Implementation guide for interoperable medicines

This guidance is under active development by NHS England and content may be added or updated on a regular basis.

Admission, Discharge and change in Medication / Chris Packet

This example is in the process of being updated...

Patient Journey: Chris Packet

  1. Chris is prescribed repeat medication of Paracetamol, Codeine and Ibuprofen by his GP. This is via the EPS and is out of scope for this implementation guide. Please assume the GP record of 'current medication' has been shared with the regional shared medication record.
  2. Chris is admitted to hospital. A medicines reconcillation process is undertaken. The ePMA system receives a Bundle of MedicationStatement resources [Example 1] from the regional shared medication record.
  3. The hospital doctor stops the Codeine medication and starts Pregabalin medication. A MedicationRequest [Example 2] is sent to the hospital pharmacy, unless the medication is available from ward stock.
  4. If sent to the hospital pharmacy, they dispense and return a MedicationDispense [Example 3] to the ePMA system.
  5. Chris is to be discharged and given two weeks supply of medication as a 'To Take Out' (TTO). A MedicationRequest [Example 4] is sent to the hospital pharmacy, unless the medication is available from ward stock.
  6. If sent to the hospital pharmacy, they dispense and return a MedicationDispense [Example 5] to the ePMA system.
  7. Chris' discharge medications are verified by a pharmacist. Due to Chris also on renal medication, the on-going dosage for the GP to continue Pregabalin is changed. Two MedicationStatement [Example 6] resources are sent to the regional shared medication record stating that Codeine medication has been stopped and Pregabalin, with the amended dose, has been started. A discharge summary is sent to Chris' GP requesting that their records are updated to stop Codeine and start Pregabalin.
  8. The GP actions the discharge instructions, changes Chris' repeat medication and authorises a new prescription for his medication in time for when his TTO supply runs out. This is via the EPS and is out of scope for this implementation guide.
  9. When the regional shared medication record is next updated from GP records it will include a MedicationStatement for the stopped Codeine medication, and a MedicationStatement for the new Pregabalin medication. See [Example 7].

Expected Outcome

At the start of this scenario, the patient's current medication is:

  • Paracetamol 500mg tablets - take 2 tablets - four times - daily - oral
  • Codeine 30mg tablets - take 2 tablets - four times - daily - oral
  • Ibuprofen 800mg modified-release tablets - take one - two times - daily - oral

At the end of this scenario, the patient's current medication is:

  • Paracetamol 500mg tablets - take 2 tablets - four times - daily - oral
  • [STOPPED] Codeine 30mg tablets - take 2 tablets - four times - daily - oral
  • Ibuprofen 800mg modified-release tablets - take one - two times - daily - oral
  • Pregabalin 100mg tablets - two times per day - oral

Note: The data held within a shared record should be fully structured and coded. Text is shown here to aid human readability.

Example 1: GP MedicationStatement

Note: This example below is a draft and requires clinical verification.

Chris currently has three active medications:

  1. Paracetamol 500mg tablet - take 2 tablets - four times - daily - oral
  2. Codeine 30mg tablet - take 2 tablets - four times - daily - oral
  3. Ibuprofen 800mg modified-release tablet - take one - two times - daily - oral

Actors

Provider System = GP System

Consumer System = Any system requiring a view of current medication, including a shared patient record

Example

<Bundle xmlns="http://hl7.org/fhir">
    <id value="7cd3f180-76f7-4bc6-b6d5-e672acd83b81" />
    <identifier>
        <system value="urn:[organisation_name]:[system_name]" />
        <value value="urn:8cd8108d-8c72-4fe9-a284-cd28b127fcfa" />
    </identifier>
    <type value="message" />
    <timestamp value="2021-05-07T13:00:25Z" />
    <!--   Message Header   -->
    <entry>
        <fullUrl value="urn:message-header-234234234" />
        <resource>
            <MessageHeader>
                <id value="message-header-234234234" />
                <eventCoding>
                    <system value="http://hl7.org/fhir/message-events" />
                    <code value="current-medication" />
                    <display value="Current Medication" />
                </eventCoding>
                <source>
                    <name value="ACME GP Systems" />
                    <software value="ACME GP" />
                    <version value="5.5.00" />
                    <endpoint value="urn:nhs-uk:addressing:ods:M12345" />
                </source>
                <focus>
                    <reference value="urn:medication-statement-1234" />
                </focus>
                <focus>
                    <reference value="urn:medication-statement-3452456" />
                </focus>
                <focus>
                    <reference value="urn:medication-statement-876543" />
                </focus>
            </MessageHeader>
        </resource>
    </entry>
    <!--  // Patient associated with the encounter  -->
    <entry>
        <fullUrl value="urn:patient-01912" />
        <resource>
            <Patient>
                <id value="patient-01912" />
                <identifier>
                    <system value="https://fhir.nhs.uk/Id/nhs-number" />
                    <value value="4857773456" />
                </identifier>
                <name>
                    <use value="official" />
                    <text value="Mr Chris Packet" />
                    <family value="Packet" />
                    <given value="Chris" />
                    <prefix value="Mr" />
                </name>
                <gender value="male" />
                <birthDate value="1995-11-12" />
            </Patient>
        </resource>
    </entry>
    <!--  // Prescribing clinician associated with the encounter.   -->
    <entry>
        <fullUrl value="urn:staff-0002" />
        <resource>
            <Practitioner>
                <id value="staff-0002" />
                <name>
                    <text value="Dr Maikeu Better" />
                    <family value="Better" />
                    <given value="Maikeu" />
                    <prefix value="Dr" />
                </name>
                <qualification>
                    <code>
                        <coding>
                            <system value="https://fhir.hl7.org.uk/Id/gmc-number" />
                            <code value="2145879" />
                            <display value="General Medical Council" />
                        </coding>
                    </code>
                </qualification>
            </Practitioner>
        </resource>
    </entry>
    <!--  // Medication #1: Paracetamol 500mg tablets  -->
    <entry>
        <fullUrl value="urn:medication-685463" />
        <resource>
            <Medication>
                <id value="medication-685463" />
                <code>
                    <coding>
                        <system value="http://snomed.info/sct" />
                        <code value="90332006" />
                        <display value="Paracetamol 500mg tablets" />
                    </coding>
                </code>
            </Medication>
        </resource>
    </entry>
    <!--  // MedicationStatement #1: Paracetamol 500mg tablets  -->
    <entry>
        <fullUrl value="urn:medication-statement-1234" />
        <resource>
            <MedicationStatement>
                <id value="medication-statement-1234" />
                <status value="active" />
                <category>
                    <coding>
                        <system value="http://hl7.org/fhir/medication-request-category" />
                        <code value="patientspecified" />
                        <display value="patientspecified" />
                    </coding>
                </category>
                <medicationReference>
                    <reference value="medication-685463" />
                    <display value="Paracetamol 500mg tablets" />
                </medicationReference>
                <subject>
                    <reference value="patient-01912" />
                    <display value="Mr Chris PACKET" />
                </subject>
                <dateAsserted value="2021-05-07T13:00:25Z" />
                <informationSource>
                    <reference value="staff-0002" />
                    <display value="Dr Maikeu Better" />
                </informationSource>
                <dosage>
                    <timing>
                        <repeat>
                            <frequency value="4" />
                            <period value="1" />
                            <periodUnit value="d" />
                        </repeat>
                    </timing>
                    <route>
                        <coding>
                            <system value="http://snomed.info/sct" />
                            <code value="26643006" />
                            <display value="oral" />
                        </coding>
                    </route>
                    <doseAndRate>
                        <doseQuantity>
                            <value value="2" />
                            <unit value="tablet" />
                            <system value="http://snomed.info/sct" />
                            <code value="428673006" />
                        </doseQuantity>
                    </doseAndRate>
                </dosage>
            </MedicationStatement>
        </resource>
    </entry>
    <!--  // Medication #2: Codeine 30mg tablet -->
    <entry>
        <fullUrl value="urn:medication-634523423" />
        <resource>
            <Medication>
                <id value="medication-634523423" />
                <code>
                    <coding>
                        <system value="http://snomed.info/sct" />
                        <code value="322503009" />
                        <display value="Codeine 30mg tablets" />
                    </coding>
                </code>
            </Medication>
        </resource>
    </entry>
    <!--  // MedicationStatement #2: Codeine 30mg tablet  -->
    <entry>
        <fullUrl value="urn:medication-statement-3452456" />
        <resource>
            <MedicationStatement>
                <id value="medication-statement-3452456" />
                <status value="active" />
                <category>
                    <coding>
                        <system value="http://hl7.org/fhir/medication-request-category" />
                        <code value="patientspecified" />
                        <display value="patientspecified" />
                    </coding>
                </category>
                <medicationReference>
                    <reference value="medication-634523423" />
                    <display value="Codeine 30mg tablets" />
                </medicationReference>
                <subject>
                    <reference value="patient-01912" />
                    <display value="Mr Chris PACKET" />
                </subject>
                <dateAsserted value="2021-05-07T13:00:25Z" />
                <informationSource>
                    <reference value="staff-0002" />
                    <display value="Dr Maikeu Better" />
                </informationSource>
                <dosage>
                    <timing>
                        <repeat>
                            <frequency value="4" />
                            <period value="1" />
                            <periodUnit value="d" />
                        </repeat>
                    </timing>
                    <route>
                        <coding>
                            <system value="http://snomed.info/sct" />
                            <code value="26643006" />
                            <display value="oral" />
                        </coding>
                    </route>
                    <doseAndRate>
                        <doseQuantity>
                            <value value="2" />
                            <unit value="tablet" />
                            <system value="http://snomed.info/sct" />
                            <code value="428673006" />
                        </doseQuantity>
                    </doseAndRate>
                </dosage>
            </MedicationStatement>
        </resource>
    </entry>
    <!--  // Medication #3: Ibuprofen 800mg modified-release tablets  -->
    <entry>
        <fullUrl value="urn:medication-784234" />
        <resource>
            <Medication>
                <id value="medication-784234" />
                <code>
                    <coding>
                        <system value="http://snomed.info/sct" />
                        <code value="39110311000001101" />
                        <display value="Ibuprofen 800mg modified-release tablets" />
                    </coding>
                </code>
            </Medication>
        </resource>
    </entry>
    <!--  // MedicationStatement #3: Ibuprofen 800mg modified-release tablets  -->
    <entry>
        <fullUrl value="urn:medication-statement-876543" />
        <resource>
            <MedicationStatement>
                <id value="medication-statement-876543" />
                <status value="active" />
                <category>
                    <coding>
                        <system value="http://hl7.org/fhir/medication-request-category" />
                        <code value="patientspecified" />
                        <display value="patientspecified" />
                    </coding>
                </category>
                <medicationReference>
                    <reference value="medication-634523423" />
                    <display value="Ibuprofen 800mg modified-release tablets" />
                </medicationReference>
                <subject>
                    <reference value="patient-01912" />
                    <display value="Mr Chris PACKET" />
                </subject>
                <dateAsserted value="2021-05-07T13:00:25Z" />
                <informationSource>
                    <reference value="staff-0002" />
                    <display value="Dr Maikeu Better" />
                </informationSource>
                <dosage>
                    <timing>
                        <repeat>
                            <frequency value="2" />
                            <period value="1" />
                            <periodUnit value="d" />
                        </repeat>
                    </timing>
                    <route>
                        <coding>
                            <system value="http://snomed.info/sct" />
                            <code value="26643006" />
                            <display value="oral" />
                        </coding>
                    </route>
                    <doseAndRate>
                        <doseQuantity>
                            <value value="1" />
                            <unit value="tablet" />
                            <system value="http://snomed.info/sct" />
                            <code value="428673006" />
                        </doseQuantity>
                    </doseAndRate>
                </dosage>
            </MedicationStatement>
        </resource>
    </entry>
</Bundle>

