[DRAFT] GP Connect (Patient Facing) Prescriptions

Note: This is a deprecated version (draft) of the specification - please see the latest for the latest version.

Task

UKCore-Task

Task

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{
    "resourceType": "Task",
    "id": "7c747c6e-15c8-4b2f-8aa0-441f2ef703d6",
    "identifier":  [
        {
            "system": "https://tools.ietf.org/html/rfc4122",
            "value": "30d65c8e-98e8-4806-b6a6-fpwjfkhs729"
        }
    ],
    "status": "requested",
    "intent": "order",
    "code": {
        "coding":  [
            {
                "system": "http://snomed.info/sct",
                "code": "103742009",
                "display": "Renewal of prescription"
            }
        ]
    },
    "focus": {
        "reference": "MedicationRequest/b269d1d7-1acf-47bb-8b3c-e38b583d9a07"
    },
    "for": {
        "reference": "Patient/9000000009",
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9000000009"
        },
        "display": "Jane Smith"
    },
    "authoredOn": "2022-10-13T09:20:27.000Z",
    "lastModified": "2022-10-13T09:20:27.000Z",
    "requester": {
        "reference": "Patient/9000000009",
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9000000009"
        },
        "display": "Jane Smith"
    },
    "note":  [
        {
            "authorString": "Patient",
            "text": "ran out of previous prescription"
        }
    ],
    "input":  [
        {
            "type": {
                "coding":  [
                    {
                        "system": "https://fhir.hl7.org.uk/GPConnect-PrescriptionOrderingParameters",
                        "code": "preferred-performer",
                        "display": "Preferred performer"
                    }
                ]
            },
            "valueIdentifier": {
                "system": "https://fhir.nhs.uk/Id/ods-organization-code",
                "value": "FLM49"
            }
        }
    ]
}

Definition

A Task resource describes an activity that can be performed and tracks the state of completion of that activity. It is a representation that an activity should be or has been initiated, and eventually, represents the successful or unsuccessful completion of that activity.

A Task resource often exists in parallel with clinical resources.

In this instance, the task will exist have a focus reference of a MedicationRequest.

Minimum Viable Content

A minimum viable content that all provider and consumer systems should support is the following elements.

Element	Required?
id
meta.profile
instantiatesCanonical
instantiatesUri
basedOn
identifier
basedOn
groupIdentifier
partOf
status
statusReason
businessStatus
intent
priority
code
description
focus
for
encounter
executionPeriod
authoredOn
lastModified
requester
performerType
owner
reasonCode
reasonReference
insurance
note
relevantHistory
restriction
input
output

id

DataType	Optionality	Cardinality
identifier	required	1:1

The logical identifier of the Task resource.

Example

 "id":"44f85d15-8744-47c2-a790-4f5e38aacdb0"

meta.profile

DataType	Optionality	Cardinality
uri	required	1:1

The Task profile URL.

Fixed value: https://fhir.hl7.org.uk/StructureDefinition/UKCore-Task

Example

"meta": {
    "profile": [
      "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Task"
    ]
}

identifier

identifier must be present within the task resource and the value must be a UUID.

"identifier":  [
    {
        "system": "https://tools.ietf.org/html/rfc4122",
        "value": "5AC84C11-DB8B-44DA-8FCF-8980B3D13596"      
    }
],

Comment

This is a business identifier, not a resource identifier.

status

DataType	Optionality	Cardinality
code	required	1:1

The status of the Task must be provided and updated as the Task passes through the GP system workflow.

Status	Description
requested	Repeat request has been submitted to the GP practice but processing has not started.
accepted	The request has passed auto-system checks, e.g. valid patient, practice, etc. and is now pending user processing.
rejected	The request will not be actioned. The business reason will be conveyed in ‘statusReason’, e.g. patient not known at the practice.
cancelled	The patient cancelled the request before it was actioned.
in-progress	The request has been processed by a prescription clerk and is awaiting confirmation/authorisation (signing) by a prescriber.
completed	The prescription has been authorised/signed. Refer to the EPS state model for the dispensing status.
failed	A prescription has not been authorised. The business reason will be conveyed in ‘statusReason’, e.g. on clinical grounds.

Example

 "status": completed

statusReason

DataType	Optionality	Cardinality
string	optional, only used to notify the patient of rejection reasons	1:1

This will be free text containing the rejection reason to be shown back to the patient.

