NHS Digital FHIR Medicines

Prescription Order Homecare Repeat Medication

Outpatient repeat disensing single item prescription for 4 x weekly issues. This is very similar to the Prescription Order Homecare Prepare message with the addition of the a digital signature in the Provenence resource.

{
    "resourceType": "Bundle",
    "id": "hce-DC2C66-A1B2C3-23407B",
    "meta": {
        "lastUpdated": "2021-07-29T01:43:30+00:00"
    },
    "identifier": {
        "system": "https://tools.ietf.org/html/rfc4122",
        "value": "ad945a29-85f8-439a-b590-6789719adc16"
    },
    "type": "message",
    "timestamp": "2020-11-02T01:44:30+00:00",
    "entry":  [
        {
            "fullUrl": "urn:uuid:311316d3-1de0-4f7c-8109-c950ead1c717",
            "resource": {
                "resourceType": "MessageHeader",
                "eventCoding": {
                    "system": "https://fhir.nhs.uk/CodeSystem/message-event",
                    "code": "prescription-order",
                    "display": "Prescription Order"
                },
                "source": {
                    "endpoint": "https://directory.spineservices.nhs.uk/STU3/Organization/RBA"
                },
                "focus":  [
                    {
                        "type": "MedicationRequest",
                        "reference": "urn:uuid:a54219b8-f741-4c47-b662-e4f8dfa49ab6"
                    }
                ]
            }
        },
        {
            "fullUrl": "urn:uuid:a54219b8-f741-4c47-b662-e4f8dfa49ab6",
            "resource": {
                "resourceType": "MedicationRequest",
                "extension":  [
                    {
                        "url": "https://fhir.nhs.uk/StructureDefinition/Extension-DM-PrescriptionType",
                        "valueCoding": {
                            "system": "https://fhir.nhs.uk/CodeSystem/prescription-type",
                            "code": "1201",
                            "display": "Outpatient Homecare Prescriber - Medical Prescriber"
                        }
                    },
                    {
                        "url": "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-MedicationRepeatInformation",
                        "extension":  [
                            {
                                "url": "numberOfPrescriptionsIssued",
                                "valueUnsignedInt": 1
                            },
                            {
                                "url": "authorisationExpiryDate",
                                "valueDateTime": "2020-08-07"
                            }
                        ]
                    }
                ],
                "identifier":  [
                    {
                        "system": "https://fhir.nhs.uk/Id/prescription-order-item-number",
                        "value": "a54219b8-f741-4c47-b662-e4f8dfa49ab6"
                    }
                ],
                "status": "active",
                "intent": "original-order",
                "category":  [
                    {
                        "coding":  [
                            {
                                "system": "http://terminology.hl7.org/CodeSystem/medicationrequest-category",
                                "code": "outpatient",
                                "display": "Outpatient"
                            }
                        ]
                    }
                ],
                "medicationCodeableConcept": {
                    "coding":  [
                        {
                            "system": "http://snomed.info/sct",
                            "code": "15517911000001104",
                            "display": "Methotrexate 10mg/0.2ml solution for injection pre-filled syringes"
                        }
                    ]
                },
                "subject": {
                    "reference": "urn:uuid:78d3c2eb-009e-4ec8-a358-b042954aa9b2"
                },
                "authoredOn": "2020-07-13T12:00:00+00:00",
                "requester": {
                    "reference": "urn:uuid:56166769-c1c4-4d07-afa8-132b5dfca666"
                },
                "basedOn":  [
                    {
                        "reference": "https://elmpt-hospitals.nhs.uk/MedicationRequest/654321"
                    }
                ],
                "groupIdentifier": {
                    "extension":  [
                        {
                            "url": "https://fhir.nhs.uk/StructureDefinition/Extension-DM-PrescriptionId",
                            "valueIdentifier": {
                                "system": "https://fhir.nhs.uk/Id/prescription",
                                "value": "ad945a29-85f8-439a-b590-6789719adc16"
                            }
                        }
                    ],
                    "system": "https://fhir.nhs.uk/Id/prescription-order-number",
                    "value": "DC2C66-A1B2C3-23407B"
                },
                "courseOfTherapyType": {
                    "coding":  [
                        {
                            "system": "http://terminology.hl7.org/CodeSystem/medicationrequest-course-of-therapy",
                            "code": "continuous",
                            "display": "Continuous long term therapy"
                        }