{
    "resourceType": "Bundle",
    "id": "7cd3f180-76f7-4bc6-b6d5-e672acd83b81",
    "identifier": {
        "system": "urn:[organisation_name]:[system_name]",
        "value": "urn:8cd8108d-8c72-4fe9-a284-cd28b127fcfa"
    },
    "type": "message",
    "timestamp": "05/07/2021 13:00:25",
    "entry":  [
        {
            "fullUrl": "urn:message-header-234234234",
            "resource": {
                "resourceType": "MessageHeader",
                "id": "message-header-234234234",
                "eventCoding": {
                    "system": "http://hl7.org/fhir/message-events",
                    "code": "current-medication",
                    "display": "Current Medication"
                },
                "source": {
                    "name": "ACME GP Systems",
                    "software": "ACME GP",
                    "version": "5.5.00",
                    "endpoint": "urn:nhs-uk:addressing:ods:M12345"
                },
                "focus":  [
                    {
                        "reference": "urn:medication-statement-1234"
                    },
                    {
                        "reference": "urn:medication-statement-3452456"
                    },
                    {
                        "reference": "urn:medication-statement-876543"
                    }
                ]
            }
        },
        {
            "fullUrl": "urn:patient-01912",
            "resource": {
                "resourceType": "Patient",
                "id": "patient-01912",
                "identifier":  [
                    {
                        "system": "https://fhir.nhs.uk/Id/nhs-number",
                        "value": "4857773456"
                    }
                ],
                "name":  [
                    {
                        "use": "official",
                        "text": "Mr Chris Packet",
                        "family": "Packet",
                        "given":  [
                            "Chris"
                        ],
                        "prefix":  [
                            "Mr"
                        ]
                    }
                ],
                "gender": "male",
                "birthDate": "1995-11-12"
            }
        },
        {
            "fullUrl": "urn:staff-0002",
            "resource": {
                "resourceType": "Practitioner",
                "id": "staff-0002",
                "name":  [
                    {
                        "text": "Dr Maikeu Better",
                        "family": "Better",
                        "given":  [
                            "Maikeu"
                        ],
                        "prefix":  [
                            "Dr"
                        ]
                    }
                ],
                "qualification":  [
                    {
                        "code": {
                            "coding":  [
                                {
                                    "system": "https://fhir.hl7.org.uk/Id/gmc-number",
                                    "code": "2145879",
                                    "display": "General Medical Council"
                                }
                            ]
                        }
                    }
                ]
            }
        },
        {
            "fullUrl": "urn:medication-685463",
            "resource": {
                "resourceType": "Medication",
                "id": "medication-685463",
                "code": {
                    "coding":  [
                        {
                            "system": "http://snomed.info/sct",
                            "code": "90332006",
                            "display": "Paracetamol 500mg tablets"
                        }
                    ]
                }
            }
        },
        {
            "fullUrl": "urn:medication-statement-1234",
            "resource": {
                "resourceType": "MedicationStatement",
                "id": "medication-statement-1234",
                "status": "active",
                "category": {
                    "coding":  [
                        {
                            "system": "http://hl7.org/fhir/medication-request-category",
                            "code": "patientspecified",
                            "display": "patientspecified"
                        }
                    ]
                },
                "medicationReference": {
                    "reference": "medication-685463",
                    "display": "Paracetamol 500mg tablets"
                },
                "subject": {
                    "reference": "patient-01912",
                    "display": "Mr Chris PACKET"
                },
                "dateAsserted": "05/07/2021 13:00:25",
                "informationSource": {
                    "reference": "staff-0002",
                    "display": "Dr Maikeu Better"
                },
                "dosage":  [
                    {
                        "timing": {
                            "repeat": {
                                "frequency": 4,
                                "period": 1,
                                "periodUnit": "d"
                            }
                        },
                        "route": {
                            "coding":  [
                                {
                                    "system": "http://snomed.info/sct",
                                    "code": "26643006",
                                    "display": "oral"
                                }
                            ]
                        },
                        "doseAndRate":  [
                            {
                                "doseQuantity": {
                                    "value": 2,
                                    "unit": "tablet",
                                    "system": "http://snomed.info/sct",
                                    "code": "428673006"
                                }
                            }
                        ]
                    }
                ]
            }
        },
        {
            "fullUrl": "urn:medication-634523423",
            "resource": {
                "resourceType": "Medication",
                "id": "medication-634523423",
                "code": {
                    "coding":  [
                        {
                            "system": "http://snomed.info/sct",
                            "code": "322503009",
                            "display": "Codeine 30mg tablets"
                        }
                    ]
                }
            }
        },
        {
            "fullUrl": "urn:medication-statement-3452456",
            "resource": {
                "resourceType": "MedicationStatement",
                "id": "medication-statement-3452456",
                "status": "active",
                "category": {
                    "coding":  [
                        {
                            "system": "http://hl7.org/fhir/medication-request-category",
                            "code": "patientspecified",
                            "display": "patientspecified"
                        }
                    ]
                },
                "medicationReference": {
                    "reference": "medication-634523423",
                    "display": "Codeine 30mg tablets"
                },
                "subject": {
                    "reference": "patient-01912",
                    "display": "Mr Chris PACKET"
                },
                "dateAsserted": "05/07/2021 13:00:25",
                "informationSource": {
                    "reference": "staff-0002",
                    "display": "Dr Maikeu Better"
                },
                "dosage":  [
                    {
                        "timing": {
                            "repeat": {
                                "frequency": 4,
                                "period": 1,
                                "periodUnit": "d"
                            }
                        },
                        "route": {
                            "coding":  [
                                {
                                    "system": "http://snomed.info/sct",
                                    "code": "26643006",
                                    "display": "oral"
                                }
                            ]
                        },
                        "doseAndRate":  [
                            {
                                "doseQuantity": {
                                    "value": 2,
                                    "unit": "tablet",
                                    "system": "http://snomed.info/sct",
                                    "code": "428673006"
                                }
                            }
                        ]
                    }
                ]
            }
        },
        {
            "fullUrl": "urn:medication-784234",
            "resource": {
                "resourceType": "Medication",
                "id": "medication-784234",
                "code": {
                    "coding":  [
                        {
                            "system": "http://snomed.info/sct",
                            "code": "39110311000001101",
                            "display": "Ibuprofen 800mg modified-release tablets"
                        }
                    ]
                }
            }
        },
        {
            "fullUrl": "urn:medication-statement-876543",
            "resource": {
                "resourceType": "MedicationStatement",
                "id": "medication-statement-876543",
                "status": "active",
                "category": {
                    "coding":  [
                        {
                            "system": "http://hl7.org/fhir/medication-request-category",
                            "code": "patientspecified",
                            "display": "patientspecified"
                        }
                    ]
                },
                "medicationReference": {
                    "reference": "medication-634523423",
                    "display": "Ibuprofen 800mg modified-release tablets"
                },
                "subject": {
                    "reference": "patient-01912",
                    "display": "Mr Chris PACKET"
                },
                "dateAsserted": "05/07/2021 13:00:25",
                "informationSource": {
                    "reference": "staff-0002",
                    "display": "Dr Maikeu Better"
                },
                "dosage":  [
                    {
                        "timing": {
                            "repeat": {
                                "frequency": 2,
                                "period": 1,
                                "periodUnit": "d"
                            }
                        },
                        "route": {
                            "coding":  [
                                {
                                    "system": "http://snomed.info/sct",
                                    "code": "26643006",
                                    "display": "oral"
                                }
                            ]
                        },
                        "doseAndRate":  [
                            {
                                "doseQuantity": {
                                    "value": 1,
                                    "unit": "tablet",
                                    "system": "http://snomed.info/sct",
                                    "code": "428673006"
                                }
                            }
                        ]
                    }
                ]
            }
        }
    ]
}
Bundle.id[0]7cd3f180-76f7-4bc6-b6d5-e672acd83b81
Bundle.identifier[0].system[0]urn:[organisation_name]:[system_name]
Bundle.identifier[0].value[0]urn:8cd8108d-8c72-4fe9-a284-cd28b127fcfa
Bundle.type[0]message
Bundle.timestamp[0]2021-05-07T13:00:25+00:00
Bundle.entry[0].fullUrl[0]urn:message-header-234234234
Bundle.entry[0].resource[0].id[0]message-header-234234234
Bundle.entry[0].resource[0].event[0].system[0]http://hl7.org/fhir/message-events
Bundle.entry[0].resource[0].event[0].code[0]current-medication
Bundle.entry[0].resource[0].event[0].display[0]Current Medication
Bundle.entry[0].resource[0].source[0].name[0]ACME GP Systems
Bundle.entry[0].resource[0].source[0].software[0]ACME GP
Bundle.entry[0].resource[0].source[0].version[0]5.5.00
Bundle.entry[0].resource[0].source[0].endpoint[0]urn:nhs-uk:addressing:ods:M12345
Bundle.entry[0].resource[0].focus[0].reference[0]urn:medication-statement-1234
Bundle.entry[0].resource[0].focus[1].reference[0]urn:medication-statement-3452456
Bundle.entry[0].resource[0].focus[2].reference[0]urn:medication-statement-876543
Bundle.entry[1].fullUrl[0]urn:patient-01912
Bundle.entry[1].resource[0].id[0]patient-01912
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]4857773456
Bundle.entry[1].resource[0].name[0].use[0]official
Bundle.entry[1].resource[0].name[0].text[0]Mr Chris Packet
Bundle.entry[1].resource[0].name[0].family[0]Packet
Bundle.entry[1].resource[0].name[0].given[0]Chris
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]1995-11-12
Bundle.entry[2].fullUrl[0]urn:staff-0002
Bundle.entry[2].resource[0].id[0]staff-0002
Bundle.entry[2].resource[0].name[0].text[0]Dr Maikeu Better
Bundle.entry[2].resource[0].name[0].family[0]Better
Bundle.entry[2].resource[0].name[0].given[0]Maikeu
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]2145879
Bundle.entry[2].resource[0].qualification[0].code[0].coding[0].display[0]General Medical Council
Bundle.entry[3].fullUrl[0]urn:medication-685463
Bundle.entry[3].resource[0].id[0]medication-685463
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]90332006
Bundle.entry[3].resource[0].code[0].coding[0].display[0]Paracetamol 500mg tablets
Bundle.entry[4].fullUrl[0]urn:medication-statement-1234
Bundle.entry[4].resource[0].id[0]medication-statement-1234
Bundle.entry[4].resource[0].status[0]active
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]patientspecified
Bundle.entry[4].resource[0].category[0].coding[0].display[0]patientspecified
Bundle.entry[4].resource[0].medication[0].reference[0]medication-685463
Bundle.entry[4].resource[0].medication[0].display[0]Paracetamol 500mg tablets
Bundle.entry[4].resource[0].subject[0].reference[0]patient-01912
Bundle.entry[4].resource[0].subject[0].display[0]Mr Chris PACKET
Bundle.entry[4].resource[0].dateAsserted[0]2021-05-07T13:00:25Z
Bundle.entry[4].resource[0].informationSource[0].reference[0]staff-0002
Bundle.entry[4].resource[0].informationSource[0].display[0]Dr Maikeu Better
Bundle.entry[4].resource[0].dosage[0].timing[0].repeat[0].frequency[0]4
Bundle.entry[4].resource[0].dosage[0].timing[0].repeat[0].period[0]1
Bundle.entry[4].resource[0].dosage[0].timing[0].repeat[0].periodUnit[0]d
Bundle.entry[4].resource[0].dosage[0].route[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[4].resource[0].dosage[0].route[0].coding[0].code[0]26643006
Bundle.entry[4].resource[0].dosage[0].route[0].coding[0].display[0]oral
Bundle.entry[4].resource[0].dosage[0].doseAndRate[0].dose[0].value[0]2
Bundle.entry[4].resource[0].dosage[0].doseAndRate[0].dose[0].unit[0]tablet
Bundle.entry[4].resource[0].dosage[0].doseAndRate[0].dose[0].system[0]http://snomed.info/sct
Bundle.entry[4].resource[0].dosage[0].doseAndRate[0].dose[0].code[0]428673006
Bundle.entry[5].fullUrl[0]urn:medication-634523423
Bundle.entry[5].resource[0].id[0]medication-634523423
Bundle.entry[5].resource[0].code[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[5].resource[0].code[0].coding[0].code[0]322503009
Bundle.entry[5].resource[0].code[0].coding[0].display[0]Codeine 30mg tablets
Bundle.entry[6].fullUrl[0]urn:medication-statement-3452456
Bundle.entry[6].resource[0].id[0]medication-statement-3452456
Bundle.entry[6].resource[0].status[0]active
Bundle.entry[6].resource[0].category[0].coding[0].system[0]http://hl7.org/fhir/medication-request-category
Bundle.entry[6].resource[0].category[0].coding[0].code[0]patientspecified
Bundle.entry[6].resource[0].category[0].coding[0].display[0]patientspecified
Bundle.entry[6].resource[0].medication[0].reference[0]medication-634523423
Bundle.entry[6].resource[0].medication[0].display[0]Codeine 30mg tablets
Bundle.entry[6].resource[0].subject[0].reference[0]patient-01912
Bundle.entry[6].resource[0].subject[0].display[0]Mr Chris PACKET
Bundle.entry[6].resource[0].dateAsserted[0]2021-05-07T13:00:25Z
Bundle.entry[6].resource[0].informationSource[0].reference[0]staff-0002
Bundle.entry[6].resource[0].informationSource[0].display[0]Dr Maikeu Better
Bundle.entry[6].resource[0].dosage[0].timing[0].repeat[0].frequency[0]4
Bundle.entry[6].resource[0].dosage[0].timing[0].repeat[0].period[0]1
Bundle.entry[6].resource[0].dosage[0].timing[0].repeat[0].periodUnit[0]d
Bundle.entry[6].resource[0].dosage[0].route[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[6].resource[0].dosage[0].route[0].coding[0].code[0]26643006
Bundle.entry[6].resource[0].dosage[0].route[0].coding[0].display[0]oral
Bundle.entry[6].resource[0].dosage[0].doseAndRate[0].dose[0].value[0]2
Bundle.entry[6].resource[0].dosage[0].doseAndRate[0].dose[0].unit[0]tablet
Bundle.entry[6].resource[0].dosage[0].doseAndRate[0].dose[0].system[0]http://snomed.info/sct
Bundle.entry[6].resource[0].dosage[0].doseAndRate[0].dose[0].code[0]428673006
Bundle.entry[7].fullUrl[0]urn:medication-784234
Bundle.entry[7].resource[0].id[0]medication-784234
Bundle.entry[7].resource[0].code[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[7].resource[0].code[0].coding[0].code[0]39110311000001101
Bundle.entry[7].resource[0].code[0].coding[0].display[0]Ibuprofen 800mg modified-release tablets
Bundle.entry[8].fullUrl[0]urn:medication-statement-876543
Bundle.entry[8].resource[0].id[0]medication-statement-876543
Bundle.entry[8].resource[0].status[0]active
Bundle.entry[8].resource[0].category[0].coding[0].system[0]http://hl7.org/fhir/medication-request-category
Bundle.entry[8].resource[0].category[0].coding[0].code[0]patientspecified
Bundle.entry[8].resource[0].category[0].coding[0].display[0]patientspecified
Bundle.entry[8].resource[0].medication[0].reference[0]medication-634523423
Bundle.entry[8].resource[0].medication[0].display[0]Ibuprofen 800mg modified-release tablets
Bundle.entry[8].resource[0].subject[0].reference[0]patient-01912
Bundle.entry[8].resource[0].subject[0].display[0]Mr Chris PACKET
Bundle.entry[8].resource[0].dateAsserted[0]2021-05-07T13:00:25Z
Bundle.entry[8].resource[0].informationSource[0].reference[0]staff-0002
Bundle.entry[8].resource[0].informationSource[0].display[0]Dr Maikeu Better
Bundle.entry[8].resource[0].dosage[0].timing[0].repeat[0].frequency[0]2
Bundle.entry[8].resource[0].dosage[0].timing[0].repeat[0].period[0]1
Bundle.entry[8].resource[0].dosage[0].timing[0].repeat[0].periodUnit[0]d
Bundle.entry[8].resource[0].dosage[0].route[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[8].resource[0].dosage[0].route[0].coding[0].code[0]26643006
Bundle.entry[8].resource[0].dosage[0].route[0].coding[0].display[0]oral
Bundle.entry[8].resource[0].dosage[0].doseAndRate[0].dose[0].value[0]1
Bundle.entry[8].resource[0].dosage[0].doseAndRate[0].dose[0].unit[0]tablet
Bundle.entry[8].resource[0].dosage[0].doseAndRate[0].dose[0].system[0]http://snomed.info/sct
Bundle.entry[8].resource[0].dosage[0].doseAndRate[0].dose[0].code[0]428673006
Bundle

