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Please note: This guidance has been superseded by the Implementation guide for digitial medicines, which contains up-to-date information.

Scenario: Inpatient Discharge

Patient Paige Turner is discharged from hospital following an admission where she was diagnosed as being diabetic. She was prescribed 4 weeks quantity of Metformin 500mg tablets by Dr Makieu Well, to take twice daily on an on-going basis.

The medication request was recorded by pharmacist Bill Ding. Paige’s GP will be instructed to continue this course of medication within a discharge note.

MedicationRequest

Note: This example below is a draft and requires clinical verification.
<!-- This xml example is for illustrative purposes only and has not been clinically verified. -->
<Bundle xmlns="http://hl7.org/fhir">
    <id value="32e2adf8-595b-4b39-b6f1-f0073464c7f9" />
    <type value="message" />
    <!--    Message Header    -->
    <entry>
        <fullUrl value="message-header-167434" />
        <resource>
            <MessageHeader>
                <id value="message-header-167434" />
                <text>
                    <status value="generated" />
                    <div xmlns="http://www.w3.org/1999/xhtml"><p>The quick brown fox jumps over the lazy dog</p></div>
                </text>
                <event>
                    <system value="https://fhir.nhs.uk/STU3/CodeSystem/EventType-1" />
                    <code value="individual-requirements-1" />
                    <display value="Individual Requirements" />
                </event>
                <timestamp value="2021-05-07T16:15:32Z" />
                <source>
                    <endpoint value="nhs-uk:addressing:ods:T48NT" />
                </source>
                <focus>
                    <reference value="med-req-843920" />
                </focus>
            </MessageHeader>
        </resource>
    </entry>
    <!-- Patient associated with the encounter. -->
    <entry>
        <fullUrl value="patient-113582401" />
        <resource>
            <Patient>
                <id value="patient-113582401" />
                <identifier>
                    <extension url="https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-NHSNumberVerificationStatus-1">
                        <valueCodeableConcept>
                            <coding>
                                <system value="https://fhir.hl7.org.uk/STU3/CodeSystem/CareConnect-NHSNumberVerificationStatus-1" />
                                <code value="01" />
                                <display value="Number present and verified" />
                            </coding>
                        </valueCodeableConcept>
                    </extension>
                    <system value="https://fhir.nhs.uk/Id/nhs-number" />
                    <value value="113582401" />
                </identifier>
                <name>
                    <use value="official" />
                    <text value="Ms Paige Turner" />
                    <family value="Turner" />
                    <given value="Paige" />
                    <prefix value="Ms" />
                </name>
                <gender value="female" />
                <birthDate value="1982-11-20" />
            </Patient>
        </resource>
    </entry>
    <!-- Prescribing clinician associated with the encounter.  -->
    <entry>
        <fullUrl value="staff-0001" />
        <resource>
            <Practitioner>
                <id value="staff-0001" />
                <name>
                    <text value="Dr Makieu Well" />
                    <family value="Well" />
                    <given value="Makieu" />
                    <prefix value="Dr" />
                </name>
                <qualification>
                    <code>
                        <coding>
                            <system value="https://fhir.hl7.org.uk/Id/gmc-number" />
                            <code value="2145879" />
                            <display value="General Medical Council" />
                        </coding>
                    </code>
                </qualification>
            </Practitioner>
        </resource>
    </entry>
    <!--  Ward Pharmacist associated with the encounter.  -->
    <entry>
        <fullUrl value="staff-0002" />
        <resource>
            <Practitioner>
                <id value="staff-0002" />
                <name>
                    <text value="Bill Ding" />
                    <family value="Ding" />
                    <given value="Bill" />
                </name>
                <qualification>
                    <code>
                        <coding>
                            <system value="https://fhir.hl7.org.uk/Id/gphc-number" />
                            <code value="1234567" />
                            <display value="General Pharmaceutical Council" />
                        </coding>
                    </code>
                </qualification>
            </Practitioner>
        </resource>
    </entry>
    <!-- Medication prescribed  -->
    <entry>
        <fullUrl value="medication-325278007" />
        <resource>
            <Medication>
                <id value="medication-325278007" />
                <code>
                    <coding>
                        <system value="http://snomed.info/sct" />
                        <code value="325278007" />
                        <display value="Metformin 500mg tablets" />
                    </coding>
                </code>
            </Medication>
        </resource>
    </entry>
    <!--  Medication Request  -->
    <entry>
        <fullUrl value="med-req-843920" />
        <resource>
            <MedicationRequest>
                <id value="med-req-843920" />
                <status value="active" />
                <intent value="order" />
                <category>
                    <coding>
                        <system value="http://hl7.org/fhir/medication-request-category" />
                        <code value="discharge" />
                        <display value="discharge" />
                    </coding>
                </category>
                <medicationReference>
                    <reference value="medication-321987003" />
                    <display value="Metformin 500mg tablets" />
                </medicationReference>
                <subject>
                    <reference value="patient-113582401" />
                    <display value="Ms Paige Turner" />
                </subject>
                <authoredOn value="2020-05-20T11:19:00Z" />
                <requester>
                    <agent>
                        <reference value="staff-0001" />
                        <display value="Dr Makieu Well" />