                    ]
                },
                "dosageInstruction":  [
                    {
                        "text": "10 milligram, Inject, Subcutaneous route, once weekly",
                        "additionalInstruction":  [
                            {
                                "coding":  [
                                    {
                                        "system": "http://snomed.info/sct",
                                        "code": "421769005",
                                        "display": "Follow directions"
                                    }
                                ]
                            }
                        ],
                        "patientInstruction": "As directed",
                        "timing": {
                            "repeat": {
                                "boundsDuration": {
                                    "value": 10,
                                    "unit": "day",
                                    "system": "http://unitsofmeasure.org",
                                    "code": "d"
                                },
                                "frequency": 5,
                                "period": 1,
                                "periodUnit": "d"
                            }
                        },
                        "route": {
                            "coding":  [
                                {
                                    "system": "http://snomed.info/sct",
                                    "code": "34206005",
                                    "display": "Subcutaneous route"
                                }
                            ]
                        },
                        "method": {
                            "coding":  [
                                {
                                    "system": "http://snomed.info/sct",
                                    "code": "422145002",
                                    "display": "Inject"
                                }
                            ]
                        },
                        "doseAndRate":  [
                            {
                                "doseQuantity": {
                                    "value": 10,
                                    "unit": "milligram",
                                    "system": "http://unitsofmeasure.org",
                                    "code": "mg"
                                }
                            }
                        ]
                    }
                ],
                "dispenseRequest": {
                    "extension":  [
                        {
                            "url": "https://fhir.nhs.uk/StructureDefinition/Extension-DM-PerformerSiteType",
                            "valueCoding": {
                                "system": "https://fhir.nhs.uk/CodeSystem/dispensing-site-preference",
                                "code": "P2"
                            }
                        }
                    ],
                    "validityPeriod": {
                        "start": "2020-07-13T12:00:00+00:00",
                        "end": "2020-08-07T12:00:00+00:00"
                    },
                    "numberOfRepeatsAllowed": 0,
                    "quantity": {
                        "value": 1,
                        "unit": "Injection",
                        "system": "http://snomed.info/sct",
                        "code": "3092611000001103"
                    },
                    "expectedSupplyDuration": {
                        "value": 7,
                        "unit": "day",
                        "system": "http://unitsofmeasure.org",
                        "code": "d"
                    },
                    "performer": {
                        "identifier": {
                            "system": "https://fhir.nhs.uk/Id/ods-organization-code",
                            "value": "VNE51"
                        }
                    }
                },
                "substitution": {
                    "allowedBoolean": false
                }
            }
        },
        {
            "fullUrl": "urn:uuid:78d3c2eb-009e-4ec8-a358-b042954aa9b2",
            "resource": {
                "resourceType": "Patient",
                "identifier":  [
                    {
                        "system": "https://fhir.nhs.uk/Id/nhs-number",
                        "value": "9453740519"
                    }
                ],
                "name":  [
                    {
                        "use": "official",
                        "family": "CORY",
                        "given":  [
                            "ETTA"
                        ],
                        "prefix":  [
                            "MISS"
                        ]
                    }
                ],
                "gender": "female",
                "birthDate": "1999-01-04",
                "address":  [
                    {
                        "use": "home",
                        "line":  [
                            "123 Dale Avenue",
                            "Long Eaton",
                            "Nottingham"
                        ],
                        "postalCode": "NG10 1NP"
                    }