Example 2: Inpatient MedicationRequest

Note: This example below is a draft and requires clinical verification.

Chris is started on new medication. 75mg of Pregabalin twice per day for three days, increased to 75mg three times per day thereafter.

Actors

Provider System = Ward EMPA system

Consumer System = Hospital pharamcy system

Example

<Bundle xmlns="http://hl7.org/fhir">
    <id value="7d107ed2-70c6-43d9-9cbe-f19c319d1456" />
    <identifier>
        <system value="urn:[organisation_name]:[system_name]" />
        <value value="urn:8cd8108d-8c72-4fe9-a284-cd28b127fcfa" />
    </identifier>
    <type value="message" />
    <timestamp value="2021-05-07T16:15:32Z" />
    <!--    Message Header    -->
    <entry>
        <fullUrl value="urn:message-header-167434" />
        <resource>
            <MessageHeader>
                <id value="urn:message-header-167434" />
                <eventCoding>
                    <system value="https://fhir.hl7.org.uk//CodeSystem/message-event" />
                    <code value="prescription-order" />
                    <display value="Prescription Order" />
                </eventCoding>
                <source>
                    <name value="ACME Clinical Systems" />
                    <software value="ACME ePMA" />
                    <version value="3.5.68" />
                    <endpoint value="urn:nhs-uk:addressing:ods:T48NT" />
                </source>
                <focus>
                    <reference value="urn:med-req-01923" />
                </focus>
            </MessageHeader>
        </resource>
    </entry>
    <!--  // Patient associated with the encounter   -->
    <entry>
        <fullUrl value="urn:patient-01912" />
        <resource>
            <Patient>
                <id value="patient-01912" />
                <identifier>
                    <system value="https://fhir.nhs.uk/Id/nhs-number" />
                    <value value="4857773456" />
                </identifier>
                <name>
                    <use value="official" />
                    <text value="Mr Chris Packet" />
                    <family value="Packet" />
                    <given value="Chris" />
                    <prefix value="Mr" />
                </name>
                <gender value="male" />
                <birthDate value="1995-11-12" />
            </Patient>
        </resource>
    </entry>
    <!--  // Prescribing clinician associated with the encounter.   -->
    <entry>
        <fullUrl value="urn:staff-1112" />
        <resource>
            <Practitioner>
                <id value="staff-1112" />
                <name>
                    <text value="Dr Maikeu Well" />
                    <family value="Well" />
                    <given value="Maikeu" />
                    <prefix value="Dr" />
                </name>
                <qualification>
                    <code>
                        <coding>
                            <system value="https://fhir.hl7.org.uk/Id/gmc-number" />
                            <code value="2145879" />
                            <display value="General Medical Council" />
                        </coding>
                    </code>
                </qualification>
            </Practitioner>
        </resource>
    </entry>
    <!--  // Medication prescribed   -->
    <entry>
        <fullUrl value="urn:medication-99101" />
        <resource>
            <Medication>
                <id value="medication-99101" />
                <code>
                    <coding>
                        <system value="http://snomed.info/sct" />
                        <code value="415159003" />
                        <display value="Pregabalin" />
                    </coding>
                </code>
            </Medication>
        </resource>
    </entry>
    <!--   // Medication Request   -->
    <entry>
        <fullUrl value="urn:med-req-01923" />
        <resource>
            <MedicationRequest>
                <id value="med-req-01923" />
                <identifier>
                    <value value="6d2bfb69-656a-45ef-92d0-d4aae02bb438" />
                </identifier>
                <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>
                <priority value="routine" />
                <medicationReference>
                    <reference value="medication-99101" />
                    <display value="Pregabalin" />
                </medicationReference>
                <subject>
                    <reference value="patient-01912" />
                    <display value="Mr Chris Packet" />
                </subject>
                <authoredOn value="2021-05-07T18:12:41+01:00" />
                <requester>
                    <reference value="staff-1112" />
                    <display value="Dr Maikeu Well" />
                </requester>
                <recorder>
                    <reference value="staff-1112" />
                    <display value="Dr Maikeu Well" />
                </recorder>
                <dosageInstruction>
                    <sequence value="1" />
                    <timing>
                        <repeat>
                            <boundsDuration>
                                <value value="3" />
                                <unit value="day" />
                                <system value="http://unitsofmeasure.org" />
                                <code value="d" />
                            </boundsDuration>
                            <frequency value="2" />
                            <period value="1" />
                            <periodUnit value="d" />
                        </repeat>
                    </timing>
                    <route>
                        <coding>
                            <system value="http://snomed.info/sct" />
                            <code value="26643006" />
                            <display value="oral" />
                        </coding>
                    </route>
                    <doseAndRate>
                        <doseQuantity>
                            <value value="75" />
                            <unit value="milligram" />
                            <system value="http://unitsofmeasure.org" />
                            <code value="mg" />
                        </doseQuantity>
                    </doseAndRate>
                </dosageInstruction>
                <dosageInstruction>
                    <sequence value="2" />
                    <timing>
                        <repeat>
                            <frequency value="3" />
                            <period value="1" />
                            <periodUnit value="d" />
                        </repeat>
                    </timing>
                    <route>
                        <coding>
                            <system value="http://snomed.info/sct" />
                            <code value="26643006" />
                            <display value="oral" />
                        </coding>
                    </route>
                    <doseAndRate>
                        <doseQuantity>
                            <value value="75" />
                            <unit value="milligram" />
                            <system value="http://unitsofmeasure.org" />
                            <code value="mg" />
                        </doseQuantity>
                    </doseAndRate>
                </dosageInstruction>
                <substitution>
                    <allowedBoolean value="false" />
                </substitution>
            </MedicationRequest>
        </resource>
    </entry>
</Bundle>