                    </agent>
                </requester>
                <recorder>
                    <reference value="staff-0002" />
                    <display value="Bill Ding" />
                </recorder>
                <dosageInstruction>
                    <timing>
                        <repeat>
                            <frequency value="2" />
                            <period value="1" />
                            <periodUnit value="d" />
                        </repeat>
                    </timing>
                </dosageInstruction>
                <dispenseRequest>
                    <quantity>
                        <value value="56" />
                        <unit value="tablet" />
                        <system value="http://snomed.info/sct" />
                        <code value="428673006" />
                    </quantity>
                </dispenseRequest>
                <substitution>
                    <allowed value="false" />
                </substitution>
            </MedicationRequest>
        </resource>
    </entry>
</Bundle>

{
    "resourceType": "Bundle",
    "id": "32e2adf8-595b-4b39-b6f1-f0073464c7f9",
    "type": "message",
    "entry":  [
        {
            "fullUrl": "message-header-167434",
            "resource": {
                "resourceType": "MessageHeader",
                "id": "message-header-167434",
                "text": {
                    "status": "generated",
                    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>The quick brown fox jumps over the lazy dog</p></div>"
                },
                "event": {
                    "system": "https://fhir.nhs.uk/STU3/CodeSystem/EventType-1",
                    "code": "individual-requirements-1",
                    "display": "Individual Requirements"
                },
                "timestamp": "2021-05-07T16:15:32+00:00",
                "source": {
                    "endpoint": "nhs-uk:addressing:ods:T48NT"
                },
                "focus":  [
                    {
                        "reference": "med-req-843920"
                    }
                ]
            }
        },
        {
            "fullUrl": "patient-113582401",
            "resource": {
                "resourceType": "Patient",
                "id": "patient-113582401",
                "identifier":  [
                    {
                        "extension":  [
                            {
                                "url": "https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-NHSNumberVerificationStatus-1",
                                "valueCodeableConcept": {
                                    "coding":  [
                                        {
                                            "system": "https://fhir.hl7.org.uk/STU3/CodeSystem/CareConnect-NHSNumberVerificationStatus-1",
                                            "code": "01",
                                            "display": "Number present and verified"
                                        }
                                    ]
                                }
                            }
                        ],
                        "system": "https://fhir.nhs.uk/Id/nhs-number",
                        "value": "113582401"
                    }
                ],
                "name":  [
                    {
                        "use": "official",
                        "text": "Ms Paige Turner",
                        "family": "Turner",
                        "given":  [
                            "Paige"
                        ],
                        "prefix":  [
                            "Ms"
                        ]
                    }
                ],
                "gender": "female",
                "birthDate": "1982-11-20"
            }
        },
        {
            "fullUrl": "staff-0001",
            "resource": {
                "resourceType": "Practitioner",
                "id": "staff-0001",
                "name":  [
                    {
                        "text": "Dr Makieu Well",
                        "family": "Well",
                        "given":  [
                            "Makieu"
                        ],
                        "prefix":  [
                            "Dr"
                        ]
                    }
                ],
                "qualification":  [
                    {
                        "code": {
                            "coding":  [
                                {
                                    "system": "https://fhir.hl7.org.uk/Id/gmc-number",
                                    "code": "2145879",
                                    "display": "General Medical Council"
                                }
                            ]
                        }
                    }
                ]
            }
        },
        {
            "fullUrl": "staff-0002",
            "resource": {
                "resourceType": "Practitioner",
                "id": "staff-0002",
                "name":  [
                    {
                        "text": "Bill Ding",
                        "family": "Ding",
                        "given":  [
                            "Bill"
                        ]
                    }
                ],
                "qualification":  [
                    {
                        "code": {
                            "coding":  [
                                {
                                    "system": "https://fhir.hl7.org.uk/Id/gphc-number",
                                    "code": "1234567",
                                    "display": "General Pharmaceutical Council"
                                }
                            ]
                        }
                    }
                ]
            }
        },
        {
            "fullUrl": "medication-325278007",
            "resource": {
                "resourceType": "Medication",
                "id": "medication-325278007",
                "code": {
                    "coding":  [
                        {
                            "system": "http://snomed.info/sct",
                            "code": "325278007",
                            "display": "Metformin 500mg tablets"
                        }
                    ]
                }
            }
        },
        {
            "fullUrl": "med-req-843920",
            "resource": {
                "resourceType": "MedicationRequest",
                "id": "med-req-843920",
                "status": "active",
                "intent": "order",
                "category": {
                    "coding":  [
                        {
