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Please note: This guidance has been superseded by the Implementation guide for digitial medicines, which contains up-to-date information.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

Patient Scott Chegg is prescribed a Goserelin 3.6mg implant by Dr Justin Thyme to be administered by IM injection in the Outpatients department on 1st May 2020.

The medication request is written and sent to pharmacy by ward nurse Levy Tate based on Dr Thyme's instructions.

MedicationRequest

Note: This example below is a draft and requires clinical verification.
<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-342355475687898" />
                </focus>
            </MessageHeader>
        </resource>
    </entry>
    <!-- Patient associated with the encounter. -->
    <entry>
        <fullUrl value="patient-3204221854" />
        <resource>
            <Patient>
                <id value="patient-3204221854" />
                <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="3204221854" />
                </identifier>
                <name>
                    <use value="official" />
                    <text value="Mr Scott Chegg" />
                    <family value="Chegg" />
                    <given value="Scott" />
                    <prefix value="Mr" />
                </name>
                <gender value="male" />
                <birthDate value="1960-04-02" />
            </Patient>
        </resource>
    </entry>
    <!-- Prescribing clinician associated with the encounter.  -->
    <entry>
        <fullUrl value="staff-0001" />
        <resource>
            <Practitioner>
                <id value="staff-0001" />
                <name>
                    <text value="Dr Justin Thyme" />
                    <family value="Thyme" />
                    <given value="Justin" />
                    <prefix value="Dr" />
                </name>
                <qualification>
                    <code>
                        <coding>
                            <system value="https://fhir.hl7.org.uk/Id/gmc-number" />
                            <code value="1234567" />
                            <display value="General Medical Council" />
                        </coding>
                    </code>
                </qualification>
            </Practitioner>
        </resource>
    </entry>
    <!-- Ward nurse associated with the encounter.  -->
    <entry>
        <fullUrl value="staff-0003" />
        <resource>
            <Practitioner>
                <id value="staff-0003" />
                <name>
                    <text value="Levy Tate" />
                    <family value="Tate" />
                    <given value="Levy" />
                </name>
                <qualification>
                    <code>
                        <coding>
                            <system value="https://fhir.hl7.org.uk/Id/nmc-number" />
                            <code value="71A2998E" />
                            <display value="Nurse Midwifery Council" />
                        </coding>
                    </code>
                </qualification>
            </Practitioner>
        </resource>
    </entry>
    <!-- Medication prescribed  -->
    <entry>
        <fullUrl value="medication-327337009" />
        <resource>
            <Medication>
                <id value="medication-327337009" />
                <code>
                    <coding>
                        <system value="http://snomed.info/sct" />
                        <code value="327337009" />
                        <display value="Goserelin 3.6mg implant pre-filled syringes" />
                    </coding>
                </code>
            </Medication>
        </resource>
    </entry>
    <!--  Medication Request  -->
    <entry>
        <fullUrl value="med-req-342355475687898" />
        <resource>
            <MedicationRequest>
                <id value="med-req-342355475687898" />
                <status value="active" />
                <intent value="order" />
                <category>
                    <coding>
                        <system value="http://hl7.org/fhir/medication-request-category" />
                        <code value="inpatient" />
                        <display value="inpatient" />
                    </coding>
                </category>
                <medicationReference>
                    <reference value="medication-327337009" />
                    <display value="Goserelin 3.6mg implant pre-filled syringes" />
                </medicationReference>
                <subject>
                    <reference value="patient-3204221854" />
                    <display value="Mr Scott Chegg" />
                </subject>
                <authoredOn value="2020-04-30T17:00:00Z" />
                <requester>
                    <agent>
                        <reference value="staff-0001" />
                        <display value="Dr Justin Thyme" />
                    </agent>
                </requester>
                <recorder>
                    <reference value="staff-0003" />
                    <display value="Levy Tate" />
                </recorder>
                <dosageInstruction>
                    <timing>
                        <event value="2020-05-01" />
                        <repeat>
                            <count value="1" />
                        </repeat>
                    </timing>
                    <site>
                        <coding>
                            <system value="http://snomed.info/sct" />
                            <code value="59380008" />
                            <display value="Anterior abdominal wall structure" />
                        </coding>
                    </site>
                    <route>
                        <coding>
