UK Core Implementation Guide 0.2.0 - STU1

StructureDefinition-UKCore-Medication

Defines the UK Core constraints and extensions on the Medication resource for the minimal set of data to query and retrieve medication information.

Profile Purpose

This profile is primarily used for the identification and definition of a medication for the purposes of prescribing, dispensing, and administering a medication as well as for making statements about medication use.

Snapshot View

MedicationTradeFamilyI0..1Extension(CodeableConcept)
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
codeΣ1..1CodeableConceptBinding
statusΣ ?!0..1codeBinding
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
form0..1CodeableConceptBinding
amountΣ I0..1Ratio
itemCodeableConceptCodeableConcept
itemReferenceReference(Substance | UK Core Medication)
isActive0..1boolean
strengthI0..1Ratio
lotNumber0..1string
expirationDate0..1dateTime

Differential View

MedicationTradeFamilyI0..1Extension(CodeableConcept)
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
codeΣ1..1CodeableConceptBinding
statusΣ ?!0..1codeBinding
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
form0..1CodeableConceptBinding
amountΣ I0..1Ratio
itemCodeableConceptCodeableConcept
itemReferenceReference(Substance | UK Core Medication)
isActive0..1boolean
strengthI0..1Ratio
lotNumber0..1string
expirationDate0..1dateTime

Hybrid View

MedicationTradeFamilyI0..1Extension(CodeableConcept)
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
codeΣ1..1CodeableConceptBinding
statusΣ ?!0..1codeBinding
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
form0..1CodeableConceptBinding
amountΣ I0..1Ratio
itemCodeableConceptCodeableConcept
itemReferenceReference(Substance | UK Core Medication)
isActive0..1boolean
strengthI0..1Ratio
lotNumber0..1string
expirationDate0..1dateTime

Table View

Medication..
Medication.extension..
Medication.extensionExtension..
Medication.identifier..
Medication.identifier.assignerReference(UK Core Organization)..
Medication.code1..
Medication.manufacturerReference(UK Core Organization)..
Medication.manufacturer.identifier..
Medication.manufacturer.identifier.assignerReference(UK Core Organization)..
Medication.form..
Medication.ingredient..
Medication.ingredient.item[x]CodeableConcept, Reference(Substance | UK Core Medication)..