                            "system": "http://hl7.org/fhir/medication-request-category",
                            "code": "discharge",
                            "display": "discharge"
                        }
                    ]
                },
                "medicationReference": {
                    "reference": "medication-321987003",
                    "display": "Metformin 500mg tablets"
                },
                "subject": {
                    "reference": "patient-113582401",
                    "display": "Ms Paige Turner"
                },
                "authoredOn": "2020-05-20T11:19:00Z",
                "requester": {
                    "agent": {
                        "reference": "staff-0001",
                        "display": "Dr Makieu Well"
                    }
                },
                "recorder": {
                    "reference": "staff-0002",
                    "display": "Bill Ding"
                },
                "dosageInstruction":  [
                    {
                        "timing": {
                            "repeat": {
                                "frequency": 2,
                                "period": 1,
                                "periodUnit": "d"
                            }
                        }
                    }
                ],
                "dispenseRequest": {
                    "quantity": {
                        "value": 56,
                        "unit": "tablet",
                        "system": "http://snomed.info/sct",
                        "code": "428673006"
                    }
                },
                "substitution": {
                    "allowed": false
                }
            }
        }
    ]
}
Bundle.id[0]32e2adf8-595b-4b39-b6f1-f0073464c7f9
Bundle.type[0]message
Bundle.entry[0].fullUrl[0]message-header-167434
Bundle.entry[0].resource[0].id[0]message-header-167434
Bundle.entry[0].resource[0].text[0].status[0]generated
Bundle.entry[0].resource[0].text[0].div[0]<div xmlns="http://www.w3.org/1999/xhtml"><p>The quick brown fox jumps over the lazy dog</p></div>
Bundle.entry[0].resource[0].event[0].system[0]https://fhir.nhs.uk/STU3/CodeSystem/EventType-1
Bundle.entry[0].resource[0].event[0].code[0]individual-requirements-1
Bundle.entry[0].resource[0].event[0].display[0]Individual Requirements
Bundle.entry[0].resource[0].timestamp[0]2021-05-07T16:15:32+00:00
Bundle.entry[0].resource[0].source[0].endpoint[0]nhs-uk:addressing:ods:T48NT
Bundle.entry[0].resource[0].focus[0].reference[0]med-req-843920
Bundle.entry[1].fullUrl[0]patient-113582401
Bundle.entry[1].resource[0].id[0]patient-113582401
Bundle.entry[1].resource[0].identifier[0].extension[0].url[0]https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-NHSNumberVerificationStatus-1
Bundle.entry[1].resource[0].identifier[0].extension[0].value[0].coding[0].system[0]https://fhir.hl7.org.uk/STU3/CodeSystem/CareConnect-NHSNumberVerificationStatus-1
Bundle.entry[1].resource[0].identifier[0].extension[0].value[0].coding[0].code[0]01
Bundle.entry[1].resource[0].identifier[0].extension[0].value[0].coding[0].display[0]Number present and verified
Bundle.entry[1].resource[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
Bundle.entry[1].resource[0].identifier[0].value[0]113582401
Bundle.entry[1].resource[0].name[0].use[0]official
Bundle.entry[1].resource[0].name[0].text[0]Ms Paige Turner
Bundle.entry[1].resource[0].name[0].family[0]Turner
Bundle.entry[1].resource[0].name[0].given[0]Paige
Bundle.entry[1].resource[0].name[0].prefix[0]Ms
Bundle.entry[1].resource[0].gender[0]female
Bundle.entry[1].resource[0].birthDate[0]1982-11-20
Bundle.entry[2].fullUrl[0]staff-0001
Bundle.entry[2].resource[0].id[0]staff-0001
Bundle.entry[2].resource[0].name[0].text[0]Dr Makieu Well
Bundle.entry[2].resource[0].name[0].family[0]Well
Bundle.entry[2].resource[0].name[0].given[0]Makieu
Bundle.entry[2].resource[0].name[0].prefix[0]Dr
Bundle.entry[2].resource[0].qualification[0].code[0].coding[0].system[0]https://fhir.hl7.org.uk/Id/gmc-number
Bundle.entry[2].resource[0].qualification[0].code[0].coding[0].code[0]2145879
Bundle.entry[2].resource[0].qualification[0].code[0].coding[0].display[0]General Medical Council
Bundle.entry[3].fullUrl[0]staff-0002
Bundle.entry[3].resource[0].id[0]staff-0002
Bundle.entry[3].resource[0].name[0].text[0]Bill Ding
Bundle.entry[3].resource[0].name[0].family[0]Ding
Bundle.entry[3].resource[0].name[0].given[0]Bill
Bundle.entry[3].resource[0].qualification[0].code[0].coding[0].system[0]https://fhir.hl7.org.uk/Id/gphc-number
Bundle.entry[3].resource[0].qualification[0].code[0].coding[0].code[0]1234567
Bundle.entry[3].resource[0].qualification[0].code[0].coding[0].display[0]General Pharmaceutical Council
Bundle.entry[4].fullUrl[0]medication-325278007
Bundle.entry[4].resource[0].id[0]medication-325278007
Bundle.entry[4].resource[0].code[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[4].resource[0].code[0].coding[0].code[0]325278007
Bundle.entry[4].resource[0].code[0].coding[0].display[0]Metformin 500mg tablets
Bundle.entry[5].fullUrl[0]med-req-843920
Bundle.entry[5].resource[0].id[0]med-req-843920
Bundle.entry[5].resource[0].status[0]active
Bundle.entry[5].resource[0].intent[0]order
Bundle.entry[5].resource[0].category[0].coding[0].system[0]http://hl7.org/fhir/medication-request-category
Bundle.entry[5].resource[0].category[0].coding[0].code[0]discharge
Bundle.entry[5].resource[0].category[0].coding[0].display[0]discharge
Bundle.entry[5].resource[0].medication[0].reference[0]medication-321987003
Bundle.entry[5].resource[0].medication[0].display[0]Metformin 500mg tablets
Bundle.entry[5].resource[0].subject[0].reference[0]patient-113582401
Bundle.entry[5].resource[0].subject[0].display[0]Ms Paige Turner
Bundle.entry[5].resource[0].authoredOn[0]2020-05-20T11:19:00Z
Bundle.entry[5].resource[0].requester[0].agent[0].reference[0]staff-0001
Bundle.entry[5].resource[0].requester[0].agent[0].display[0]Dr Makieu Well
Bundle.entry[5].resource[0].recorder[0].reference[0]staff-0002
Bundle.entry[5].resource[0].recorder[0].display[0]Bill Ding
Bundle.entry[5].resource[0].dosageInstruction[0].timing[0].repeat[0].frequency[0]2
Bundle.entry[5].resource[0].dosageInstruction[0].timing[0].repeat[0].period[0]1
Bundle.entry[5].resource[0].dosageInstruction[0].timing[0].repeat[0].periodUnit[0]d
Bundle.entry[5].resource[0].dispenseRequest[0].quantity[0].value[0]56
Bundle.entry[5].resource[0].dispenseRequest[0].quantity[0].unit[0]tablet
Bundle.entry[5].resource[0].dispenseRequest[0].quantity[0].system[0]http://snomed.info/sct
Bundle.entry[5].resource[0].dispenseRequest[0].quantity[0].code[0]428673006
Bundle.entry[5].resource[0].substitution[0].allowed[0]False
Bundle

MedicationDispense

Note: This example below is a draft and requires clinical verification.