                            <system value="http://snomed.info/sct" />
                            <code value="78421000" />
                            <display value="intramuscular route" />
                        </coding>
                    </route>
                    <method>
                        <coding>
                            <system value="http://snomed.info/sct" />
                            <code value="422145002" />
                            <display value="inject" />
                        </coding>
                    </method>
                </dosageInstruction>
                <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": "2021-05-07T16:15:32Z",
                "source": {
                    "endpoint": "nhs-uk:addressing:ods:T48NT"
                },
                "focus":  [
                    {
                        "reference": "med-req-342355475687898"
                    }
                ]
            }
        },
        {
            "fullUrl": "patient-3204221854",
            "resource": {
                "resourceType": "Patient",
                "id": "patient-3204221854",
                "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": "3204221854"
                    }
                ],
                "name":  [
                    {
                        "use": "official",
                        "text": "Mr Scott Chegg",
                        "family": "Chegg",
                        "given":  [
                            "Scott"
                        ],
                        "prefix":  [
                            "Mr"
                        ]
                    }
                ],
                "gender": "male",
                "birthDate": "1960-04-02"
            }
        },
        {
            "fullUrl": "staff-0001",
            "resource": {
                "resourceType": "Practitioner",
                "id": "staff-0001",
                "name":  [
                    {
                        "text": "Dr Justin Thyme",
                        "family": "Thyme",
                        "given":  [
                            "Justin"
                        ],
                        "prefix":  [
                            "Dr"
                        ]
                    }
                ],
                "qualification":  [
                    {
                        "code": {
                            "coding":  [
                                {
                                    "system": "https://fhir.hl7.org.uk/Id/gmc-number",
                                    "code": "1234567",
                                    "display": "General Medical Council"
                                }
                            ]
                        }
                    }
                ]
            }
        },
        {
            "fullUrl": "staff-0003",
            "resource": {
                "resourceType": "Practitioner",
                "id": "staff-0003",
                "name":  [
                    {
                        "text": "Levy Tate",
                        "family": "Tate",
                        "given":  [
                            "Levy"
                        ]
                    }
                ],
                "qualification":  [
                    {
                        "code": {
                            "coding":  [
                                {
                                    "system": "https://fhir.hl7.org.uk/Id/nmc-number",
                                    "code": "71A2998E",
                                    "display": "Nurse Midwifery Council"
                                }
                            ]
                        }
                    }
                ]
            }
        },
        {
            "fullUrl": "medication-327337009",
            "resource": {
                "resourceType": "Medication",
                "id": "medication-327337009",
                "code": {
                    "coding":  [
                        {
                            "system": "http://snomed.info/sct",
                            "code": "327337009",
                            "display": "Goserelin 3.6mg implant pre-filled syringes"
                        }
                    ]
                }
            }
        },
        {
            "fullUrl": "med-req-342355475687898",
            "resource": {
                "resourceType": "MedicationRequest",
                "id": "med-req-342355475687898",
                "status": "active",
                "intent": "order",
                "category": {
                    "coding":  [
                        {
                            "system": "http://hl7.org/fhir/medication-request-category",
                            "code": "inpatient",
                            "display": "inpatient"
                        }
                    ]
                },
                "medicationReference": {
                    "reference": "medication-327337009",
                    "display": "Goserelin 3.6mg implant pre-filled syringes"
                },
                "subject": {
                    "reference": "patient-3204221854",
                    "display": "Mr Scott Chegg"
                },
                "authoredOn": "2020-04-30T17:00:00Z",
                "requester": {
                    "agent": {
                        "reference": "staff-0001",
                        "display": "Dr Justin Thyme"
                    }
                },
                "recorder": {
                    "reference": "staff-0003",
                    "display": "Levy Tate"
                },
                "dosageInstruction":  [
                    {
                        "timing": {
                            "event":  [
                                "2020-05-01"
