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Please note: This guidance has been superseded by the Implementation guide for digitial medicines, which contains up-to-date information.

Medications on Admission

On admission to any secondary/tertiary care setting, a medicines reconciliation process is generally undertaken by pharmacists and pharmacy technicians. This process comprises five steps:

  1. Collect an accurate medication history from appropriate sources prior to admission, or had been recently prescribed
  2. Develop a list of medications to be prescribed or review a list of medications which have currently been prescribed
  3. Compare the medications on the two lists identifying medications which have not been prescribed, where doses have changed, or new medications have been prescribed
  4. Make clinical decisions based on the comparison and the patients current symptoms
  5. Communicate gaps, confirm changes and provide recommendations of the new list to appropriate caregivers and to the patient.

Inpatient Admissions

The steps as listed above would be typically undertaken and recorded within the Trust ePMA system. Changes to on-going medication will be recorded within the Trust ePMA system and explained to the patient and other caregivers over the course of the admission and any further changes on discharge.

Outpatient Appointment / Treatment

The steps above would be typically undertaken as listed and recorded within the Trust ePMA system.

General Practice Transfer / New Registrations

When a patient registers with a GP practice the medicines reconciliation process is supported by the GP2GP service that makes available the patient's GP record from their previous GP practice clinical system. For new patient registrations where there is no existing primary care record, the GP will ask the patient to describe or bring in their current medication.

Applicable FHIR resources: MedicationStatement

back to top