<!--   This xml example is for illustrative purposes only and has not been clinically verified.   -->
<Bundle xmlns="http://hl7.org/fhir">
    <id value="830a2a41-cca8-46a3-a35c-3237cb9828e4" />
    <type value="message" />
    <!--    Message Header    -->
    <entry>
        <fullUrl value="message-header-167434" />
        <resource>
            <MessageHeader>
                <id value="message-header-167434" />
                <text>
                    <status value="generated" />
                    <div xmlns="http://www.w3.org/1999/xhtml"><p>The quick brown fox jumps over the lazy dog</p></div>
                </text>
                <event>
                    <system value="https://fhir.nhs.uk/STU3/CodeSystem/EventType-1" />
                    <code value="individual-requirements-1" />
                    <display value="Individual Requirements" />
                </event>
                <timestamp value="2021-05-07T16:15:32Z" />
                <source>
                    <endpoint value="nhs-uk:addressing:ods:T48NT" />
                </source>
                <focus>
                    <reference value="medication-disp-324234234" />
                </focus>
            </MessageHeader>
        </resource>
    </entry>
    <!--  Patient associated with the encounter.  -->
    <entry>
        <fullUrl value="patient-113582401" />
        <resource>
            <Patient>
                <id value="patient-113582401" />
                <identifier>
                    <extension url="https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-NHSNumberVerificationStatus-1">
                        <valueCodeableConcept>
                            <coding>
                                <system value="https://fhir.hl7.org.uk/STU3/CodeSystem/CareConnect-NHSNumberVerificationStatus-1" />
                                <code value="01" />
                                <display value="Number present and verified" />
                            </coding>
                        </valueCodeableConcept>
                    </extension>
                    <system value="https://fhir.nhs.uk/Id/nhs-number" />
                    <value value="113582401" />
                </identifier>
                <name>
                    <use value="official" />
                    <text value="Ms Paige Turner" />
                    <family value="Turner" />
                    <given value="Paige" />
                    <prefix value="Ms" />
                </name>
                <gender value="female" />
                <birthDate value="1982-11-20" />
            </Patient>
        </resource>
    </entry>
    <!--    Performer associated with the encounter.    -->
    <entry>
        <fullUrl value="staff-0002" />
        <resource>
            <Practitioner>
                <id value="staff-0002" />
                <name>
                    <text value="Dr Allo Kate" />
                    <family value="Kate" />
                    <given value="Allo" />
                    <prefix value="Dr" />
                </name>
                <qualification>
                    <code>
                        <coding>
                            <system value="https://fhir.hl7.org.uk/Id/gpc-number" />
                            <code value="123543" />
                            <display value="General Pharmaceutical Council" />
                        </coding>
                    </code>
                </qualification>
            </Practitioner>
        </resource>
    </entry>
    <!--  Medication prescribed   -->
    <entry>
        <fullUrl value="medication-325278007" />
        <resource>
            <Medication>
                <id value="medication-325278007" />
                <code>
                    <coding>
                        <system value="http://snomed.info/sct" />
                        <code value="325278007" />
                        <display value="Metformin 500mg tablets" />
                    </coding>
                </code>
            </Medication>
        </resource>
    </entry>
    <!--    Medication Dispense    -->
    <entry>
        <fullUrl value="medication-disp-324234234" />
        <resource>
            <MedicationDispense>
                <id value="medication-disp-324234234" />
                <status value="in-progress" />
                <category>
                    <coding>
                        <system value="http://hl7.org/fhir/medication-request-category" />
                        <code value="discharge" />
                        <display value="discharge" />
                    </coding>
                </category>
                <medicationReference>
                    <reference value="medication-325278007" />
                    <display value="Metformin 500mg tablets" />
                </medicationReference>
                <subject>
                    <reference value="patient-113582401" />
                    <display value="Ms Paige Turner" />
                </subject>
                <performer>
                    <actor>
                        <reference value="staff-0002" />
                        <display value="Dr Allo Kate" />
                    </actor>
                </performer>
                <dosageInstruction>
                    <timing>
                        <repeat>
                            <frequency value="2" />
                            <period value="1" />
                            <periodUnit value="d" />
                        </repeat>
                    </timing>
                    <route>
                        <coding>
                            <system value="http://snomed.info/sct" />
                            <code value="428673006" />
                            <display value="oral" />
                        </coding>