                            ],
                            "repeat": {
                                "count": 1
                            }
                        },
                        "site": {
                            "coding":  [
                                {
                                    "system": "http://snomed.info/sct",
                                    "code": "59380008",
                                    "display": "Anterior abdominal wall structure"
                                }
                            ]
                        },
                        "route": {
                            "coding":  [
                                {
                                    "system": "http://snomed.info/sct",
                                    "code": "78421000",
                                    "display": "intramuscular route"
                                }
                            ]
                        },
                        "method": {
                            "coding":  [
                                {
                                    "system": "http://snomed.info/sct",
                                    "code": "422145002",
                                    "display": "inject"
                                }
                            ]
                        }
                    }
                ],
                "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-342355475687898
Bundle.entry[1].fullUrl[0]patient-3204221854
Bundle.entry[1].resource[0].id[0]patient-3204221854
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]3204221854
Bundle.entry[1].resource[0].name[0].use[0]official
Bundle.entry[1].resource[0].name[0].text[0]Mr Scott Chegg
Bundle.entry[1].resource[0].name[0].family[0]Chegg
Bundle.entry[1].resource[0].name[0].given[0]Scott
Bundle.entry[1].resource[0].name[0].prefix[0]Mr
Bundle.entry[1].resource[0].gender[0]male
Bundle.entry[1].resource[0].birthDate[0]1960-04-02
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 Justin Thyme
Bundle.entry[2].resource[0].name[0].family[0]Thyme
Bundle.entry[2].resource[0].name[0].given[0]Justin
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]1234567
Bundle.entry[2].resource[0].qualification[0].code[0].coding[0].display[0]General Medical Council
Bundle.entry[3].fullUrl[0]staff-0003
Bundle.entry[3].resource[0].id[0]staff-0003
Bundle.entry[3].resource[0].name[0].text[0]Levy Tate
Bundle.entry[3].resource[0].name[0].family[0]Tate
Bundle.entry[3].resource[0].name[0].given[0]Levy
Bundle.entry[3].resource[0].qualification[0].code[0].coding[0].system[0]https://fhir.hl7.org.uk/Id/nmc-number
Bundle.entry[3].resource[0].qualification[0].code[0].coding[0].code[0]71A2998E
Bundle.entry[3].resource[0].qualification[0].code[0].coding[0].display[0]Nurse Midwifery Council
Bundle.entry[4].fullUrl[0]medication-327337009
Bundle.entry[4].resource[0].id[0]medication-327337009
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]327337009
Bundle.entry[4].resource[0].code[0].coding[0].display[0]Goserelin 3.6mg implant pre-filled syringes
Bundle.entry[5].fullUrl[0]med-req-342355475687898
Bundle.entry[5].resource[0].id[0]med-req-342355475687898
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]inpatient
Bundle.entry[5].resource[0].category[0].coding[0].display[0]inpatient
Bundle.entry[5].resource[0].medication[0].reference[0]medication-327337009
Bundle.entry[5].resource[0].medication[0].display[0]Goserelin 3.6mg implant pre-filled syringes
Bundle.entry[5].resource[0].subject[0].reference[0]patient-3204221854
Bundle.entry[5].resource[0].subject[0].display[0]Mr Scott Chegg
Bundle.entry[5].resource[0].authoredOn[0]2020-04-30T17:00:00Z
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 Justin Thyme
Bundle.entry[5].resource[0].recorder[0].reference[0]staff-0003
Bundle.entry[5].resource[0].recorder[0].display[0]Levy Tate
Bundle.entry[5].resource[0].dosageInstruction[0].timing[0].event[0]2020-05-01
Bundle.entry[5].resource[0].dosageInstruction[0].timing[0].repeat[0].count[0]1
Bundle.entry[5].resource[0].dosageInstruction[0].site[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[5].resource[0].dosageInstruction[0].site[0].coding[0].code[0]59380008
Bundle.entry[5].resource[0].dosageInstruction[0].site[0].coding[0].display[0]Anterior abdominal wall structure
Bundle.entry[5].resource[0].dosageInstruction[0].route[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[5].resource[0].dosageInstruction[0].route[0].coding[0].code[0]78421000
Bundle.entry[5].resource[0].dosageInstruction[0].route[0].coding[0].display[0]intramuscular route
Bundle.entry[5].resource[0].dosageInstruction[0].method[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[5].resource[0].dosageInstruction[0].method[0].coding[0].code[0]422145002
Bundle.entry[5].resource[0].dosageInstruction[0].method[0].coding[0].display[0]inject
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="8abbb84b-efac-4cd0-85fb-296fc13d6f67" />
    <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-56756345423" />
                </focus>
            </MessageHeader>
        </resource>
    </entry>
    <!--   Patient associated with the encounter.   -->
    <entry>
        <fullUrl value="patient-3204221854" />
        <resource>
            <Patient>
                <id value="patient-3204221854" />
                <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="3204221854" />
                </identifier>
                <name>
                    <use value="official" />
                    <text value="Mr Scott Chegg" />
                    <family value="Chegg" />
                    <given value="Scott" />
                    <prefix value="Mr" />
                </name>
                <gender value="male" />
                <birthDate value="1960-04-02" />
            </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-327337009" />