{
    "resourceType": "Bundle",
    "id": "7d107ed2-70c6-43d9-9cbe-f19c319d1456",
    "identifier": {
        "system": "urn:[organisation_name]:[system_name]",
        "value": "urn:8cd8108d-8c72-4fe9-a284-cd28b127fcfa"
    },
    "type": "message",
    "timestamp": "05/07/2021 16:15:32",
    "entry":  [
        {
            "fullUrl": "urn:message-header-167434",
            "resource": {
                "resourceType": "MessageHeader",
                "id": "urn:message-header-167434",
                "eventCoding": {
                    "system": "https://fhir.hl7.org.uk//CodeSystem/message-event",
                    "code": "prescription-order",
                    "display": "Prescription Order"
                },
                "source": {
                    "name": "ACME Clinical Systems",
                    "software": "ACME ePMA",
                    "version": "3.5.68",
                    "endpoint": "urn:nhs-uk:addressing:ods:T48NT"
                },
                "focus":  [
                    {
                        "reference": "urn:med-req-01923"
                    }
                ]
            }
        },
        {
            "fullUrl": "urn:patient-01912",
            "resource": {
                "resourceType": "Patient",
                "id": "patient-01912",
                "identifier":  [
                    {
                        "system": "https://fhir.nhs.uk/Id/nhs-number",
                        "value": "4857773456"
                    }
                ],
                "name":  [
                    {
                        "use": "official",
                        "text": "Mr Chris Packet",
                        "family": "Packet",
                        "given":  [
                            "Chris"
                        ],
                        "prefix":  [
                            "Mr"
                        ]
                    }
                ],
                "gender": "male",
                "birthDate": "1995-11-12"
            }
        },
        {
            "fullUrl": "urn:staff-1112",
            "resource": {
                "resourceType": "Practitioner",
                "id": "staff-1112",
                "name":  [
                    {
                        "text": "Dr Maikeu Well",
                        "family": "Well",
                        "given":  [
                            "Maikeu"
                        ],
                        "prefix":  [
                            "Dr"
                        ]
                    }
                ],
                "qualification":  [
                    {
                        "code": {
                            "coding":  [
                                {
                                    "system": "https://fhir.hl7.org.uk/Id/gmc-number",
                                    "code": "2145879",
                                    "display": "General Medical Council"
                                }
                            ]
                        }
                    }
                ]
            }
        },
        {
            "fullUrl": "urn:medication-99101",
            "resource": {
                "resourceType": "Medication",
                "id": "medication-99101",
                "code": {
                    "coding":  [
                        {
                            "system": "http://snomed.info/sct",
                            "code": "415159003",
                            "display": "Pregabalin"
                        }
                    ]
                }
            }
        },
        {
            "fullUrl": "urn:med-req-01923",
            "resource": {
                "resourceType": "MedicationRequest",
                "id": "med-req-01923",
                "identifier":  [
                    {
                        "value": "6d2bfb69-656a-45ef-92d0-d4aae02bb438"
                    }
                ],
                "status": "active",
                "intent": "order",
                "category":  [
                    {
                        "coding":  [
                            {
                                "system": "http://hl7.org/fhir/medication-request-category",
                                "code": "inpatient",
                                "display": "inpatient"
                            }
                        ]
                    }
                ],
                "priority": "routine",
                "medicationReference": {
                    "reference": "medication-99101",
                    "display": "Pregabalin"
                },
                "subject": {
                    "reference": "patient-01912",
                    "display": "Mr Chris Packet"
                },
                "authoredOn": "05/07/2021 17:12:41",
                "requester": {
                    "reference": "staff-1112",
                    "display": "Dr Maikeu Well"
                },
                "recorder": {
                    "reference": "staff-1112",
                    "display": "Dr Maikeu Well"
                },
                "dosageInstruction":  [
                    {
                        "sequence": 1,
                        "timing": {
                            "repeat": {
                                "boundsDuration": {
                                    "value": 3,
                                    "unit": "day",
                                    "system": "http://unitsofmeasure.org",
                                    "code": "d"
                                },
                                "frequency": 2,
                                "period": 1,
                                "periodUnit": "d"
                            }
                        },
                        "route": {
                            "coding":  [
                                {
                                    "system": "http://snomed.info/sct",
                                    "code": "26643006",
                                    "display": "oral"
                                }
                            ]
                        },
                        "doseAndRate":  [
                            {
                                "doseQuantity": {
                                    "value": 75,
                                    "unit": "milligram",
                                    "system": "http://unitsofmeasure.org",
                                    "code": "mg"
                                }
                            }
                        ]
                    },
                    {
                        "sequence": 2,
                        "timing": {
                            "repeat": {
                                "frequency": 3,
                                "period": 1,
                                "periodUnit": "d"
                            }
                        },
                        "route": {
                            "coding":  [
                                {
                                    "system": "http://snomed.info/sct",
                                    "code": "26643006",
                                    "display": "oral"
                                }
                            ]
                        },
                        "doseAndRate":  [
                            {
                                "doseQuantity": {
                                    "value": 75,
                                    "unit": "milligram",
                                    "system": "http://unitsofmeasure.org",
                                    "code": "mg"
                                }
                            }
                        ]
                    }
                ],
                "substitution": {
                    "allowedBoolean": false
                }
            }
        }
    ]
}
Bundle.id[0]7d107ed2-70c6-43d9-9cbe-f19c319d1456
Bundle.identifier[0].system[0]urn:[organisation_name]:[system_name]
Bundle.identifier[0].value[0]urn:8cd8108d-8c72-4fe9-a284-cd28b127fcfa
Bundle.type[0]message
Bundle.timestamp[0]2021-05-07T16:15:32+00:00
Bundle.entry[0].fullUrl[0]urn:message-header-167434
Bundle.entry[0].resource[0].id[0]urn:message-header-167434
Bundle.entry[0].resource[0].event[0].system[0]https://fhir.hl7.org.uk//CodeSystem/message-event
Bundle.entry[0].resource[0].event[0].code[0]prescription-order
Bundle.entry[0].resource[0].event[0].display[0]Prescription Order
Bundle.entry[0].resource[0].source[0].name[0]ACME Clinical Systems
Bundle.entry[0].resource[0].source[0].software[0]ACME ePMA
Bundle.entry[0].resource[0].source[0].version[0]3.5.68
Bundle.entry[0].resource[0].source[0].endpoint[0]urn:nhs-uk:addressing:ods:T48NT
Bundle.entry[0].resource[0].focus[0].reference[0]urn:med-req-01923
Bundle.entry[1].fullUrl[0]urn:patient-01912
Bundle.entry[1].resource[0].id[0]patient-01912
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]4857773456
Bundle.entry[1].resource[0].name[0].use[0]official
Bundle.entry[1].resource[0].name[0].text[0]Mr Chris Packet
Bundle.entry[1].resource[0].name[0].family[0]Packet
Bundle.entry[1].resource[0].name[0].given[0]Chris
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]1995-11-12
Bundle.entry[2].fullUrl[0]urn:staff-1112
Bundle.entry[2].resource[0].id[0]staff-1112
Bundle.entry[2].resource[0].name[0].text[0]Dr Maikeu Well
Bundle.entry[2].resource[0].name[0].family[0]Well
Bundle.entry[2].resource[0].name[0].given[0]Maikeu
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]2145879
Bundle.entry[2].resource[0].qualification[0].code[0].coding[0].display[0]General Medical Council
Bundle.entry[3].fullUrl[0]urn:medication-99101
Bundle.entry[3].resource[0].id[0]medication-99101
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]415159003
Bundle.entry[3].resource[0].code[0].coding[0].display[0]Pregabalin
Bundle.entry[4].fullUrl[0]urn:med-req-01923
Bundle.entry[4].resource[0].id[0]med-req-01923
Bundle.entry[4].resource[0].identifier[0].value[0]6d2bfb69-656a-45ef-92d0-d4aae02bb438
Bundle.entry[4].resource[0].status[0]active
Bundle.entry[4].resource[0].intent[0]order
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]inpatient
Bundle.entry[4].resource[0].category[0].coding[0].display[0]inpatient
Bundle.entry[4].resource[0].priority[0]routine
Bundle.entry[4].resource[0].medication[0].reference[0]medication-99101
Bundle.entry[4].resource[0].medication[0].display[0]Pregabalin
Bundle.entry[4].resource[0].subject[0].reference[0]patient-01912
Bundle.entry[4].resource[0].subject[0].display[0]Mr Chris Packet
Bundle.entry[4].resource[0].authoredOn[0]2021-05-07T18:12:41+01:00
Bundle.entry[4].resource[0].requester[0].reference[0]staff-1112
Bundle.entry[4].resource[0].requester[0].display[0]Dr Maikeu Well
Bundle.entry[4].resource[0].recorder[0].reference[0]staff-1112
Bundle.entry[4].resource[0].recorder[0].display[0]Dr Maikeu Well
Bundle.entry[4].resource[0].dosageInstruction[0].sequence[0]1
Bundle.entry[4].resource[0].dosageInstruction[0].timing[0].repeat[0].bounds[0].value[0]3
Bundle.entry[4].resource[0].dosageInstruction[0].timing[0].repeat[0].bounds[0].unit[0]day
Bundle.entry[4].resource[0].dosageInstruction[0].timing[0].repeat[0].bounds[0].system[0]http://unitsofmeasure.org
Bundle.entry[4].resource[0].dosageInstruction[0].timing[0].repeat[0].bounds[0].code[0]d
Bundle.entry[4].resource[0].dosageInstruction[0].timing[0].repeat[0].frequency[0]2
Bundle.entry[4].resource[0].dosageInstruction[0].timing[0].repeat[0].period[0]1
Bundle.entry[4].resource[0].dosageInstruction[0].timing[0].repeat[0].periodUnit[0]d
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]26643006
Bundle.entry[4].resource[0].dosageInstruction[0].route[0].coding[0].display[0]oral
Bundle.entry[4].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].value[0]75
Bundle.entry[4].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].unit[0]milligram
Bundle.entry[4].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].system[0]http://unitsofmeasure.org
Bundle.entry[4].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].code[0]mg
Bundle.entry[4].resource[0].dosageInstruction[1].sequence[0]2
Bundle.entry[4].resource[0].dosageInstruction[1].timing[0].repeat[0].frequency[0]3
Bundle.entry[4].resource[0].dosageInstruction[1].timing[0].repeat[0].period[0]1
Bundle.entry[4].resource[0].dosageInstruction[1].timing[0].repeat[0].periodUnit[0]d
Bundle.entry[4].resource[0].dosageInstruction[1].route[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[4].resource[0].dosageInstruction[1].route[0].coding[0].code[0]26643006
Bundle.entry[4].resource[0].dosageInstruction[1].route[0].coding[0].display[0]oral
Bundle.entry[4].resource[0].dosageInstruction[1].doseAndRate[0].dose[0].value[0]75
Bundle.entry[4].resource[0].dosageInstruction[1].doseAndRate[0].dose[0].unit[0]milligram
Bundle.entry[4].resource[0].dosageInstruction[1].doseAndRate[0].dose[0].system[0]http://unitsofmeasure.org
Bundle.entry[4].resource[0].dosageInstruction[1].doseAndRate[0].dose[0].code[0]mg
Bundle.entry[4].resource[0].substitution[0].allowed[0]False
Bundle