                    </route>
                    <doseQuantity>
                        <value value="56" />
                        <unit value="tablet" />
                        <system value="http://snomed.info/sct" />
                        <code value="428673006" />
                    </doseQuantity>
                </dosageInstruction>
            </MedicationDispense>
        </resource>
    </entry>
</Bundle>

{
    "resourceType": "Bundle",
    "id": "830a2a41-cca8-46a3-a35c-3237cb9828e4",
    "type": "message",
    "entry":  [
        {
            "fullUrl": "message-header-167434",
            "resource": {
                "resourceType": "MessageHeader",
                "id": "message-header-167434",
                "text": {
                    "status": "generated",
                    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>The quick brown fox jumps over the lazy dog</p></div>"
                },
                "event": {
                    "system": "https://fhir.nhs.uk/STU3/CodeSystem/EventType-1",
                    "code": "individual-requirements-1",
                    "display": "Individual Requirements"
                },
                "timestamp": "2021-05-07T16:15:32+00:00",
                "source": {
                    "endpoint": "nhs-uk:addressing:ods:T48NT"
                },
                "focus":  [
                    {
                        "reference": "medication-disp-324234234"
                    }
                ]
            }
        },
        {
            "fullUrl": "patient-113582401",
            "resource": {
                "resourceType": "Patient",
                "id": "patient-113582401",
                "identifier":  [
                    {
                        "extension":  [
                            {
                                "url": "https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-NHSNumberVerificationStatus-1",
                                "valueCodeableConcept": {
                                    "coding":  [
                                        {
                                            "system": "https://fhir.hl7.org.uk/STU3/CodeSystem/CareConnect-NHSNumberVerificationStatus-1",
                                            "code": "01",
                                            "display": "Number present and verified"
                                        }
                                    ]
                                }
                            }
                        ],
                        "system": "https://fhir.nhs.uk/Id/nhs-number",
                        "value": "113582401"
                    }
                ],
                "name":  [
                    {
                        "use": "official",
                        "text": "Ms Paige Turner",
                        "family": "Turner",
                        "given":  [
                            "Paige"
                        ],
                        "prefix":  [
                            "Ms"
                        ]
                    }
                ],
                "gender": "female",
                "birthDate": "1982-11-20"
            }
        },
        {
            "fullUrl": "staff-0002",
            "resource": {
                "resourceType": "Practitioner",
                "id": "staff-0002",
                "name":  [
                    {
                        "text": "Dr Allo Kate",
                        "family": "Kate",
                        "given":  [
                            "Allo"
                        ],
                        "prefix":  [
                            "Dr"
                        ]
                    }
                ],
                "qualification":  [
                    {
                        "code": {
                            "coding":  [
                                {
                                    "system": "https://fhir.hl7.org.uk/Id/gpc-number",
                                    "code": "123543",
                                    "display": "General Pharmaceutical Council"
                                }
                            ]
                        }
                    }
                ]
            }
        },
        {
            "fullUrl": "medication-325278007",
            "resource": {
                "resourceType": "Medication",
                "id": "medication-325278007",
                "code": {
                    "coding":  [
                        {
                            "system": "http://snomed.info/sct",
                            "code": "325278007",
                            "display": "Metformin 500mg tablets"
                        }
                    ]
                }
            }
        },
        {
            "fullUrl": "medication-disp-324234234",
            "resource": {
                "resourceType": "MedicationDispense",
                "id": "medication-disp-324234234",
                "status": "in-progress",
                "category": {
                    "coding":  [
                        {
                            "system": "http://hl7.org/fhir/medication-request-category",
                            "code": "discharge",
                            "display": "discharge"
                        }
                    ]
                },
                "medicationReference": {
                    "reference": "medication-325278007",
                    "display": "Metformin 500mg tablets"
                },
                "subject": {
                    "reference": "patient-113582401",
                    "display": "Ms Paige Turner"
                },
                "performer":  [
                    {
                        "actor": {
                            "reference": "staff-0002",