        <resource>
            <Medication>
                <id value="medication-327337009" />
                <code>
                    <coding>
                        <system value="http://snomed.info/sct" />
                        <code value="327337009" />
                        <display value="Goserelin 3.6mg implant pre-filled syringes" />
                    </coding>
                </code>
            </Medication>
        </resource>
    </entry>
    <!--     Medication Dispense     -->
    <entry>
        <fullUrl value="medication-disp-56756345423" />
        <resource>
            <MedicationDispense>
                <id value="medication-disp-56756345423" />
                <status value="in-progress" />
                <category>
                    <coding>
                        <system value="http://hl7.org/fhir/medication-request-category" />
                        <code value="outpatient" />
                        <display value="outpatient" />
                    </coding>
                </category>
                <medicationReference>
                    <reference value="medication-327337009" />
                    <display value="Goserelin 3.6mg implant pre-filled syringes" />
                </medicationReference>
                <subject>
                    <reference value="patient-3204221854" />
                    <display value="Mr Scott Chegg" />
                </subject>
                <performer>
                    <actor>
                        <reference value="staff-0002" />
                        <display value="Dr Allo Kate" />
                    </actor>
                </performer>
                <dosageInstruction>
                    <timing>
                        <event value="2020-05-01" />
                        <repeat>
                            <count value="1" />
                        </repeat>
                    </timing>
                    <site>
                        <coding>
                            <system value="http://snomed.info/sct" />
                            <code value="59380008" />
                            <display value="Anterior abdominal wall structure" />
                        </coding>
                    </site>
                    <route>
                        <coding>
                            <system value="http://snomed.info/sct" />
                            <code value="78421000" />
                            <display value="intramuscular route" />
                        </coding>
                    </route>
                    <method>
                        <coding>
                            <system value="http://snomed.info/sct" />
                            <code value="422145002" />
                            <display value="inject" />
                        </coding>
                    </method>
                    <doseQuantity>
                        <value value="1" />
                        <unit value="Vial" />
                        <system value="http://snomed.info/sct" />
                        <code value="415818006" />
                    </doseQuantity>
                </dosageInstruction>
            </MedicationDispense>
        </resource>
    </entry>
</Bundle>

{
    "resourceType": "Bundle",
    "id": "8abbb84b-efac-4cd0-85fb-296fc13d6f67",
    "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>"
                },
                "timestamp": "2021-05-07T16:15:32Z",
                "event": {
                    "system": "https://fhir.nhs.uk/STU3/CodeSystem/EventType-1",
                    "code": "individual-requirements-1",
                    "display": "Individual Requirements"
                },
                "source": {
                    "endpoint": "nhs-uk:addressing:ods:T48NT"
                },
                "focus":  [
                    {
                        "reference": "medication-disp-56756345423"
                    }
                ]
            }
        },
        {
            "fullUrl": "patient-3204221854",
            "resource": {
                "resourceType": "Patient",
                "id": "patient-3204221854",
                "identifier":  [
                    {
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                                "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",
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                                            "display": "Number present and verified"
                                        }
                                    ]
                                }
                            }
                        ],
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                        "value": "3204221854"
                    }
                ],
                "name":  [
                    {
                        "use": "official",
                        "text": "Mr Scott Chegg",
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                "name":  [
                    {
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                        "family": "Kate",
                        "given":  [
                            "Allo"
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                        "prefix":  [
                            "Dr"
                        ]
                    }
                ],
                "qualification":  [
                    {
                        "code": {
                            "coding":  [
                                {
                                    "system": "https://fhir.hl7.org.uk/Id/gpc-number",
                                    "code": "123543",
                                    "display": "General Pharmaceutical Council"
                                }
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                ]
