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.

Voluven 10% infusion 500ml Freeflex bags (Fresenius Kabi Ltd), infuse intravenously at a rate of 30ml/kg for 10 hours

Product-based prescription. Route method, dose duration, and dose expressed a rate ratio.

Note The rateRatio could also be modelled using a UCUM unit within a doseQuantity. In this example we are using the slightly more complex rateRatio structre.

<doseQuantity>
  <value value="30"/>
  <unit value="millilitres per kilogram"/>
  <system value="http://unitsofmeasure.org"/>
  <code value="ml/kg"/>
</doseQuantity>



<MedicationRequest xmlns="http://hl7.org/fhir">
    <id value="10850aa9-133b-4a33-aea7-5bef3b71ab9b" />
    <contained>
        <Medication>
            <id value="med1" />
            <code>
                <coding>
                    <system value="http://snomed.info/sct" />
                    <code value="21514511000001103" />
                    <display value="Voluven 10% infusion 500ml Freeflex bags (Fresenius Kabi Ltd)" />
                </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>
                <duration value="10" />
                <durationUnit value="h" />
            </repeat>
        </timing>
        <route>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="47625008" />
                <display value="intravenous" />
            </coding>
        </route>
        <method>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="129330003" />
                <display value="infusion" />
            </coding>
        </method>
        <rateRatio>
            <numerator>
                <value value="30" />
                <unit value="millilitre" />
                <system value="http://unitsofmeasure.org" />
                <code value="mL" />
            </numerator>
            <denominator>
                <value value="1" />
                <unit value="kilogram" />
                <system value="http://unitsofmeasure.org" />
                <code value="kg" />
            </denominator>
        </rateRatio>
    </dosageInstruction>
</MedicationRequest>

{
    "resourceType": "MedicationRequest",
    "id": "10850aa9-133b-4a33-aea7-5bef3b71ab9b",
    "contained":  [
        {
            "resourceType": "Medication",
            "id": "med1",
            "code": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "21514511000001103",
                        "display": "Voluven 10% infusion 500ml Freeflex bags (Fresenius Kabi Ltd)"
                    }
                ]
            }
        }
    ],
    "status": "active",
    "intent": "order",
    "medicationReference": {
        "reference": "#med1"
    },
    "subject": {
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9999999999"
        }
    },
    "dosageInstruction":  [
        {
            "timing": {
                "repeat": {
                    "duration": 10,
                    "durationUnit": "h"
                }
            },
            "route": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "47625008",
                        "display": "intravenous"
                    }
                ]
            },
            "method": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "129330003",
                        "display": "infusion"
                    }
                ]
            },
            "rateRatio": {
                "numerator": {
                    "value": 30,
                    "unit": "millilitre",
                    "system": "http://unitsofmeasure.org",
                    "code": "mL"
                },
                "denominator": {
                    "value": 1,
                    "unit": "kilogram",
                    "system": "http://unitsofmeasure.org",
                    "code": "kg"
                }
            }
        }
    ]
}
MedicationRequest.id[0]10850aa9-133b-4a33-aea7-5bef3b71ab9b
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]21514511000001103
MedicationRequest.contained[0].code[0].coding[0].display[0]Voluven 10% infusion 500ml Freeflex bags (Fresenius Kabi Ltd)
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].duration[0]10
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].durationUnit[0]h
MedicationRequest.dosageInstruction[0].route[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].route[0].coding[0].code[0]47625008
MedicationRequest.dosageInstruction[0].route[0].coding[0].display[0]intravenous
MedicationRequest.dosageInstruction[0].method[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].method[0].coding[0].code[0]129330003
MedicationRequest.dosageInstruction[0].method[0].coding[0].display[0]infusion
MedicationRequest.dosageInstruction[0].rate[0].numerator[0].value[0]30
MedicationRequest.dosageInstruction[0].rate[0].numerator[0].unit[0]millilitre
MedicationRequest.dosageInstruction[0].rate[0].numerator[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].rate[0].numerator[0].code[0]mL
MedicationRequest.dosageInstruction[0].rate[0].denominator[0].value[0]1
MedicationRequest.dosageInstruction[0].rate[0].denominator[0].unit[0]kilogram
MedicationRequest.dosageInstruction[0].rate[0].denominator[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].rate[0].denominator[0].code[0]kg
MedicationRequest
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