UK Core Implementation Guide STU3 Sequence

Please note:

This version is not suitable for implementation. It's purpose is to provide FHIR assets and guidance in support of Clinical and Technical Assurance Sprint 6. Other versions of the UK Core are available: here
Please follow the guidance in the C&TA Sprint 6 pack to provide feedback.
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`medication[x]`

Important: Rules for determining the value of this element when constructing the resource from other FHIR resources.

When only a `MedicationRequest` is known

Rule: Use the medication defined within the MedicationStatement.basedOn.reference: MedicationRequest.medication[x]

When only a `MedicationDispense` is known

Rule: Use the medication defined within the MedicationStatement.partOf.reference:MedicationDispense.medication[x].

When both the `MedicationRequest` and `MedicationDispense` are known

Rule: Where different dm+d concepts are used within the MedicationStatement.basedOn.reference:MedicationRequest.medication[x] and MedicationDispense.partOf.reference:MedicationDispense.medication[x], use the medication defined within the MedicationStatement.partOf.reference:MedicationDispense.medication[x].

The dispensing record will be the most specific and accurate for what will be given to the patient.

Also note that the MedicationDispense.dosageInstruction may differ from that stated in the MedicationRequest.dosageInstruction. The pharmacy team may have applied their own dosage instruction to make it more suitable for a medicine's administration label.

When both the `MedicationRequest` and `MedicationDispense` are not known

Rule: Use the medication information available within the source clinical system.

Medication WITH dm+d code

Where a dm+d code exists it SHALL be used either as MedicationStatement.medicationCodeableConcept.coding or as MedicationStatement.medicationReference:Medication.code.

Where CodeableConcept is used, MedicationStatement.medicationCodeableConcept.coding is the dm+d code and MedicationStatement.medicationCodeableConcept.text is dm+d concept name/description.

Can be either a dm+d code as a CodeableConcept or reference to Profile UKCore-Medication resource. Using a CodeableConcept is preferred unless additional data if required that would be contained within a Profile UKCore-Medication resource.

The elements MedicationStatement.medicationCodeableConcept.coding and MedicationStatement.medicationReference:Medication.code are both bound to ValueSet UKCore-MedicationCode

Examples where a reference to a Profile UKCore-Medication would be applicable include:

Record a VTM with a specific form
Record manufacturer with a concept as described in ValueSet UKCore-MedicationCode
Record batch number
Record ingredients (for example with a magisterial prescription or an excipient).

Medication WITHOUT dm+d code

Medication not published within the dm+d may be requested in the Acute care setting.

In this scenario it is recommended to use the CodeableConcept variant for this element.

If the prescribing system has both a locally assigned code and description for the medication then;

The MedicationStatement.medicationCodeableConcept.text SHOULD be the description for the medication.
The MedicationStatement.medicationCodeableConcept.coding.code SHOULD be the code for the medication.
The MedicationStatement.medicationCodeableConcept.coding.display SHOULD be the description for the medication, i.e. the same value as MedicationStatement.medicationCodeableConcept.text.

If the prescribing system only has a description for the medication then;

The MedicationStatement.medicationCodeableConcept.text SHOULD be the locally assigned description for the medication.

medication[x]

Important: Rules for determining the value of this element when constructing the resource from other FHIR resources.

When only a MedicationRequest is known

When only a MedicationDispense is known

When both the MedicationRequest and MedicationDispense are known