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.

Salbutamol, 100-200mcg to be inhaled when required up to 4 times daily, using the metered dose device

Dose-based prescription (VTM) using additional instruction for device. 
<MedicationRequest xmlns="http://hl7.org/fhir">
    <id value="a8ca980c-72aa-11e7-8cf7-a6006ad3dba0" />
    <contained>
        <Medication>
            <id value="med1" />
            <code>
                <coding>
                    <system value="http://snomed.info/sct" />
                    <code value="91143003" />
                    <display value="Salbutamol" />
                </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>
        <additionalInstruction>
            <text value="using the metered dose device" />
        </additionalInstruction>
        <asNeededBoolean value="true" />
        <route>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="18679011000001101" />
                <display value="inhalation" />
            </coding>
        </route>
        <doseRange>
            <low>
                <value value="100" />
                <unit value="microgram" />
                <system value="http://unitsofmeasure.org" />
                <code value="ug" />
            </low>
            <high>
                <value value="200" />
                <unit value="microgram" />
                <system value="http://unitsofmeasure.org" />
                <code value="ug" />
            </high>
        </doseRange>
        <maxDosePerPeriod>
            <numerator>
                <value value="4" />
                <unit value="dose" />
                <system value="http://snomed.info/sct" />
                <code value="3317411000001100" />
            </numerator>
            <denominator>
                <value value="1" />
                <unit value="day" />
                <system value="http://unitsofmeasure.org" />
                <code value="d" />
            </denominator>
        </maxDosePerPeriod>
    </dosageInstruction>
</MedicationRequest>

{
    "resourceType": "MedicationRequest",
    "id": "a8ca980c-72aa-11e7-8cf7-a6006ad3dba0",
    "contained":  [
        {
            "resourceType": "Medication",
            "id": "med1",
            "code": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "91143003",
                        "display": "Salbutamol"
                    }
                ]
            }
        }
    ],
    "status": "active",
    "intent": "order",
    "medicationReference": {
        "reference": "#med1"
    },
    "subject": {
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9999999999"
        }
    },
    "dosageInstruction":  [
        {
            "additionalInstruction":  [
                {
                    "text": "using the metered dose device"
                }
            ],
            "asNeededBoolean": true,
            "route": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "18679011000001101",
                        "display": "inhalation"
                    }
                ]
            },
            "doseRange": {
                "low": {
                    "value": 100,
                    "unit": "microgram",
                    "system": "http://unitsofmeasure.org",
                    "code": "ug"
                },
                "high": {
                    "value": 200,
                    "unit": "microgram",
                    "system": "http://unitsofmeasure.org",
                    "code": "ug"
                }
            },
            "maxDosePerPeriod": {
                "numerator": {
                    "value": 4,
                    "unit": "dose",
                    "system": "http://snomed.info/sct",
                    "code": "3317411000001100"
                },
                "denominator": {
                    "value": 1,
                    "unit": "day",
                    "system": "http://unitsofmeasure.org",
                    "code": "d"
                }
            }
        }
    ]
}
MedicationRequest.id[0]a8ca980c-72aa-11e7-8cf7-a6006ad3dba0
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]91143003
MedicationRequest.contained[0].code[0].coding[0].display[0]Salbutamol
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].additionalInstruction[0].text[0]using the metered dose device
MedicationRequest.dosageInstruction[0].asNeeded[0]True
MedicationRequest.dosageInstruction[0].route[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].route[0].coding[0].code[0]18679011000001101
MedicationRequest.dosageInstruction[0].route[0].coding[0].display[0]inhalation
MedicationRequest.dosageInstruction[0].dose[0].low[0].value[0]100
MedicationRequest.dosageInstruction[0].dose[0].low[0].unit[0]microgram
MedicationRequest.dosageInstruction[0].dose[0].low[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].dose[0].low[0].code[0]ug
MedicationRequest.dosageInstruction[0].dose[0].high[0].value[0]200
MedicationRequest.dosageInstruction[0].dose[0].high[0].unit[0]microgram
MedicationRequest.dosageInstruction[0].dose[0].high[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].dose[0].high[0].code[0]ug
MedicationRequest.dosageInstruction[0].maxDosePerPeriod[0].numerator[0].value[0]4
MedicationRequest.dosageInstruction[0].maxDosePerPeriod[0].numerator[0].unit[0]dose
MedicationRequest.dosageInstruction[0].maxDosePerPeriod[0].numerator[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].maxDosePerPeriod[0].numerator[0].code[0]3317411000001100
MedicationRequest.dosageInstruction[0].maxDosePerPeriod[0].denominator[0].value[0]1
MedicationRequest.dosageInstruction[0].maxDosePerPeriod[0].denominator[0].unit[0]day
MedicationRequest.dosageInstruction[0].maxDosePerPeriod[0].denominator[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].maxDosePerPeriod[0].denominator[0].code[0]d
MedicationRequest
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