"statusReason": {
    "text": "No longer suitable, please contact GP to organise an appointment"
},

intent

DataType	Optionality	Cardinality
code	required	1:1

Is needed for FHIR compliance reasons. The value must always be order in this use case.

    "intent": "order",

code

DataType	Optionality	Cardinality
code	required	1:1

The code indicates the action to perform on the focus resource.

It is a Snomed CT and must always be set Renewal of prescription.

Snomed CT	Display
103742009	Renewal of prescription

"code" : {
    "coding" : [ {
      "system" : "http://snomed.info/sct",
      "code" : 103742009,
      "display" : "Renewal of prescription"
    } ]
  },

focus

DataType	Optionality	Cardinality
Reference(MedicationRequest)	required	1:1

The focus must point to a previous MedicationRequest when requesting an instance of a prescription. The MedicationRequest must have an intent of plan.

In returning the Task resource the provider must return a short summary of the referenced medication resource under the display element with the corresponding reference.

This display must contain the type of prescription, i.e. repeat, acute etc. and the title of the medication. See the example below.

Example

  "focus": {
    "reference": "MedicationRequest/b269d1d7-1acf-47bb-8b3c-e38b583d9a07"
    "display": "Repeat prescription for Pulmicort 100 Turbohaler (AstraZeneca UK Ltd)"
  },

for

DataType	Optionality	Cardinality
Reference(Patient)	required	1:1

This must reference the patient that the request is for, using NHS number as the ID.

Example

  "for" : {
    "reference" : "Patient/9000000009",
    "identifier" : {
      "system" : "https://fhir.nhs.uk/Id/nhs-number",
      "value" : 9000000009
    },
    "display" : "Jane Smith"
  },

authoredOn

DataType	Optionality	Cardinality
dateTime	required	1:1

The dateTime of the request being made.

Example

  "authoredOn" : "2022-10-13T09:20:27.000Z",

lastModified

DataType	Optionality	Cardinality
dateTime	optional	1:1

The `dateTime` that the Task object was last modified.

Example

  "lastModified" : "2022-10-13T09:20:27.000Z",

requester

DataType	Optionality	Cardinality
Reference(Patient)	required	1:1

In this use case, since it is Patient Facing the requester must always be the Patient. Beyond MVP this could be updated to facilitate proxy ordering.

Example

"requester" : {
    "reference" : "Patient/9000000009",
    "identifier" : {
      "system" : "https://fhir.nhs.uk/Id/nhs-number",
      "value" : 9000000009
    },
    "display" : "Jane Smith"
},

note

DataType	Optionality	Cardinality
Annotation	optional	0:1

Note to be supplied by the patient when completing the request.

Example

  "note": [
    {
      "authorString": "Patient",
      "text": "ran out of previous prescription"
    }
  ]

input

DataType	Optionality	Cardinality
Code	optional	0:1

Information used to perform the task.

In this case it will be supplied when the patient wishes for their prescription to be dispensed by a different pharmacy to their nominated pharmacy on PDS.

When applicable it must contain the organization ODS code and reference the code preferred-performer.

The set of prescription ordering parameters can be found here.

Example

"input": [
    {
        "type": {
            "coding": [
                {
                    "system": "https://fhir.hl7.org.uk/GPConnect-PrescriptionOrderingParameters",
                    "code": "preferred-performer",
                    "display": "Preferred performer"
                }
            ]
        },
        "valueIdentifier": {
            "system": "https://fhir.nhs.uk/Id/ods-organization-code",
            "value": "FLM49"
        }
    }
]

output

DataType	Optionality	Cardinality
Code	Conditional	0..1

Information produced as part of the task.

This can be used to identify the prescription outside of the scope of the patient facing API.

In this specific case, once the prescription is created and been sent to EPS to be dispensed. This allows full end to end tracking of the request.

When applicable it must contain the EPS prescription ID and reference the code sent-to-eps.

The set of prescription ordering parameters can be found here.

Example

"output": [
    {
        "type": {
            "coding": [
                {
                    "system": "https://fhir.hl7.org.uk/GPConnect-PrescriptionOrderingParameters",
                    "code": "sent-to-eps",
                    "display": "Sent to EPS"
                }
            ]
        },
            "valueIdentifier": {
                "system": "https://fhir.nhs.uk/Id/prescription-order-item-number",
                "value": "4857b9d3-b714-44b9-9e67-3df67275b785"
            }
    }
]