                            "display": "Dr Allo Kate"
                        }
                    }
                ],
                "dosageInstruction":  [
                    {
                        "timing": {
                            "repeat": {
                                "frequency": 2,
                                "period": 1,
                                "periodUnit": "d"
                            }
                        },
                        "route": {
                            "coding":  [
                                {
                                    "system": "http://snomed.info/sct",
                                    "code": "428673006",
                                    "display": "oral"
                                }
                            ]
                        },
                        "doseQuantity": {
                            "value": 56,
                            "unit": "tablet",
                            "system": "http://snomed.info/sct",
                            "code": "428673006"
                        }
                    }
                ]
            }
        }
    ]
}
Bundle.id[0]830a2a41-cca8-46a3-a35c-3237cb9828e4
Bundle.type[0]message
Bundle.entry[0].fullUrl[0]message-header-167434
Bundle.entry[0].resource[0].id[0]message-header-167434
Bundle.entry[0].resource[0].text[0].status[0]generated
Bundle.entry[0].resource[0].text[0].div[0]<div xmlns="http://www.w3.org/1999/xhtml"><p>The quick brown fox jumps over the lazy dog</p></div>
Bundle.entry[0].resource[0].event[0].system[0]https://fhir.nhs.uk/STU3/CodeSystem/EventType-1
Bundle.entry[0].resource[0].event[0].code[0]individual-requirements-1
Bundle.entry[0].resource[0].event[0].display[0]Individual Requirements
Bundle.entry[0].resource[0].timestamp[0]2021-05-07T16:15:32+00:00
Bundle.entry[0].resource[0].source[0].endpoint[0]nhs-uk:addressing:ods:T48NT
Bundle.entry[0].resource[0].focus[0].reference[0]medication-disp-324234234
Bundle.entry[1].fullUrl[0]patient-113582401
Bundle.entry[1].resource[0].id[0]patient-113582401
Bundle.entry[1].resource[0].identifier[0].extension[0].url[0]https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-NHSNumberVerificationStatus-1
Bundle.entry[1].resource[0].identifier[0].extension[0].value[0].coding[0].system[0]https://fhir.hl7.org.uk/STU3/CodeSystem/CareConnect-NHSNumberVerificationStatus-1
Bundle.entry[1].resource[0].identifier[0].extension[0].value[0].coding[0].code[0]01
Bundle.entry[1].resource[0].identifier[0].extension[0].value[0].coding[0].display[0]Number present and verified
Bundle.entry[1].resource[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
Bundle.entry[1].resource[0].identifier[0].value[0]113582401
Bundle.entry[1].resource[0].name[0].use[0]official
Bundle.entry[1].resource[0].name[0].text[0]Ms Paige Turner
Bundle.entry[1].resource[0].name[0].family[0]Turner
Bundle.entry[1].resource[0].name[0].given[0]Paige
Bundle.entry[1].resource[0].name[0].prefix[0]Ms
Bundle.entry[1].resource[0].gender[0]female
Bundle.entry[1].resource[0].birthDate[0]1982-11-20
Bundle.entry[2].fullUrl[0]staff-0002
Bundle.entry[2].resource[0].id[0]staff-0002
Bundle.entry[2].resource[0].name[0].text[0]Dr Allo Kate
Bundle.entry[2].resource[0].name[0].family[0]Kate
Bundle.entry[2].resource[0].name[0].given[0]Allo
Bundle.entry[2].resource[0].name[0].prefix[0]Dr
Bundle.entry[2].resource[0].qualification[0].code[0].coding[0].system[0]https://fhir.hl7.org.uk/Id/gpc-number
Bundle.entry[2].resource[0].qualification[0].code[0].coding[0].code[0]123543
Bundle.entry[2].resource[0].qualification[0].code[0].coding[0].display[0]General Pharmaceutical Council
Bundle.entry[3].fullUrl[0]medication-325278007
Bundle.entry[3].resource[0].id[0]medication-325278007
Bundle.entry[3].resource[0].code[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[3].resource[0].code[0].coding[0].code[0]325278007
Bundle.entry[3].resource[0].code[0].coding[0].display[0]Metformin 500mg tablets
Bundle.entry[4].fullUrl[0]medication-disp-324234234
Bundle.entry[4].resource[0].id[0]medication-disp-324234234
Bundle.entry[4].resource[0].status[0]in-progress
Bundle.entry[4].resource[0].category[0].coding[0].system[0]http://hl7.org/fhir/medication-request-category
Bundle.entry[4].resource[0].category[0].coding[0].code[0]discharge
Bundle.entry[4].resource[0].category[0].coding[0].display[0]discharge
Bundle.entry[4].resource[0].medication[0].reference[0]medication-325278007
Bundle.entry[4].resource[0].medication[0].display[0]Metformin 500mg tablets
Bundle.entry[4].resource[0].subject[0].reference[0]patient-113582401
Bundle.entry[4].resource[0].subject[0].display[0]Ms Paige Turner
Bundle.entry[4].resource[0].performer[0].actor[0].reference[0]staff-0002
Bundle.entry[4].resource[0].performer[0].actor[0].display[0]Dr Allo Kate
Bundle.entry[4].resource[0].dosageInstruction[0].timing[0].repeat[0].frequency[0]2
Bundle.entry[4].resource[0].dosageInstruction[0].timing[0].repeat[0].period[0]1
Bundle.entry[4].resource[0].dosageInstruction[0].timing[0].repeat[0].periodUnit[0]d
Bundle.entry[4].resource[0].dosageInstruction[0].route[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[4].resource[0].dosageInstruction[0].route[0].coding[0].code[0]428673006
Bundle.entry[4].resource[0].dosageInstruction[0].route[0].coding[0].display[0]oral
Bundle.entry[4].resource[0].dosageInstruction[0].dose[0].value[0]56
Bundle.entry[4].resource[0].dosageInstruction[0].dose[0].unit[0]tablet
Bundle.entry[4].resource[0].dosageInstruction[0].dose[0].system[0]http://snomed.info/sct
Bundle.entry[4].resource[0].dosageInstruction[0].dose[0].code[0]428673006
Bundle

MedicationStatement

Note: This example below is a draft and requires clinical verification.
Important: The MedicationStatement resource does not currently have a category of discharge.