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        {
            "fullUrl": "medication-327337009",
            "resource": {
                "resourceType": "Medication",
                "id": "medication-327337009",
                "code": {
                    "coding":  [
                        {
                            "system": "http://snomed.info/sct",
                            "code": "327337009",
                            "display": "Goserelin 3.6mg implant pre-filled syringes"
                        }
                    ]
                }
            }
        },
        {
            "fullUrl": "medication-disp-56756345423",
            "resource": {
                "resourceType": "MedicationDispense",
                "id": "medication-disp-56756345423",
                "status": "in-progress",
                "category": {
                    "coding":  [
                        {
                            "system": "http://hl7.org/fhir/medication-request-category",
                            "code": "outpatient",
                            "display": "outpatient"
                        }
                    ]
                },
                "medicationReference": {
                    "reference": "medication-327337009",
                    "display": "Goserelin 3.6mg implant pre-filled syringes"
                },
                "subject": {
                    "reference": "patient-3204221854",
                    "display": "Mr Scott Chegg"
                },
                "performer":  [
                    {
                        "actor": {
                            "reference": "staff-0002",
                            "display": "Dr Allo Kate"
                        }
                    }
                ],
                "dosageInstruction":  [
                    {
                        "timing": {
                            "event":  [
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                            ],
                            "repeat": {
                                "count": 1
                            }
                        },
                        "site": {
                            "coding":  [
                                {
                                    "system": "http://snomed.info/sct",
                                    "code": "59380008",
                                    "display": "Anterior abdominal wall structure"
                                }
                            ]
                        },
                        "route": {
                            "coding":  [
                                {
                                    "system": "http://snomed.info/sct",
                                    "code": "78421000",
                                    "display": "intramuscular route"
                                }
                            ]
                        },
                        "method": {
                            "coding":  [
                                {
                                    "system": "http://snomed.info/sct",
                                    "code": "422145002",
                                    "display": "inject"
                                }
                            ]
                        },
                        "doseQuantity": {
                            "value": 1,
                            "unit": "Vial",
                            "system": "http://snomed.info/sct",
                            "code": "415818006"
                        }
                    }
                ]
            }
        }
    ]
}
Bundle.id[0]8abbb84b-efac-4cd0-85fb-296fc13d6f67
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-56756345423
Bundle.entry[1].fullUrl[0]patient-3204221854
Bundle.entry[1].resource[0].id[0]patient-3204221854
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]3204221854
Bundle.entry[1].resource[0].name[0].use[0]official
Bundle.entry[1].resource[0].name[0].text[0]Mr Scott Chegg
Bundle.entry[1].resource[0].name[0].family[0]Chegg
Bundle.entry[1].resource[0].name[0].given[0]Scott
Bundle.entry[1].resource[0].name[0].prefix[0]Mr
Bundle.entry[1].resource[0].gender[0]male
Bundle.entry[1].resource[0].birthDate[0]1960-04-02
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-327337009
Bundle.entry[3].resource[0].id[0]medication-327337009
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]327337009
Bundle.entry[3].resource[0].code[0].coding[0].display[0]Goserelin 3.6mg implant pre-filled syringes
Bundle.entry[4].fullUrl[0]medication-disp-56756345423
Bundle.entry[4].resource[0].id[0]medication-disp-56756345423
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]outpatient
Bundle.entry[4].resource[0].category[0].coding[0].display[0]outpatient
Bundle.entry[4].resource[0].medication[0].reference[0]medication-327337009
Bundle.entry[4].resource[0].medication[0].display[0]Goserelin 3.6mg implant pre-filled syringes
Bundle.entry[4].resource[0].subject[0].reference[0]patient-3204221854
Bundle.entry[4].resource[0].subject[0].display[0]Mr Scott Chegg
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].event[0]2020-05-01
Bundle.entry[4].resource[0].dosageInstruction[0].timing[0].repeat[0].count[0]1
Bundle.entry[4].resource[0].dosageInstruction[0].site[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[4].resource[0].dosageInstruction[0].site[0].coding[0].code[0]59380008
Bundle.entry[4].resource[0].dosageInstruction[0].site[0].coding[0].display[0]Anterior abdominal wall structure
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]78421000
Bundle.entry[4].resource[0].dosageInstruction[0].route[0].coding[0].display[0]intramuscular route
Bundle.entry[4].resource[0].dosageInstruction[0].method[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[4].resource[0].dosageInstruction[0].method[0].coding[0].code[0]422145002
