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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