<!--    This xml example is for illustrative purposes only and has not been clinically verified.    -->
<Bundle xmlns="http://hl7.org/fhir">
    <id value="ba54fcc3-6128-41e5-b621-b8b84465e769" />
    <type value="message" />
    <!--       Message Header       -->
    <entry>
        <fullUrl value="message-header-167434" />
        <resource>
            <MessageHeader>
                <id value="message-header-167434" />
                <text>
                    <status value="generated" />
                    <div xmlns="http://www.w3.org/1999/xhtml"><p>The quick brown fox jumps over the lazy dog</p></div>
                </text>
                <event>
                    <system value="https://fhir.nhs.uk/STU3/CodeSystem/EventType-1" />
                    <code value="individual-requirements-1" />
                    <display value="Individual Requirements" />
                </event>
                <timestamp value="2021-05-07T16:15:32Z" />
                <source>
                    <endpoint value="nhs-uk:addressing:ods:T48NT" />
                </source>
                <focus>
                    <reference value="med-req-56745612" />
                </focus>
            </MessageHeader>
        </resource>
    </entry>
    <!--    Patient associated with the encounter.    -->
    <entry>
        <fullUrl value="patient-113582401" />
        <resource>
            <Patient>
                <id value="patient-113582401" />
                <identifier>
                    <extension url="https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-NHSNumberVerificationStatus-1">
                        <valueCodeableConcept>
                            <coding>
                                <system value="https://fhir.hl7.org.uk/STU3/CodeSystem/CareConnect-NHSNumberVerificationStatus-1" />
                                <code value="01" />
                                <display value="Number present and verified" />
                            </coding>
                        </valueCodeableConcept>
                    </extension>
                    <system value="https://fhir.nhs.uk/Id/nhs-number" />
                    <value value="113582401" />
                </identifier>
                <name>
                    <use value="official" />
                    <text value="Ms Paige Turner" />
                    <family value="Turner" />
                    <given value="Paige" />
                    <prefix value="Ms" />
                </name>
                <gender value="female" />
                <birthDate value="1982-11-20" />
            </Patient>
        </resource>
    </entry>
    <!--    Medication   -->
    <entry>
        <fullUrl value="medication-325278007" />
        <resource>
            <Medication>
                <id value="medication-325278007" />
                <code>
                    <coding>
                        <system value="http://snomed.info/sct" />
                        <code value="325278007" />
                        <display value="Metformin 500mg tablets" />
                    </coding>
                </code>
            </Medication>
        </resource>
    </entry>
    <!--     Medication Statement     -->
    <entry>
        <fullUrl value="medication-statement-67843453" />
        <resource>
            <MedicationStatement>
                <id value="medication-statement-67843453" />
                <status value="active" />
                <!--   Unknown - the MedicationStatement resource does not have a category for `discharge`   -->
                <!--  
                <category>
                    <coding>
                        <system value="http://hl7.org/fhir/medication-request-category" />
                        <code value="" />
                        <display value="" />
                    </coding>
                </category>
                  -->
                <medicationReference>
                    <reference value="medication-325278007" />
                    <display value="Metformin 500mg tablets" />
                </medicationReference>
                <subject>
                    <reference value="patient-4738562854" />
                    <display value="Ms Paige Turner" />
                </subject>
                <taken value="unk" />
                <dosage>
                    <timing>
                        <repeat>
                            <frequency value="2" />
                            <period value="1" />
                            <periodUnit value="d" />
                        </repeat>
                    </timing>
                    <route>
                        <coding>
                            <system value="http://snomed.info/sct" />
                            <code value="26643006" />
                            <display value="oral" />
                        </coding>
                    </route>
                    <doseQuantity>
                        <value value="56" />
                        <unit value="tablet" />
                        <system value="http://snomed.info/sct" />
                        <code value="428673006" />
                    </doseQuantity>
                </dosage>
            </MedicationStatement>
        </resource>
    </entry>
</Bundle>

{
    "resourceType": "Bundle",
    "id": "ba54fcc3-6128-41e5-b621-b8b84465e769",
    "type": "message",
    "entry":  [
        {
            "fullUrl": "message-header-167434",
            "resource": {
                "resourceType": "MessageHeader",
                "id": "message-header-167434",
                "text": {
                    "status": "generated",
                    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>The quick brown fox jumps over the lazy dog</p></div>"
                },
                "event": {
                    "system": "https://fhir.nhs.uk/STU3/CodeSystem/EventType-1",
                    "code": "individual-requirements-1",
                    "display": "Individual Requirements"
                },
                "timestamp": "2021-05-07T16:15:32+00:00",
                "source": {
                    "endpoint": "nhs-uk:addressing:ods:T48NT"
                },
                "focus":  [
                    {
                        "reference": "med-req-56745612"
                    }
                ]
            }
        },
        {
            "fullUrl": "patient-113582401",
            "resource": {
                "resourceType": "Patient",
                "id": "patient-113582401",
                "identifier":  [
                    {
                        "extension":  [
                            {
                                "url": "https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-NHSNumberVerificationStatus-1",
                                "valueCodeableConcept": {