Bundle.entry[4].resource[0].dosageInstruction[0].method[0].coding[0].display[0]inject
Bundle.entry[4].resource[0].dosageInstruction[0].dose[0].value[0]1
Bundle.entry[4].resource[0].dosageInstruction[0].dose[0].unit[0]Vial
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]415818006
Bundle

MedicationStatement

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="973ca712-a049-496b-b21e-83be8a9cdd86" />
    <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-statement-87634423" />
                </focus>
            </MessageHeader>
        </resource>
    </entry>
    <!--      Patient associated with the encounter.      -->
    <entry>
        <fullUrl value="patient-3204221854" />
        <resource>
            <Patient>
                <id value="patient-3204221854" />
                <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="3204221854" />
                </identifier>
                <name>
                    <use value="official" />
                    <text value="Mr Scott Chegg" />
                    <family value="Chegg" />
                    <given value="Scott" />
                    <prefix value="Mr" />
                </name>
                <gender value="male" />
                <birthDate value="1960-04-02" />
            </Patient>
        </resource>
    </entry>
    <!--      Medication     -->
    <entry>
        <fullUrl value="medication-327337009" />
        <resource>
            <Medication>
                <id value="medication-327337009" />
                <code>
                    <coding>
                        <system value="http://snomed.info/sct" />
                        <code value="327337009" />
                        <display value="Goserelin 3.6mg implant pre-filled syringes" />
                    </coding>
                </code>
            </Medication>
        </resource>
    </entry>
    <!--       Medication Statement       -->
    <entry>
        <fullUrl value="med-statement-87634423" />
        <resource>
            <MedicationStatement>
                <id value="medication-statement-87634423" />
                <status value="active" />
                <category>
                    <coding>
                        <system value="http://hl7.org/fhir/medication-request-category" />
                        <code value="outpatient" />
                        <display value="outpatient" />
                    </coding>
                </category>
                <medicationReference>
                    <reference value="medication-327337009" />
                    <display value="Goserelin 3.6mg implant pre-filled syringes" />
                </medicationReference>
                <subject>
                    <reference value="patient-3204221854" />
                    <display value="Mr Scott Chegg" />
                </subject>
                <taken value="unk" />
                <dosage>
                    <timing>
                        <event value="2020-05-01" />
                        <repeat>
                            <count value="1" />
                        </repeat>
                    </timing>
                    <site>
                        <coding>
                            <system value="http://snomed.info/sct" />
                            <code value="59380008" />
                            <display value="Anterior abdominal wall structure" />
                        </coding>
                    </site>
                    <route>
                        <coding>
                            <system value="http://snomed.info/sct" />
                            <code value="78421000" />
                            <display value="intramuscular route" />
                        </coding>
                    </route>
                    <method>
                        <coding>
                            <system value="http://snomed.info/sct" />
                            <code value="422145002" />
                            <display value="inject" />
                        </coding>
                    </method>
                    <doseQuantity>
                        <value value="1" />
                        <unit value="Vial" />
                        <system value="http://snomed.info/sct" />
                        <code value="415818006" />
                    </doseQuantity>
                </dosage>
            </MedicationStatement>
        </resource>
    </entry>
</Bundle>

{
    "resourceType": "Bundle",
    "id": "973ca712-a049-496b-b21e-83be8a9cdd86",
    "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": "2021-05-07T16:15:32Z",
                "source": {
                    "endpoint": "nhs-uk:addressing:ods:T48NT"
                },
                "focus":  [
                    {
                        "reference": "med-statement-87634423"
                    }
                ]
            }
        },
        {
            "fullUrl": "patient-3204221854",
            "resource": {
                "resourceType": "Patient",
                "id": "patient-3204221854",
                "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": "3204221854"
                    }
                ],
                "name":  [
                    {
                        "use": "official",
                        "text": "Mr Scott Chegg",
                        "family": "Chegg",
                        "given":  [
                            "Scott"
                        ],
                        "prefix":  [
                            "Mr"
                        ]
                    }
                ],
                "gender": "male",
                "birthDate": "1960-04-02"
            }
        },
        {
            "fullUrl": "medication-327337009",
            "resource": {
                "resourceType": "Medication",
