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Please note: This guidance has been superseded by the Implementation guide for digitial medicines, which contains up-to-date information.

Hospital Transfer

Applicable for the following use cases;

  • Internal transfer, to a ward using a different ePMA system.
  • Transfer to another hospital, using a different ePMA system.

The most simple implementation of these use cases will be a RESTful POST to the destination ePMA [B] system. The FHIR Message posted being a Bundle of MedicationStatement resources and related/referenced resources.

Where ePMA [B] does not operate as a FHIR server then an alternative architecture would be for ePMA [B] to query ePMA [A] using GET operations.


use-case-epma-to-epma


Where more detailed records are required, a MedicationStatement can reference a MedicationRequest using the MedicationStatement.basedOn element.

Note: At the time of writing, it is unclear how a MedicationStatement could also reference a MedicationDispense resource.

The difference between the clinical data shared in a transfer compared to that shared within a discharge process would be the inclusion of medication activity specific to the inpatient treatment, which is not relevant after discharge. For example, painkillers, pre-operative medication etc. These are sometimes described as ephemeral medications, i.e. medications that are started during an episode of care and discontinued within that same care episode.

It is not expected that ICS and shared medication records will include ephemeral medication records as these would add unnecessary complexity to the shared record for minimal value.

Applicable FHIR resources: MedicationStatement and optionally MedicationRequest

Note: The data required to be shared for a hospital transfer in addition to the medications data is out of scope for this implementation guide.
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