XML View

<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="UKCore-Medication" />
    <url value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Medication" />
    <version value="2.1.0" />
    <name value="UKCoreMedication" />
    <title value="UK Core Medication" />
    <status value="active" />
    <date value="2021-09-10" />
    <publisher value="HL7 UK" />
    <contact>
        <name value="HL7 UK" />
        <telecom>
            <system value="email" />
            <value value="secretariat@hl7.org.uk" />
            <use value="work" />
            <rank value="1" />
        </telecom>
    </contact>
    <contact>
        <name value="NHS Digital" />
        <telecom>
            <system value="email" />
            <value value="interoperabilityteam@nhs.net" />
            <use value="work" />
            <rank value="2" />
        </telecom>
    </contact>
    <description value="Defines the UK Core constraints and extensions on the Medication resource for the minimal set of data to query and retrieve medication information." />
    <purpose value="This profile is primarily used for the identification and definition of a medication for the purposes of prescribing, dispensing, and administering a medication as well as for making statements about medication use." />
    <copyright value="Copyright &#169; 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the &quot;License&quot;); you may not use this file except in compliance with the License. You may obtain a copy of the License at  http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an &quot;AS IS&quot; BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7&#174; FHIR&#174; standard Copyright &#169; 2011+ HL7 The HL7&#174; FHIR&#174; standard is used under the FHIR license. You may obtain a copy of the FHIR license at  https://www.hl7.org/fhir/license.html." />
    <fhirVersion value="4.0.1" />
    <mapping>
        <identity value="script10.6" />
        <uri value="http://ncpdp.org/SCRIPT10_6" />
        <name value="Mapping to NCPDP SCRIPT 10.6" />
    </mapping>
    <mapping>
        <identity value="rim" />
        <uri value="http://hl7.org/v3" />
        <name value="RIM Mapping" />
    </mapping>
    <mapping>
        <identity value="w5" />
        <uri value="http://hl7.org/fhir/fivews" />
        <name value="FiveWs Pattern Mapping" />
    </mapping>
    <mapping>
        <identity value="v2" />
        <uri value="http://hl7.org/v2" />
        <name value="HL7 v2 Mapping" />
    </mapping>
    <kind value="resource" />
    <abstract value="false" />
    <type value="Medication" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Medication" />
    <derivation value="constraint" />
    <differential>
        <element id="Medication.extension">
            <path value="Medication.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <rules value="open" />
            </slicing>
        </element>
        <element id="Medication.extension:MedicationTradeFamily">
            <path value="Medication.extension" />
            <sliceName value="MedicationTradeFamily" />
            <short value="A Trade Family or brand associated with a Medication, in particular a Virtual Therapeutic Moiety (VTM)" />
            <definition value="A Trade Family or brand associated with a Medication, in particular a Virtual Therapeutic Moiety (VTM)." />
            <type>
                <code value="Extension" />
                <profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-MedicationTradeFamily" />
            </type>
        </element>
        <element id="Medication.identifier.assigner">
            <path value="Medication.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="Medication.code">
            <path value="Medication.code" />
            <min value="1" />
            <binding>
                <strength value="extensible" />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationCode" />
            </binding>
        </element>
        <element id="Medication.manufacturer">
            <path value="Medication.manufacturer" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="Medication.manufacturer.identifier.assigner">
            <path value="Medication.manufacturer.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="Medication.form">
            <path value="Medication.form" />
            <binding>
                <strength value="extensible" />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationForm" />
            </binding>
        </element>
        <element id="Medication.ingredient.item[x]">
            <path value="Medication.ingredient.item[x]" />
            <type>
                <code value="CodeableConcept" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Substance" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Medication" />
            </type>
        </element>
    </differential>
</StructureDefinition>

JSON View

{
    "resourceType": "StructureDefinition",
    "id": "UKCore-Medication",
    "url": "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Medication",
    "version": "2.1.0",
    "name": "UKCoreMedication",
    "title": "UK Core Medication",
    "status": "active",
    "date": "2021-09-10",
    "publisher": "HL7 UK",
    "contact":  [
        {
            "name": "HL7 UK",
            "telecom":  [
                {
                    "system": "email",
                    "value": "secretariat@hl7.org.uk",
                    "use": "work",
                    "rank": 1
                }
            ]
        },
        {
            "name": "NHS Digital",
            "telecom":  [
                {
                    "system": "email",
                    "value": "interoperabilityteam@nhs.net",
                    "use": "work",
                    "rank": 2
                }
            ]
        }
    ],
    "description": "Defines the UK Core constraints and extensions on the Medication resource for the minimal set of data to query and retrieve medication information.",
    "purpose": "This profile is primarily used for the identification and definition of a medication for the purposes of prescribing, dispensing, and administering a medication as well as for making statements about medication use.",
    "copyright": "Copyright © 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the \"License\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at  http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \"AS IS\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at  https://www.hl7.org/fhir/license.html.",
    "fhirVersion": "4.0.1",
    "mapping":  [
        {
            "identity": "script10.6",
            "uri": "http://ncpdp.org/SCRIPT10_6",
            "name": "Mapping to NCPDP SCRIPT 10.6"
        },
        {
            "identity": "rim",
            "uri": "http://hl7.org/v3",
            "name": "RIM Mapping"
        },
        {
            "identity": "w5",
            "uri": "http://hl7.org/fhir/fivews",
            "name": "FiveWs Pattern Mapping"
        },
        {
            "identity": "v2",
            "uri": "http://hl7.org/v2",
            "name": "HL7 v2 Mapping"
        }
    ],
    "kind": "resource",
    "abstract": false,
    "type": "Medication",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Medication",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "Medication.extension",
                "path": "Medication.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "rules": "open"
                }
            },
            {
                "id": "Medication.extension:MedicationTradeFamily",
                "path": "Medication.extension",
                "sliceName": "MedicationTradeFamily",
                "short": "A Trade Family or brand associated with a Medication, in particular a Virtual Therapeutic Moiety (VTM)",
                "definition": "A Trade Family or brand associated with a Medication, in particular a Virtual Therapeutic Moiety (VTM).",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-MedicationTradeFamily"
                        ]
                    }
                ]
            },
            {
                "id": "Medication.identifier.assigner",
                "path": "Medication.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "Medication.code",
                "path": "Medication.code",
                "min": 1,
                "binding": {
                    "strength": "extensible",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationCode"
                }
            },
            {
                "id": "Medication.manufacturer",
                "path": "Medication.manufacturer",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "Medication.manufacturer.identifier.assigner",
                "path": "Medication.manufacturer.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "Medication.form",
                "path": "Medication.form",
                "binding": {
                    "strength": "extensible",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationForm"
                }
            },
            {
                "id": "Medication.ingredient.item[x]",
                "path": "Medication.ingredient.item[x]",
                "type":  [
                    {
                        "code": "CodeableConcept"
                    },
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Substance",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Medication"
                        ]
                    }
                ]
            }
        ]
    }
}