                ],
                "generalPractitioner":  [
                    {
                        "identifier": {
                            "system": "https://fhir.nhs.uk/Id/ods-organization-code",
                            "value": "B81001"
                        }
                    }
                ]
            }
        },
        {
            "fullUrl": "urn:uuid:56166769-c1c4-4d07-afa8-132b5dfca666",
            "resource": {
                "resourceType": "PractitionerRole",
                "identifier":  [
                    {
                        "system": "https://fhir.nhs.uk/Id/sds-role-profile-id",
                        "value": "100102238986"
                    },
                    {
                        "system": "https://fhir.hl7.org.uk/Id/nhsbsa-spurious-code",
                        "value": "G6345213"
                    }
                ],
                "practitioner": {
                    "reference": "urn:uuid:a8c85454-f8cb-498d-9629-78e2cb5fa47a"
                },
                "organization": {
                    "reference": "urn:uuid:3b4b03a5-52ba-4ba6-9b82-70350aa109d8"
                },
                "healthcareService":  [
                    {
                        "reference": "urn:uuid:54b0506d-49af-4245-9d40-d7d64902055e"
                    }
                ],
                "specialty":  [
                    {
                        "coding":  [
                            {
                                "system": "https://fhir.hl7.org.uk/CodeSystem/UKCore-PracticeSettingCode",
                                "code": "370",
                                "display": "MEDICAL ONCOLOGY"
                            }
                        ]
                    }
                ],
                "code":  [
                    {
                        "coding":  [
                            {
                                "system": "https://fhir.hl7.org.uk/CodeSystem/UKCore-SDSJobRoleName",
                                "code": "R8000"
                            }
                        ]
                    }
                ],
                "location":  [
                    {
                        "reference": "urn:uuid:044e7916-c697-4072-880e-ef44d3032962",
                        "display": "MUSGROVE PARK HOSPITAL"
                    }
                ],
                "telecom":  [
                    {
                        "system": "phone",
                        "value": "01234567890",
                        "use": "work"
                    }
                ]
            }
        },
        {
            "fullUrl": "urn:uuid:28828c55-8fa7-42d7-916f-fcf076e0c10e",
            "resource": {
                "resourceType": "Provenance",
                "target":  [
                    {
                        "reference": "urn:uuid:a54219b8-f741-4c47-b662-e4f8dfa49ab6"
                    }
                ],
                "recorded": "2008-02-27T11:38:00+00:00",
                "agent":  [
                    {
                        "who": {
                            "reference": "urn:uuid:56166769-c1c4-4d07-afa8-132b5dfca666"
                        }
                    }
                ],
                "signature":  [
                    {
                        "type":  [
                            {
                                "system": "urn:iso-astm:E1762-95:2013",
                                "code": "1.2.840.10065.1.12.1.1"
                            }
                        ],
                        "when": "2020-09-02T11:38:00+00:00",
                        "who": {
                            "reference": "urn:uuid:56166769-c1c4-4d07-afa8-132b5dfca666"
                        },
                        "data": "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"
                    }
                ]
            }
        },
        {
            "fullUrl": "urn:uuid:044e7916-c697-4072-880e-ef44d3032962",
            "resource": {
                "resourceType": "Location",
                "identifier":  [
                    {
                        "use": "official",
                        "system": "https://fhir.nhs.uk/Id/ods-organization-code",
                        "value": "RBA11"
                    }
                ],
                "status": "active",
                "mode": "instance",
                "address": {
                    "use": "work",
                    "line":  [
                        "MUSGROVE PARK HOSPITAL"
                    ],
                    "city": "TAUNTON",
                    "postalCode": "TA1 5DA",
                    "country": "NLD"
                }
            }
        },
        {
            "fullUrl": "urn:uuid:a8c85454-f8cb-498d-9629-78e2cb5fa47a",
            "resource": {
                "resourceType": "Practitioner",
                "id": "a8c85454-f8cb-498d-9629-78e2cb5fa47a",
                "identifier":  [
                    {
                        "system": "https://fhir.hl7.org.uk/Id/gmc-number",
                        "value": "C1234567"
                    }
                ],
                "name":  [
                    {
                        "family": "ALI",
                        "given":  [
                            "RAZIA"
                        ],
