayer Plc)" />
                </coding>
            </code>
        </Medication>
    </contained>
    <status value="active" />
    <intent value="order" />
    <medicationReference>
        <reference value="#med1" />
    </medicationReference>
    <subject>
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="9999999999" />
        </identifier>
    </subject>
    <dosageInstruction>
        <timing>
            <repeat>
                <frequency value="3" />
                <period value="1" />
                <periodUnit value="d" />
            </repeat>
        </timing>
        <route>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="6064005" />
                <display value="Topical" />
            </coding>
        </route>
        <doseQuantity>
            <value value="1" />
            <unit value="application" />
            <system value="http://snomed.info/sct" />
            <code value="10692211000001108" />
        </doseQuantity>
    </dosageInstruction>
</MedicationRequest>

{
    "resourceType": "MedicationRequest",
    "id": "dad3ae68-f7d7-4bad-8d6d-09e114842b53",
    "contained":  [
        {
            "resourceType": "Medication",
            "id": "med1",
            "code": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "3491511000001101",
                        "display": "Diprobase ointment (Bayer Plc)"
                    }
                ]
            }
        }
    ],
    "status": "active",
    "intent": "order",
    "medicationReference": {
        "reference": "#med1"
    },
    "subject": {
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9999999999"
        }
    },
    "dosageInstruction":  [
        {
            "timing": {
                "repeat": {
                    "frequency": 3,
                    "period": 1,
                    "periodUnit": "d"
                }
            },
            "route": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "6064005",
                        "display": "Topical"
                    }
                ]
            },
            "doseQuantity": {
                "value": 1,
                "unit": "application",
                "system": "http://snomed.info/sct",
                "code": "10692211000001108"
            }
        }
    ]
}
MedicationRequest.id[0]dad3ae68-f7d7-4bad-8d6d-09e114842b53
MedicationRequest.contained[0].id[0]med1
MedicationRequest.contained[0].code[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.contained[0].code[0].coding[0].code[0]3491511000001101
MedicationRequest.contained[0].code[0].coding[0].display[0]Diprobase ointment (Bayer Plc)
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.medication[0].reference[0]#med1
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].frequency[0]3
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].period[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].periodUnit[0]d
MedicationRequest.dosageInstruction[0].route[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].route[0].coding[0].code[0]6064005
MedicationRequest.dosageInstruction[0].route[0].coding[0].display[0]Topical
MedicationRequest.dosageInstruction[0].dose[0].value[0]1
MedicationRequest.dosageInstruction[0].dose[0].unit[0]application
MedicationRequest.dosageInstruction[0].dose[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].dose[0].code[0]10692211000001108
MedicationRequest
Dose-based instruction using a VTM. Where no dose quantity.

The VTM related to the Diprobase AMP’s is a multi-ingredient concept “White soft paraffin + Liquid paraffin” and cannot be used as a prescribing concept.

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