Example 3: Inpatient MedicationDispense

Note: This example below has been temporarily removed as under review and will be re-published very soon.

The dispensing of Pregabalin.

Actors

Provider System = Hospital pharamcy system

Consumer System = Ward EMPA system

Example

Example will be re-published soon...

Example 4: Discharge MedicationRequest

Note: This example below is a draft and requires clinical verification.

Discharge TTO medication requests for Paracetamol , Ibuprofen and Pregabalin.

Actors

Provider System = Ward EMPA system

Consumer System = Hospital pharamcy system

Example

<Bundle xmlns="http://hl7.org/fhir">
    <id value="acd1d58c-4abd-415b-a5a3-88f5dac71ec0" />
    <type value="message" />
    <timestamp value="2021-05-07T16:15:32Z" />
    <!--    Message Header    -->
    <entry>
        <fullUrl value="urn:message-header-9920192" />
        <resource>
            <MessageHeader>
                <id value="urn:message-header-9920192" />
                <eventCoding>
                    <system value="https://fhir.nhs.uk/STU3/CodeSystem/EventType-1" />
                    <code value="prescription-order" />
                    <display value="Prescription Order" />
                </eventCoding>
                <source>
                    <name value="ACME Clinical Systems" />
                    <software value="ACME ePMA" />
                    <version value="3.5.68" />
                    <endpoint value="urn:nhs-uk:addressing:ods:T48NT" />
                </source>
                <focus>
                    <reference value="urn:med-req-76462" />
                </focus>
                <focus>
                    <reference value="urn:med-req-987765745" />
                </focus>
                <focus>
                    <reference value="urn:med-req-11adfw53446" />
                </focus>
            </MessageHeader>
        </resource>
    </entry>
    <!--   // Patient associated with the encounter    -->
    <entry>
        <fullUrl value="urn:patient-01912" />
        <resource>
            <Patient>
                <id value="urn:patient-01912" />
                <identifier>
                    <system value="https://fhir.nhs.uk/Id/nhs-number" />
                    <value value="4857773456" />
                </identifier>
                <name>
                    <use value="official" />
                    <text value="Mr Chris Packet" />
                    <family value="Packet" />
                    <given value="Chris" />
                    <prefix value="Mr" />
                </name>
                <gender value="male" />
                <birthDate value="1995-11-12" />
            </Patient>
        </resource>
    </entry>
    <!--   // Prescribing clinician associated with the encounter.    -->
    <entry>
        <fullUrl value="urn:staff-1112" />
        <resource>
            <Practitioner>
                <id value="urn:staff-1112" />
                <name>
                    <text value="Dr Maikeu Well" />
                    <family value="Well" />
                    <given value="Maikeu" />
                    <prefix value="Dr" />
                </name>
                <qualification>
                    <code>
                        <coding>
                            <system value="https://fhir.hl7.org.uk/Id/gmc-number" />
                            <code value="2145879" />
                            <display value="General Medical Council" />
                        </coding>
                    </code>
                </qualification>
            </Practitioner>
        </resource>
    </entry>
    <!--   // Medication #1: Paracetamol   -->
    <entry>
        <fullUrl value="urn:medication-90332006" />
        <resource>
            <Medication>
                <id value="urn:medication-90332006" />
                <code>
                    <coding>
                        <system value="http://snomed.info/sct" />
                        <code value="90332006" />
                        <display value="Paracetamol" />
                    </coding>
                </code>
            </Medication>
        </resource>
    </entry>
    <!--    // Medication Request #1: Paracetamol 1g four times a day    -->
    <entry>
        <fullUrl value="urn:med-req-76462" />
        <resource>
            <MedicationRequest>
                <id value="urn:med-req-76462" />
                <identifier>
                    <value value="35873655-0d53-469a-9428-04df65f5cbb4" />
                </identifier>
                <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>
                <priority value="routine" />
                <medicationReference>
                    <reference value="urn:medication-90332006" />
                    <display value="Paracetamol" />
                </medicationReference>
                <subject>
                    <reference value="urn:patient-01912" />
                    <display value="Mr Chris Packet" />
                </subject>
                <authoredOn value="2021-05-14T11:34:12+01:00" />
                <requester>
                    <reference value="urn:staff-1112" />
                    <display value="Dr Maikeu Well" />
                </requester>
                <recorder>
                    <reference value="urn:staff-1112" />
                    <display value="Dr Maikeu Well" />
                </recorder>
                <dosageInstruction>
                    <timing>
                        <repeat>
                            <frequency value="4" />
                            <period value="1" />
                            <periodUnit value="d" />
                        </repeat>
                    </timing>
                    <route>
                        <coding>
                            <system value="http://snomed.info/sct" />
                            <code value="26643006" />
                            <display value="oral" />
                        </coding>
                    </route>
                    <doseAndRate>
                        <doseQuantity>
                            <value value="1" />
                            <unit value="gram" />
                            <system value="http://unitsofmeasure.org" />
                            <code value="g" />
                        </doseQuantity>
                    </doseAndRate>
                </dosageInstruction>
                <substitution>
                    <allowedBoolean value="false" />
                </substitution>
            </MedicationRequest>
        </resource>
    </entry>
    <!--   // Medication #2: Ibuprofen 800mg modified-release tablets   -->
    <entry>
        <fullUrl value="urn:medication-39110311000001101" />
        <resource>
            <Medication>
                <id value="urn:medication-39110311000001101" />
                <code>
                    <coding>
                        <system value="http://snomed.info/sct" />
                        <code value="39110311000001101" />
                        <display value="Ibuprofen 800mg modified-release tablets" />
                    </coding>
                </code>
            </Medication>
        </resource>
    </entry>
    <!--    // Medication Request #2: Ibuprofen 800mg modified-release tablets   -->
    <entry>
        <fullUrl value="urn:med-req-987765745" />
        <resource>
            <MedicationRequest>
                <id value="urn:med-req-987765745" />
                <identifier>
                    <value value="63a40946-c387-4810-9458-c573f873d7b4" />
                </identifier>
                <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>
                <priority value="routine" />
                <medicationReference>
                    <reference value="urn:medication-39110311000001101" />
                    <display value="Ibuprofen 800mg modified-release tablets" />
                </medicationReference>
                <subject>
                    <reference value="urn:patient-01912" />
                    <display value="Mr Chris Packet" />
                </subject>
                <authoredOn value="2021-05-14T11:34:12Z" />
                <requester>
                    <reference value="urn:staff-1112" />
                    <display value="Dr Maikeu Well" />
                </requester>
                <recorder>
                    <reference value="urn:staff-1112" />
                    <display value="Dr Maikeu Well" />
                </recorder>
                <dosageInstruction>
                    <timing>
                        <repeat>
                            <frequency value="2" />
                            <period value="1" />
                            <periodUnit value="d" />
                        </repeat>
                    </timing>
                    <route>
                        <coding>
                            <system value="http://snomed.info/sct" />
                            <code value="26643006" />
                            <display value="oral" />
                        </coding>
                    </route>
                    <doseAndRate>
                        <doseQuantity>
                            <value value="800" />
                            <unit value="milligram" />
                            <system value="http://unitsofmeasure.org" />
                            <code value="mg" />
                        </doseQuantity>
                    </doseAndRate>
                </dosageInstruction>
                <substitution>
                    <allowedBoolean value="false" />
                </substitution>
            </MedicationRequest>
        </resource>
    </entry>
    <!--   // Medication #3: Pregabalin   -->
    <entry>
        <fullUrl value="urn:medication-234567321" />
        <resource>
            <Medication>
                <id value="urn:medication-234567321" />
                <code>
                    <coding>
                        <system value="http://snomed.info/sct" />
                        <code value="415160008" />
                        <display value="Pregabalin" />
                    </coding>
                </code>
            </Medication>
        </resource>
    </entry>
    <!--    // Medication Request #3: Pregabalin    -->
    <entry>
        <fullUrl value="urn:med-req-11adfw53446" />
        <resource>
            <MedicationRequest>
                <id value="urn:med-req-11adfw53446" />
                <identifier>
                    <value value="63a40946-c387-4810-9458-c573f873d7b4" />
                </identifier>
                <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>
                <priority value="routine" />
                <medicationReference>
                    <reference value="urn:medication-234567321" />
                    <display value="Pregabalin" />
                </medicationReference>
                <subject>
                    <reference value="urn:patient-01912" />
                    <display value="Mr Chris Packet" />
                </subject>
                <authoredOn value="2021-05-14T11:34:12Z" />
                <requester>
                    <reference value="urn:staff-1112" />
                    <display value="Dr Maikeu Well" />
                </requester>
                <recorder>
                    <reference value="urn:staff-1112" />
                    <display value="Dr Maikeu Well" />
                </recorder>
                <dosageInstruction>
                    <timing>
                        <repeat>
                            <frequency value="3" />
                            <period value="1" />
                            <periodUnit value="d" />
                        </repeat>
                    </timing>
                    <route>
                        <coding>
                            <system value="http://snomed.info/sct" />
                            <code value="26643006" />
                            <display value="oral" />
                        </coding>
                    </route>
                    <doseAndRate>
                        <doseQuantity>
                            <value value="75" />
                            <unit value="milligram" />
                            <system value="http://unitsofmeasure.org" />
                            <code value="mg" />
                        </doseQuantity>
                    </doseAndRate>
                </dosageInstruction>
                <substitution>
                    <allowedBoolean value="false" />
                </substitution>
            </MedicationRequest>
        </resource>
    </entry>
</Bundle>