                        "prefix":  [
                            "DR"
                        ]
                    }
                ]
            }
        },
        {
            "fullUrl": "urn:uuid:3b4b03a5-52ba-4ba6-9b82-70350aa109d8",
            "resource": {
                "resourceType": "Organization",
                "id": "3b4b03a5-52ba-4ba6-9b82-70350aa109d8",
                "identifier":  [
                    {
                        "system": "https://fhir.nhs.uk/Id/ods-organization-code",
                        "value": "RBA"
                    }
                ],
                "name": "TAUNTON AND SOMERSET NHS FOUNDATION TRUST",
                "address":  [
                    {
                        "line":  [
                            "MUSGROVE PARK HOSPITAL",
                            "PARKFIELD DRIVE",
                            "TAUNTON"
                        ],
                        "postalCode": "TA1 5DA"
                    }
                ],
                "telecom":  [
                    {
                        "system": "phone",
                        "value": "01823333444",
                        "use": "work"
                    }
                ]
            }
        },
        {
            "fullUrl": "urn:uuid:54b0506d-49af-4245-9d40-d7d64902055e",
            "resource": {
                "resourceType": "HealthcareService",
                "id": "54b0506d-49af-4245-9d40-d7d64902055e",
                "identifier":  [
                    {
                        "use": "official",
                        "system": "https://fhir.nhs.uk/Id/ods-organization-code",
                        "value": "A99968"
                    }
                ],
                "active": true,
                "location":  [
                    {
                        "reference": "urn:uuid:044e7916-c697-4072-880e-ef44d3032962"
                    }
                ],
                "name": "SOMERSET BOWEL CANCER SCREENING CENTRE",
                "telecom":  [
                    {
                        "system": "phone",
                        "value": "01823 333444",
                        "use": "work"
                    }
                ]
            }
        }
    ]
}

<Bundle xmlns="http://hl7.org/fhir">
    <id value="hce-DC2C66-A1B2C3-23407B" />
    <meta>
        <lastUpdated value="2021-07-29T01:43:30+00:00" />
    </meta>
    <identifier>
        <system value="https://tools.ietf.org/html/rfc4122" />
        <value value="ad945a29-85f8-439a-b590-6789719adc16" />
    </identifier>
    <type value="message" />
    <timestamp value="2020-11-02T01:44:30+00:00" />
    <entry>
        <fullUrl value="urn:uuid:311316d3-1de0-4f7c-8109-c950ead1c717" />
        <resource>
            <MessageHeader>
                <eventCoding>
                    <system value="https://fhir.nhs.uk/CodeSystem/message-event" />
                    <code value="prescription-order" />
                    <display value="Prescription Order" />
                </eventCoding>
                <source>
                    <endpoint value="https://directory.spineservices.nhs.uk/STU3/Organization/RBA" />
                </source>
                <focus>
                    <reference value="urn:uuid:a54219b8-f741-4c47-b662-e4f8dfa49ab6" />
                    <type value="MedicationRequest" />
                </focus>
            </MessageHeader>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:a54219b8-f741-4c47-b662-e4f8dfa49ab6" />
        <resource>
            <MedicationRequest>
                <extension url="https://fhir.nhs.uk/StructureDefinition/Extension-DM-PrescriptionType">
                    <valueCoding>
                        <system value="https://fhir.nhs.uk/CodeSystem/prescription-type" />
                        <code value="1201" />
                        <display value="Outpatient Homecare Prescriber - Medical Prescriber" />
                    </valueCoding>
                </extension>
                <extension url="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-MedicationRepeatInformation">
                    <extension url="numberOfPrescriptionsIssued">
                        <valueUnsignedInt value="1" />
                    </extension>
                    <extension url="authorisationExpiryDate">
                        <valueDateTime value="2020-08-07" />
                    </extension>
                </extension>
                <identifier>
                    <system value="https://fhir.nhs.uk/Id/prescription-order-item-number" />
                    <value value="a54219b8-f741-4c47-b662-e4f8dfa49ab6" />
                </identifier>
                <status value="active" />
                <intent value="original-order" />
                <category>
                    <coding>
                        <system value="http://terminology.hl7.org/CodeSystem/medicationrequest-category" />
                        <code value="outpatient" />
                        <display value="Outpatient" />
                    </coding>
                </category>
                <medicationCodeableConcept>
                    <coding>
                        <system value="http://snomed.info/sct" />
                        <code value="15517911000001104" />
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