Examples

TimoptolEyeDrops - An example to illustrate a representation of eye drops.

Example UKCore-Medication-TimoptolEyeDrops

Example Usage Scenarios

The UK Core Medication profile will likely not be used in isolation. It does not provide the context for the medication, e.g. the patient or medication related process. It will be typically used as a referenced resource within a MedicationRequest, MedicationDispense, MedicationAdministration or MedicationStatement.


Minimum Viable Dataset

A minimum viable dataset that all provider and consumer systems should support is the following elements.

Element Reason
code A dm+d code for the medication

Context For Provider Systems

Providers systems should view elements listed as part of the minimum viable dataset in the same way as FHIR Must Support elements. Where the data is available, the provider system should include this data within the resource. Additional elements populated may be ignored by consumer systems.

Context For Consumer Systems

Consumer systems should expect the elements listed as part of the minimum viable dataset to be populated, with business data that should be relevant for the processing of the resource. Additional elements may not be populated by provider systems.


Extension: MedicationTradeFamily

Extension UKCore-MedicationTradeFamily used to identify a Trade Family or brand associated with a Medication, specifically when the medication is defined using a dm+d Virtual Therapeutic Moiety (VTM) concept.


identifier

It is recommended this is the medication unique dm+d concept id. This use of this identifier will provide a unique mechanism to return a Medication resource in a RESTful implementation anywhere across the NHS.

For example;

<reference value="https://myFHIRserver/medication/87652004"/>

Where 87652004 in this example is the unique dm+d concept id for the Virtual Therapeutic Moiety for Atenolol.

Note: Where a medication is not within the dm+d and therefore does not have a dm+d code then the approach will be a local implementation decision.

If you have a local FHIR Medication Resource server that is being used to share drug data then using the Medication Reference URL is acceptable.

If the data is being shared outside of the local environment then the Medication resource should only reference dm+d data.


code (Mandatory)

All medication must be represented using the NHS dm+d terminology.

  • The code.coding.system must be https://dmd.nhs.uk/.
  • The code.coding.code must be the NHS dm+d concept code.
  • The code.coding.display must be the NHS dm+d concept description.

status

Optional.


manufacturer

Optional.


form

Optional.

Within the dm+d terminology, the Virtual Medicinal Product (VMP), Actual Medicinal Product (AM), Virtual Medicinal Product Pack (VMPP) and Actual Medicinal Product Pack (AMPP) concepts include a coded form.

This element should be used where a medication is identified using a dm+d Virtual Theraputic Moeity (VTM) concept and the prescriber wishes to qualify the VTM with a coded form.


amount

Optional.


ingredient

Optional.


batch

Optional.


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