ePMA 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.
Please note: This guidance has been superseded by the Implementation guide for digitial medicines, which contains up-to-date information.

Element: substitution

It is recommended this element is required for an MVP implementation.

Note: If omitted or has a value of false then substitution has not occured.
Important: A suitable definition and example use-cases for a substitution need to be defined.

For example:

  • Is a sugar-free variant classed as a substitution?
  • Is a generic variant of a drug classed as a substitution?

  • Can a substitution be an entirely different medication, or should it be a new request?

  • Should a substitution only be used, for example, if supplied in a different strength than requested?

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