                                    "coding":  [
                                        {
                                            "system": "https://fhir.hl7.org.uk/STU3/CodeSystem/CareConnect-NHSNumberVerificationStatus-1",
                                            "code": "01",
                                            "display": "Number present and verified"
                                        }
                                    ]
                                }
                            }
                        ],
                        "system": "https://fhir.nhs.uk/Id/nhs-number",
                        "value": "113582401"
                    }
                ],
                "name":  [
                    {
                        "use": "official",
                        "text": "Ms Paige Turner",
                        "family": "Turner",
                        "given":  [
                            "Paige"
                        ],
                        "prefix":  [
                            "Ms"
                        ]
                    }
                ],
                "gender": "female",
                "birthDate": "1982-11-20"
            }
        },
        {
            "fullUrl": "medication-325278007",
            "resource": {
                "resourceType": "Medication",
                "id": "medication-325278007",
                "code": {
                    "coding":  [
                        {
                            "system": "http://snomed.info/sct",
                            "code": "325278007",
                            "display": "Metformin 500mg tablets"
                        }
                    ]
                }
            }
        },
        {
            "fullUrl": "medication-statement-67843453",
            "resource": {
                "resourceType": "MedicationStatement",
                "id": "medication-statement-67843453",
                "status": "active",
                "medicationReference": {
                    "reference": "medication-325278007",
                    "display": "Metformin 500mg tablets"
                },
                "subject": {
                    "reference": "patient-4738562854",
                    "display": "Ms Paige Turner"
                },
                "taken": "unk",
                "dosage":  [
                    {
                        "timing": {
                            "repeat": {
                                "frequency": 2,
                                "period": 1,
                                "periodUnit": "d"
                            }
                        },
                        "route": {
                            "coding":  [
                                {
                                    "system": "http://snomed.info/sct",
                                    "code": "26643006",
                                    "display": "oral"
                                }
                            ]
                        },
                        "doseQuantity": {
                            "value": 56,
                            "unit": "tablet",
                            "system": "http://snomed.info/sct",
                            "code": "428673006"
                        }
                    }
                ]
            }
        }
    ]
}
Bundle.id[0]ba54fcc3-6128-41e5-b621-b8b84465e769
Bundle.type[0]message
Bundle.entry[0].fullUrl[0]message-header-167434
Bundle.entry[0].resource[0].id[0]message-header-167434
Bundle.entry[0].resource[0].text[0].status[0]generated
Bundle.entry[0].resource[0].text[0].div[0]<div xmlns="http://www.w3.org/1999/xhtml"><p>The quick brown fox jumps over the lazy dog</p></div>
Bundle.entry[0].resource[0].event[0].system[0]https://fhir.nhs.uk/STU3/CodeSystem/EventType-1
Bundle.entry[0].resource[0].event[0].code[0]individual-requirements-1
Bundle.entry[0].resource[0].event[0].display[0]Individual Requirements
Bundle.entry[0].resource[0].timestamp[0]2021-05-07T16:15:32+00:00
Bundle.entry[0].resource[0].source[0].endpoint[0]nhs-uk:addressing:ods:T48NT
Bundle.entry[0].resource[0].focus[0].reference[0]med-req-56745612
Bundle.entry[1].fullUrl[0]patient-113582401
Bundle.entry[1].resource[0].id[0]patient-113582401
Bundle.entry[1].resource[0].identifier[0].extension[0].url[0]https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-NHSNumberVerificationStatus-1
Bundle.entry[1].resource[0].identifier[0].extension[0].value[0].coding[0].system[0]https://fhir.hl7.org.uk/STU3/CodeSystem/CareConnect-NHSNumberVerificationStatus-1
Bundle.entry[1].resource[0].identifier[0].extension[0].value[0].coding[0].code[0]01
Bundle.entry[1].resource[0].identifier[0].extension[0].value[0].coding[0].display[0]Number present and verified
Bundle.entry[1].resource[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
Bundle.entry[1].resource[0].identifier[0].value[0]113582401
Bundle.entry[1].resource[0].name[0].use[0]official
Bundle.entry[1].resource[0].name[0].text[0]Ms Paige Turner
Bundle.entry[1].resource[0].name[0].family[0]Turner
Bundle.entry[1].resource[0].name[0].given[0]Paige
Bundle.entry[1].resource[0].name[0].prefix[0]Ms
Bundle.entry[1].resource[0].gender[0]female
Bundle.entry[1].resource[0].birthDate[0]1982-11-20
Bundle.entry[2].fullUrl[0]medication-325278007
Bundle.entry[2].resource[0].id[0]medication-325278007
Bundle.entry[2].resource[0].code[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[2].resource[0].code[0].coding[0].code[0]325278007
Bundle.entry[2].resource[0].code[0].coding[0].display[0]Metformin 500mg tablets
Bundle.entry[3].fullUrl[0]medication-statement-67843453
Bundle.entry[3].resource[0].id[0]medication-statement-67843453
Bundle.entry[3].resource[0].status[0]active
Bundle.entry[3].resource[0].medication[0].reference[0]medication-325278007
Bundle.entry[3].resource[0].medication[0].display[0]Metformin 500mg tablets
Bundle.entry[3].resource[0].subject[0].reference[0]patient-4738562854
Bundle.entry[3].resource[0].subject[0].display[0]Ms Paige Turner
Bundle.entry[3].resource[0].taken[0]unk
Bundle.entry[3].resource[0].dosage[0].timing[0].repeat[0].frequency[0]2
Bundle.entry[3].resource[0].dosage[0].timing[0].repeat[0].period[0]1
Bundle.entry[3].resource[0].dosage[0].timing[0].repeat[0].periodUnit[0]d
Bundle.entry[3].resource[0].dosage[0].route[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[3].resource[0].dosage[0].route[0].coding[0].code[0]26643006
Bundle.entry[3].resource[0].dosage[0].route[0].coding[0].display[0]oral
Bundle.entry[3].resource[0].dosage[0].dose[0].value[0]56
Bundle.entry[3].resource[0].dosage[0].dose[0].unit[0]tablet
Bundle.entry[3].resource[0].dosage[0].dose[0].system[0]http://snomed.info/sct
Bundle.entry[3].resource[0].dosage[0].dose[0].code[0]428673006
Bundle
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