{
    "resourceType": "Bundle",
    "id": "acd1d58c-4abd-415b-a5a3-88f5dac71ec0",
    "type": "message",
    "timestamp": "05/07/2021 16:15:32",
    "entry":  [
        {
            "fullUrl": "urn:message-header-9920192",
            "resource": {
                "resourceType": "MessageHeader",
                "id": "urn:message-header-9920192",
                "eventCoding": {
                    "system": "https://fhir.nhs.uk/STU3/CodeSystem/EventType-1",
                    "code": "prescription-order",
                    "display": "Prescription Order"
                },
                "source": {
                    "name": "ACME Clinical Systems",
                    "software": "ACME ePMA",
                    "version": "3.5.68",
                    "endpoint": "urn:nhs-uk:addressing:ods:T48NT"
                },
                "focus":  [
                    {
                        "reference": "urn:med-req-76462"
                    },
                    {
                        "reference": "urn:med-req-987765745"
                    },
                    {
                        "reference": "urn:med-req-11adfw53446"
                    }
                ]
            }
        },
        {
            "fullUrl": "urn:patient-01912",
            "resource": {
                "resourceType": "Patient",
                "id": "urn:patient-01912",
                "identifier":  [
                    {
                        "system": "https://fhir.nhs.uk/Id/nhs-number",
                        "value": "4857773456"
                    }
                ],
                "name":  [
                    {
                        "use": "official",
                        "text": "Mr Chris Packet",
                        "family": "Packet",
                        "given":  [
                            "Chris"
                        ],
                        "prefix":  [
                            "Mr"
                        ]
                    }
                ],
                "gender": "male",
                "birthDate": "1995-11-12"
            }
        },
        {
            "fullUrl": "urn:staff-1112",
            "resource": {
                "resourceType": "Practitioner",
                "id": "urn:staff-1112",
                "name":  [
                    {
                        "text": "Dr Maikeu Well",
                        "family": "Well",
                        "given":  [
                            "Maikeu"
                        ],
                        "prefix":  [
                            "Dr"
                        ]
                    }
                ],
                "qualification":  [
                    {
                        "code": {
                            "coding":  [
                                {
                                    "system": "https://fhir.hl7.org.uk/Id/gmc-number",
                                    "code": "2145879",
                                    "display": "General Medical Council"
                                }
                            ]
                        }
                    }
                ]
            }
        },
        {
            "fullUrl": "urn:medication-90332006",
            "resource": {
                "resourceType": "Medication",
                "id": "urn:medication-90332006",
                "code": {
                    "coding":  [
                        {
                            "system": "http://snomed.info/sct",
                            "code": "90332006",
                            "display": "Paracetamol"
                        }
                    ]
                }
            }
        },
        {
            "fullUrl": "urn:med-req-76462",
            "resource": {
                "resourceType": "MedicationRequest",
                "id": "urn:med-req-76462",
                "identifier":  [
                    {
                        "value": "35873655-0d53-469a-9428-04df65f5cbb4"
                    }
                ],
                "status": "active",
                "intent": "order",
                "category":  [
                    {
                        "coding":  [
                            {
                                "system": "http://hl7.org/fhir/medication-request-category",
                                "code": "inpatient",
                                "display": "inpatient"
                            }
                        ]
                    }
                ],
                "priority": "routine",
                "medicationReference": {
                    "reference": "urn:medication-90332006",
                    "display": "Paracetamol"
                },
                "subject": {
                    "reference": "urn:patient-01912",
                    "display": "Mr Chris Packet"
                },
                "authoredOn": "05/14/2021 10:34:12",
                "requester": {
                    "reference": "urn:staff-1112",
                    "display": "Dr Maikeu Well"
                },
                "recorder": {
                    "reference": "urn:staff-1112",
                    "display": "Dr Maikeu Well"
                },
                "dosageInstruction":  [
                    {
                        "timing": {
                            "repeat": {
                                "frequency": 4,
                                "period": 1,
                                "periodUnit": "d"
                            }
                        },
                        "route": {
                            "coding":  [
                                {
                                    "system": "http://snomed.info/sct",
                                    "code": "26643006",
                                    "display": "oral"
                                }
                            ]
                        },
                        "doseAndRate":  [
                            {
                                "doseQuantity": {
                                    "value": 1,
                                    "unit": "gram",
                                    "system": "http://unitsofmeasure.org",
                                    "code": "g"
                                }
                            }
                        ]
                    }
                ],
                "substitution": {
                    "allowedBoolean": false
                }
            }
        },
        {
            "fullUrl": "urn:medication-39110311000001101",
            "resource": {
                "resourceType": "Medication",
                "id": "urn:medication-39110311000001101",
                "code": {
                    "coding":  [
                        {
                            "system": "http://snomed.info/sct",
                            "code": "39110311000001101",
                            "display": "Ibuprofen 800mg modified-release tablets"
                        }
                    ]
                }
            }
        },
        {
            "fullUrl": "urn:med-req-987765745",
            "resource": {
                "resourceType": "MedicationRequest",
                "id": "urn:med-req-987765745",
                "identifier":  [
                    {
                        "value": "63a40946-c387-4810-9458-c573f873d7b4"
                    }
                ],
                "status": "active",
                "intent": "order",
                "category":  [
                    {
                        "coding":  [
                            {
                                "system": "http://hl7.org/fhir/medication-request-category",
                                "code": "inpatient",
                                "display": "inpatient"
                            }
                        ]
                    }
                ],
                "priority": "routine",
                "medicationReference": {
                    "reference": "urn:medication-39110311000001101",
                    "display": "Ibuprofen 800mg modified-release tablets"
                },
                "subject": {
                    "reference": "urn:patient-01912",
                    "display": "Mr Chris Packet"
                },
                "authoredOn": "05/14/2021 11:34:12",
                "requester": {
                    "reference": "urn:staff-1112",
                    "display": "Dr Maikeu Well"
                },
                "recorder": {
                    "reference": "urn:staff-1112",
                    "display": "Dr Maikeu Well"
                },
                "dosageInstruction":  [
                    {
                        "timing": {
                            "repeat": {
                                "frequency": 2,
                                "period": 1,
                                "periodUnit": "d"
                            }
                        },
                        "route": {
                            "coding":  [
                                {
                                    "system": "http://snomed.info/sct",
                                    "code": "26643006",
                                    "display": "oral"
                                }
                            ]
                        },
                        "doseAndRate":  [
                            {
                                "doseQuantity": {
                                    "value": 800,
                                    "unit": "milligram",
                                    "system": "http://unitsofmeasure.org",
                                    "code": "mg"
                                }
                            }
                        ]
                    }
                ],
                "substitution": {
                    "allowedBoolean": false
                }
            }
        },
        {
            "fullUrl": "urn:medication-234567321",
            "resource": {
                "resourceType": "Medication",
                "id": "urn:medication-234567321",
                "code": {
                    "coding":  [
                        {
                            "system": "http://snomed.info/sct",
                            "code": "415160008",
                            "display": "Pregabalin"
                        }
                    ]
                }
            }
        },
        {
            "fullUrl": "urn:med-req-11adfw53446",
            "resource": {
                "resourceType": "MedicationRequest",
                "id": "urn:med-req-11adfw53446",
                "identifier":  [
                    {
                        "value": "63a40946-c387-4810-9458-c573f873d7b4"
                    }
                ],
                "status": "active",
                "intent": "order",
                "category":  [
                    {
                        "coding":  [