                "id": "medication-327337009",
                "code": {
                    "coding":  [
                        {
                            "system": "http://snomed.info/sct",
                            "code": "327337009",
                            "display": "Goserelin 3.6mg implant pre-filled syringes"
                        }
                    ]
                }
            }
        },
        {
            "fullUrl": "med-statement-87634423",
            "resource": {
                "resourceType": "MedicationStatement",
                "id": "medication-statement-87634423",
                "status": "active",
                "category": {
                    "coding":  [
                        {
                            "system": "http://hl7.org/fhir/medication-request-category",
                            "code": "outpatient",
                            "display": "outpatient"
                        }
                    ]
                },
                "medicationReference": {
                    "reference": "medication-327337009",
                    "display": "Goserelin 3.6mg implant pre-filled syringes"
                },
                "subject": {
                    "reference": "patient-3204221854",
                    "display": "Mr Scott Chegg"
                },
                "dosage":  [
                    {
                        "timing": {
                            "event":  [
                                "2020-05-01"
                            ],
                            "repeat": {
                                "count": 1
                            }
                        },
                        "site": {
                            "coding":  [
                                {
                                    "system": "http://snomed.info/sct",
                                    "code": "59380008",
                                    "display": "Anterior abdominal wall structure"
                                }
                            ]
                        },
                        "route": {
                            "coding":  [
                                {
                                    "system": "http://snomed.info/sct",
                                    "code": "78421000",
                                    "display": "intramuscular route"
                                }
                            ]
                        },
                        "method": {
                            "coding":  [
                                {
                                    "system": "http://snomed.info/sct",
                                    "code": "422145002",
                                    "display": "inject"
                                }
                            ]
                        },
                        "doseQuantity": {
                            "value": 1,
                            "unit": "Vial",
                            "system": "http://snomed.info/sct",
                            "code": "415818006"
                        }
                    }
                ],
                "taken": "unk"
            }
        }
    ]
}
Bundle.id[0]973ca712-a049-496b-b21e-83be8a9cdd86
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-statement-87634423
Bundle.entry[1].fullUrl[0]patient-3204221854
Bundle.entry[1].resource[0].id[0]patient-3204221854
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]3204221854
Bundle.entry[1].resource[0].name[0].use[0]official
Bundle.entry[1].resource[0].name[0].text[0]Mr Scott Chegg
Bundle.entry[1].resource[0].name[0].family[0]Chegg
Bundle.entry[1].resource[0].name[0].given[0]Scott
Bundle.entry[1].resource[0].name[0].prefix[0]Mr
Bundle.entry[1].resource[0].gender[0]male
Bundle.entry[1].resource[0].birthDate[0]1960-04-02
Bundle.entry[2].fullUrl[0]medication-327337009
Bundle.entry[2].resource[0].id[0]medication-327337009
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]327337009
Bundle.entry[2].resource[0].code[0].coding[0].display[0]Goserelin 3.6mg implant pre-filled syringes
Bundle.entry[3].fullUrl[0]med-statement-87634423
Bundle.entry[3].resource[0].id[0]medication-statement-87634423
Bundle.entry[3].resource[0].status[0]active
Bundle.entry[3].resource[0].category[0].coding[0].system[0]http://hl7.org/fhir/medication-request-category
Bundle.entry[3].resource[0].category[0].coding[0].code[0]outpatient
Bundle.entry[3].resource[0].category[0].coding[0].display[0]outpatient
Bundle.entry[3].resource[0].medication[0].reference[0]medication-327337009
Bundle.entry[3].resource[0].medication[0].display[0]Goserelin 3.6mg implant pre-filled syringes
Bundle.entry[3].resource[0].subject[0].reference[0]patient-3204221854
Bundle.entry[3].resource[0].subject[0].display[0]Mr Scott Chegg
Bundle.entry[3].resource[0].taken[0]unk
Bundle.entry[3].resource[0].dosage[0].timing[0].event[0]2020-05-01
Bundle.entry[3].resource[0].dosage[0].timing[0].repeat[0].count[0]1
Bundle.entry[3].resource[0].dosage[0].site[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[3].resource[0].dosage[0].site[0].coding[0].code[0]59380008
Bundle.entry[3].resource[0].dosage[0].site[0].coding[0].display[0]Anterior abdominal wall structure
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]78421000
Bundle.entry[3].resource[0].dosage[0].route[0].coding[0].display[0]intramuscular route
Bundle.entry[3].resource[0].dosage[0].method[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[3].resource[0].dosage[0].method[0].coding[0].code[0]422145002
Bundle.entry[3].resource[0].dosage[0].method[0].coding[0].display[0]inject
Bundle.entry[3].resource[0].dosage[0].dose[0].value[0]1
Bundle.entry[3].resource[0].dosage[0].dose[0].unit[0]Vial
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]415818006
Bundle
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