                            {
                                "system": "http://hl7.org/fhir/medication-request-category",
                                "code": "inpatient",
                                "display": "inpatient"
                            }
                        ]
                    }
                ],
                "priority": "routine",
                "medicationReference": {
                    "reference": "urn:medication-234567321",
                    "display": "Pregabalin"
                },
                "subject": {
                    "reference": "urn:patient-01912",
                    "display": "Mr Chris Packet"
                },
                "authoredOn": "05/14/2021 11:34:12",
                "requester": {
                    "reference": "urn:staff-1112",
                    "display": "Dr Maikeu Well"
                },
                "recorder": {
                    "reference": "urn:staff-1112",
                    "display": "Dr Maikeu Well"
                },
                "dosageInstruction":  [
                    {
                        "timing": {
                            "repeat": {
                                "frequency": 3,
                                "period": 1,
                                "periodUnit": "d"
                            }
                        },
                        "route": {
                            "coding":  [
                                {
                                    "system": "http://snomed.info/sct",
                                    "code": "26643006",
                                    "display": "oral"
                                }
                            ]
                        },
                        "doseAndRate":  [
                            {
                                "doseQuantity": {
                                    "value": 75,
                                    "unit": "milligram",
                                    "system": "http://unitsofmeasure.org",
                                    "code": "mg"
                                }
                            }
                        ]
                    }
                ],
                "substitution": {
                    "allowedBoolean": false
                }
            }
        }
    ]
}
Bundle.id[0]acd1d58c-4abd-415b-a5a3-88f5dac71ec0
Bundle.type[0]message
Bundle.timestamp[0]2021-05-07T16:15:32+00:00
Bundle.entry[0].fullUrl[0]urn:message-header-9920192
Bundle.entry[0].resource[0].id[0]urn:message-header-9920192
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]prescription-order
Bundle.entry[0].resource[0].event[0].display[0]Prescription Order
Bundle.entry[0].resource[0].source[0].name[0]ACME Clinical Systems
Bundle.entry[0].resource[0].source[0].software[0]ACME ePMA
Bundle.entry[0].resource[0].source[0].version[0]3.5.68
Bundle.entry[0].resource[0].source[0].endpoint[0]urn:nhs-uk:addressing:ods:T48NT
Bundle.entry[0].resource[0].focus[0].reference[0]urn:med-req-76462
Bundle.entry[0].resource[0].focus[1].reference[0]urn:med-req-987765745
Bundle.entry[0].resource[0].focus[2].reference[0]urn:med-req-11adfw53446
Bundle.entry[1].fullUrl[0]urn:patient-01912
Bundle.entry[1].resource[0].id[0]urn:patient-01912
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]4857773456
Bundle.entry[1].resource[0].name[0].use[0]official
Bundle.entry[1].resource[0].name[0].text[0]Mr Chris Packet
Bundle.entry[1].resource[0].name[0].family[0]Packet
Bundle.entry[1].resource[0].name[0].given[0]Chris
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]1995-11-12
Bundle.entry[2].fullUrl[0]urn:staff-1112
Bundle.entry[2].resource[0].id[0]urn:staff-1112
Bundle.entry[2].resource[0].name[0].text[0]Dr Maikeu Well
Bundle.entry[2].resource[0].name[0].family[0]Well
Bundle.entry[2].resource[0].name[0].given[0]Maikeu
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]2145879
Bundle.entry[2].resource[0].qualification[0].code[0].coding[0].display[0]General Medical Council
Bundle.entry[3].fullUrl[0]urn:medication-90332006
Bundle.entry[3].resource[0].id[0]urn:medication-90332006
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]90332006
Bundle.entry[3].resource[0].code[0].coding[0].display[0]Paracetamol
Bundle.entry[4].fullUrl[0]urn:med-req-76462
Bundle.entry[4].resource[0].id[0]urn:med-req-76462
Bundle.entry[4].resource[0].identifier[0].value[0]35873655-0d53-469a-9428-04df65f5cbb4
Bundle.entry[4].resource[0].status[0]active
Bundle.entry[4].resource[0].intent[0]order
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]inpatient
Bundle.entry[4].resource[0].category[0].coding[0].display[0]inpatient
Bundle.entry[4].resource[0].priority[0]routine
Bundle.entry[4].resource[0].medication[0].reference[0]urn:medication-90332006
Bundle.entry[4].resource[0].medication[0].display[0]Paracetamol
Bundle.entry[4].resource[0].subject[0].reference[0]urn:patient-01912
Bundle.entry[4].resource[0].subject[0].display[0]Mr Chris Packet
Bundle.entry[4].resource[0].authoredOn[0]2021-05-14T11:34:12+01:00
Bundle.entry[4].resource[0].requester[0].reference[0]urn:staff-1112
Bundle.entry[4].resource[0].requester[0].display[0]Dr Maikeu Well
Bundle.entry[4].resource[0].recorder[0].reference[0]urn:staff-1112
Bundle.entry[4].resource[0].recorder[0].display[0]Dr Maikeu Well
Bundle.entry[4].resource[0].dosageInstruction[0].timing[0].repeat[0].frequency[0]4
Bundle.entry[4].resource[0].dosageInstruction[0].timing[0].repeat[0].period[0]1
Bundle.entry[4].resource[0].dosageInstruction[0].timing[0].repeat[0].periodUnit[0]d
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]26643006
Bundle.entry[4].resource[0].dosageInstruction[0].route[0].coding[0].display[0]oral
Bundle.entry[4].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].value[0]1
Bundle.entry[4].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].unit[0]gram
Bundle.entry[4].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].system[0]http://unitsofmeasure.org
Bundle.entry[4].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].code[0]g
Bundle.entry[4].resource[0].substitution[0].allowed[0]False
Bundle.entry[5].fullUrl[0]urn:medication-39110311000001101
Bundle.entry[5].resource[0].id[0]urn:medication-39110311000001101
Bundle.entry[5].resource[0].code[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[5].resource[0].code[0].coding[0].code[0]39110311000001101
Bundle.entry[5].resource[0].code[0].coding[0].display[0]Ibuprofen 800mg modified-release tablets
Bundle.entry[6].fullUrl[0]urn:med-req-987765745
Bundle.entry[6].resource[0].id[0]urn:med-req-987765745
Bundle.entry[6].resource[0].identifier[0].value[0]63a40946-c387-4810-9458-c573f873d7b4
Bundle.entry[6].resource[0].status[0]active
Bundle.entry[6].resource[0].intent[0]order
Bundle.entry[6].resource[0].category[0].coding[0].system[0]http://hl7.org/fhir/medication-request-category
Bundle.entry[6].resource[0].category[0].coding[0].code[0]inpatient
Bundle.entry[6].resource[0].category[0].coding[0].display[0]inpatient
Bundle.entry[6].resource[0].priority[0]routine
Bundle.entry[6].resource[0].medication[0].reference[0]urn:medication-39110311000001101
Bundle.entry[6].resource[0].medication[0].display[0]Ibuprofen 800mg modified-release tablets
Bundle.entry[6].resource[0].subject[0].reference[0]urn:patient-01912
Bundle.entry[6].resource[0].subject[0].display[0]Mr Chris Packet
Bundle.entry[6].resource[0].authoredOn[0]2021-05-14T11:34:12Z
Bundle.entry[6].resource[0].requester[0].reference[0]urn:staff-1112
Bundle.entry[6].resource[0].requester[0].display[0]Dr Maikeu Well
Bundle.entry[6].resource[0].recorder[0].reference[0]urn:staff-1112
Bundle.entry[6].resource[0].recorder[0].display[0]Dr Maikeu Well
Bundle.entry[6].resource[0].dosageInstruction[0].timing[0].repeat[0].frequency[0]2
Bundle.entry[6].resource[0].dosageInstruction[0].timing[0].repeat[0].period[0]1
Bundle.entry[6].resource[0].dosageInstruction[0].timing[0].repeat[0].periodUnit[0]d
Bundle.entry[6].resource[0].dosageInstruction[0].route[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[6].resource[0].dosageInstruction[0].route[0].coding[0].code[0]26643006
Bundle.entry[6].resource[0].dosageInstruction[0].route[0].coding[0].display[0]oral
Bundle.entry[6].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].value[0]800
Bundle.entry[6].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].unit[0]milligram
Bundle.entry[6].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].system[0]http://unitsofmeasure.org
Bundle.entry[6].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].code[0]mg
Bundle.entry[6].resource[0].substitution[0].allowed[0]False
Bundle.entry[7].fullUrl[0]urn:medication-234567321
Bundle.entry[7].resource[0].id[0]urn:medication-234567321
Bundle.entry[7].resource[0].code[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[7].resource[0].code[0].coding[0].code[0]415160008
Bundle.entry[7].resource[0].code[0].coding[0].display[0]Pregabalin
Bundle.entry[8].fullUrl[0]urn:med-req-11adfw53446
Bundle.entry[8].resource[0].id[0]urn:med-req-11adfw53446
Bundle.entry[8].resource[0].identifier[0].value[0]63a40946-c387-4810-9458-c573f873d7b4
Bundle.entry[8].resource[0].status[0]active
Bundle.entry[8].resource[0].intent[0]order
Bundle.entry[8].resource[0].category[0].coding[0].system[0]http://hl7.org/fhir/medication-request-category
Bundle.entry[8].resource[0].category[0].coding[0].code[0]inpatient
Bundle.entry[8].resource[0].category[0].coding[0].display[0]inpatient
Bundle.entry[8].resource[0].priority[0]routine
Bundle.entry[8].resource[0].medication[0].reference[0]urn:medication-234567321
Bundle.entry[8].resource[0].medication[0].display[0]Pregabalin
Bundle.entry[8].resource[0].subject[0].reference[0]urn:patient-01912
Bundle.entry[8].resource[0].subject[0].display[0]Mr Chris Packet
Bundle.entry[8].resource[0].authoredOn[0]2021-05-14T11:34:12Z
Bundle.entry[8].resource[0].requester[0].reference[0]urn:staff-1112
Bundle.entry[8].resource[0].requester[0].display[0]Dr Maikeu Well
Bundle.entry[8].resource[0].recorder[0].reference[0]urn:staff-1112
Bundle.entry[8].resource[0].recorder[0].display[0]Dr Maikeu Well
Bundle.entry[8].resource[0].dosageInstruction[0].timing[0].repeat[0].frequency[0]3
Bundle.entry[8].resource[0].dosageInstruction[0].timing[0].repeat[0].period[0]1
Bundle.entry[8].resource[0].dosageInstruction[0].timing[0].repeat[0].periodUnit[0]d
Bundle.entry[8].resource[0].dosageInstruction[0].route[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[8].resource[0].dosageInstruction[0].route[0].coding[0].code[0]26643006
Bundle.entry[8].resource[0].dosageInstruction[0].route[0].coding[0].display[0]oral
Bundle.entry[8].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].value[0]75
Bundle.entry[8].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].unit[0]milligram
Bundle.entry[8].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].system[0]http://unitsofmeasure.org
Bundle.entry[8].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].code[0]mg
Bundle.entry[8].resource[0].substitution[0].allowed[0]False
Bundle

Example 5: Discharge MedicationDispense

Note: This example below has been temporarily removed as under review and will be re-published very soon.

The pharmacy dispenseses the following for the Discharge Medication (TTO) request

  • Paracetamol 500mg tablets, 112 tablets
  • Ibuprofen 800mg modified-release tablets, 56 tablets
  • Pregabalin 75mg tablets, 56 tablets
Note: The odd quantities are because pharmacies usually give complete packs rather than split them.

Actors

Provider System = Hospital pharamcy system

Consumer System = Ward EMPA system

Example

Example will be re-published soon...

Example 6: Discharge MedicationStatement

Note: This example below is a draft and requires clinical verification.

Codeine has been stopped. Pregabalin has been started. The MedicationStatement resources here would be included within any Discharge Summary sent to the patient's registered GP practice.

Actors

Provider System = Ward EMPA system

Consumer System = Any system requiring a view of current medication, including a shared patient record

Example

<Bundle xmlns="http://hl7.org/fhir">
    <id value="24e34f04-270d-446a-a8c2-0991c93e9b46" />
    <identifier>
        <system value="urn:[organisation_name]:[system_name]" />
        <value value="urn:8cd8108d-8c72-4fe9-a284-cd28b127fcfa" />
    </identifier>
    <type value="message" />
    <timestamp value="2021-05-07T16:15:32Z" />
    <!--    Message Header    -->
    <entry>
        <fullUrl value="urn:message-header-167434" />
        <resource>
            <MessageHeader>
                <id value="urn:message-header-167434" />
                <eventCoding>
                    <system value="https://fhir.hl7.org.uk//CodeSystem/message-event" />
                    <code value="medication-statement" />
                    <display value="Medication Statement" />
                </eventCoding>
                <source>
                    <name value="ACME Clinical Systems" />
                    <software value="ACME ePMA" />
                    <version value="3.5.68" />
                    <endpoint value="urn:nhs-uk:addressing:ods:T48NT" />
                </source>
                <focus>
                    <reference value="urn:medication-statement-1234" />
                    <reference value="urn:medication-statement-123456" />
                </focus>
            </MessageHeader>
        </resource>
    </entry>
    <!--    // Patient associated with the encounter    -->
    <entry>
        <fullUrl value="urn:patient-01912" />
        <resource>
            <Patient>
                <id value="urn:patient-01912" />
                <identifier>
                    <system value="https://fhir.nhs.uk/Id/nhs-number" />
                    <value value="4857773456" />
                </identifier>
                <name>
                    <use value="official" />
                    <text value="Mr Chris Packet" />
                    <family value="Packet" />
                    <given value="Chris" />
                    <prefix value="Mr" />
                </name>
                <gender value="male" />
                <birthDate value="1995-11-12" />
            </Patient>
        </resource>
    </entry>
    <!--     // Clinician who stopped Codine     -->
    <entry>
        <fullUrl value="urn:staff-1112" />
        <resource>
            <Practitioner>
                <id value="urn:staff-1112" />
                <name>
                    <text value="Dr Maikeu Well" />
                    <family value="Well" />
                    <given value="Maikeu" />
                    <prefix value="Dr" />
                </name>
                <qualification>
                    <code>
                        <coding>
                            <system value="https://fhir.hl7.org.uk/Id/gmc-number" />
                            <code value="2145879" />
                            <display value="General Medical Council" />
                        </coding>
                    </code>
                </qualification>
            </Practitioner>
        </resource>
    </entry>
    <!--    // Pharmacist who verified and amended the Pregabalin discharge instructions    -->
    <entry>
        <fullUrl value="urn:staff-0009" />
        <resource>
            <Practitioner>
                <id value="urn:staff-0009" />
                <name>
                    <text value="Mrs Janet Wilson" />
                    <family value="Wilson" />
                    <given value="Janet" />
                    <prefix value="Mrs" />
                </name>
                <qualification>
                    <code>
                        <coding>
                            <system value="https://fhir.hl7.org.uk/Id/gphc-number" />
                            <code value="4563190" />
                            <display value="General Pharmaceutical Council" />
                        </coding>
                    </code>
                </qualification>
            </Practitioner>
        </resource>
    </entry>
    <!--    // Medication    -->
    <entry>
        <fullUrl value="urn:medication-634523423" />
        <resource>
            <Medication>
                <id value="urn:medication-634523423" />
                <code>
                    <coding>
                        <system value="http://snomed.info/sct" />
                        <code value="322503009" />
                        <display value="Codeine 30mg tablets" />
                    </coding>
                </code>
            </Medication>
        </resource>
    </entry>
    <!--    // MedicationStatement    -->
    <entry>
        <fullUrl value="urn:medication-statement-1234" />
        <resource>
            <MedicationStatement>
                <id value="urn:medication-statement-1234" />
                <status value="stopped" />
                <category>
                    <coding>
                        <system value="http://hl7.org/fhir/medication-request-category" />
                        <code value="discharge" />
                        <display value="Discharge" />
                    </coding>
                </category>
                <medicationReference>
                    <reference value="urn:medication-634523423" />
                    <display value="Codeine 30mg tablets" />
                </medicationReference>
                <subject>
                    <reference value="urn:patient-01912" />
                    <display value="Mr Chris PACKET" />
                </subject>
                <dateAsserted value="2021-05-07T16:15:32Z" />
                <informationSource>
                    <reference value="urn:staff-1112" />
                    <display value="Dr Maikeu Better" />
                </informationSource>
                <dosage>
                    <timing>
                        <repeat>
                            <frequency value="4" />
                            <period value="1" />
                            <periodUnit value="d" />
                        </repeat>
                    </timing>
                    <route>
                        <coding>
                            <system value="http://snomed.info/sct" />
                            <code value="26643006" />
                            <display value="oral" />
                        </coding>
                    </route>
                    <doseAndRate>
                        <doseQuantity>
                            <value value="2" />
                            <unit value="tablet" />
                            <system value="http://snomed.info/sct" />
                            <code value="428673006" />
                        </doseQuantity>
                    </doseAndRate>
                </dosage>
            </MedicationStatement>
        </resource>
    </entry>
    <!--       // Medication       -->
    <entry>
        <fullUrl value="urn:medication-415159003" />
        <resource>
            <Medication>
                <id value="urn:medication-415159003" />
                <code>
                    <coding>
                        <system value="http://snomed.info/sct" />
                        <code value="415159003" />
                        <display value="Pregabalin" />
                    </coding>
                </code>
            </Medication>
        </resource>
    </entry>
    <!--       // MedicationStatement       -->
    <entry>
        <fullUrl value="urn:medication-statement-123456" />
        <resource>
            <MedicationStatement>
                <id value="urn:medication-statement-123456" />
                <status value="active" />
                <category>
                    <coding>
                        <system value="http://hl7.org/fhir/medication-request-category" />
                        <code value="discharge" />
                        <display value="Discharge" />
                    </coding>
                </category>
                <medicationReference>
                    <reference value="urn:medication-415159003" />
                    <display value="Pregabalin" />
                </medicationReference>
                <subject>
                    <reference value="urn:patient-01912" />
                    <display value="Mr Chris PACKET" />
                </subject>
                <dateAsserted value="2021-05-09T10:12:42Z" />
                <informationSource>
                    <reference value="urn:staff-0009" />
                    <display value="Mrs Janet Wilson" />
                </informationSource>
                <dosage>
                    <timing>
                        <repeat>
                            <frequency value="2" />
                            <period value="1" />
                            <periodUnit value="d" />
                        </repeat>
                    </timing>
                    <route>
                        <coding>
                            <system value="http://snomed.info/sct" />
                            <code value="26643006" />
                            <display value="oral" />
                        </coding>
                    </route>
                    <doseAndRate>
                        <doseQuantity>
                            <value value="100" />
                            <unit value="milligram" />
                            <system value="http://unitsofmeasure.org" />
                            <code value="mg" />
                        </doseQuantity>
                    </doseAndRate>
                </dosage>
            </MedicationStatement>
        </resource>
    </entry>
</Bundle>
Command 'json' could not render: File not found for 'subject=chris-packet-example-x2'
Bundle.id[0]24e34f04-270d-446a-a8c2-0991c93e9b46
Bundle.identifier[0].system[0]urn:[organisation_name]:[system_name]
Bundle.identifier[0].value[0]urn:8cd8108d-8c72-4fe9-a284-cd28b127fcfa
Bundle.type[0]message
Bundle.timestamp[0]2021-05-07T16:15:32+00:00
Bundle.entry[0].fullUrl[0]urn:message-header-167434
Bundle.entry[0].resource[0].id[0]urn:message-header-167434
Bundle.entry[0].resource[0].event[0].system[0]https://fhir.hl7.org.uk//CodeSystem/message-event
Bundle.entry[0].resource[0].event[0].code[0]medication-statement
Bundle.entry[0].resource[0].event[0].display[0]Medication Statement
Bundle.entry[0].resource[0].source[0].name[0]ACME Clinical Systems
Bundle.entry[0].resource[0].source[0].software[0]ACME ePMA
Bundle.entry[0].resource[0].source[0].version[0]3.5.68
Bundle.entry[0].resource[0].source[0].endpoint[0]urn:nhs-uk:addressing:ods:T48NT
Bundle.entry[0].resource[0].focus[0].reference[0]urn:medication-statement-123456
Bundle.entry[1].fullUrl[0]urn:patient-01912
Bundle.entry[1].resource[0].id[0]urn:patient-01912
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]4857773456
Bundle.entry[1].resource[0].name[0].use[0]official
Bundle.entry[1].resource[0].name[0].text[0]Mr Chris Packet
Bundle.entry[1].resource[0].name[0].family[0]Packet
Bundle.entry[1].resource[0].name[0].given[0]Chris
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]1995-11-12
Bundle.entry[2].fullUrl[0]urn:staff-1112
Bundle.entry[2].resource[0].id[0]urn:staff-1112
Bundle.entry[2].resource[0].name[0].text[0]Dr Maikeu Well
Bundle.entry[2].resource[0].name[0].family[0]Well
Bundle.entry[2].resource[0].name[0].given[0]Maikeu
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]2145879
Bundle.entry[2].resource[0].qualification[0].code[0].coding[0].display[0]General Medical Council
Bundle.entry[3].fullUrl[0]urn:staff-0009
Bundle.entry[3].resource[0].id[0]urn:staff-0009
Bundle.entry[3].resource[0].name[0].text[0]Mrs Janet Wilson
Bundle.entry[3].resource[0].name[0].family[0]Wilson
Bundle.entry[3].resource[0].name[0].given[0]Janet
Bundle.entry[3].resource[0].name[0].prefix[0]Mrs
Bundle.entry[3].resource[0].qualification[0].code[0].coding[0].system[0]https://fhir.hl7.org.uk/Id/gphc-number
Bundle.entry[3].resource[0].qualification[0].code[0].coding[0].code[0]4563190
Bundle.entry[3].resource[0].qualification[0].code[0].coding[0].display[0]General Pharmaceutical Council
Bundle.entry[4].fullUrl[0]urn:medication-634523423
Bundle.entry[4].resource[0].id[0]urn:medication-634523423
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]322503009
Bundle.entry[4].resource[0].code[0].coding[0].display[0]Codeine 30mg tablets
Bundle.entry[5].fullUrl[0]urn:medication-statement-1234
Bundle.entry[5].resource[0].id[0]urn:medication-statement-1234
Bundle.entry[5].resource[0].status[0]stopped
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]discharge
Bundle.entry[5].resource[0].category[0].coding[0].display[0]Discharge
Bundle.entry[5].resource[0].medication[0].reference[0]urn:medication-634523423
Bundle.entry[5].resource[0].medication[0].display[0]Codeine 30mg tablets
Bundle.entry[5].resource[0].subject[0].reference[0]urn:patient-01912
Bundle.entry[5].resource[0].subject[0].display[0]Mr Chris PACKET
Bundle.entry[5].resource[0].dateAsserted[0]2021-05-07T16:15:32Z
Bundle.entry[5].resource[0].informationSource[0].reference[0]urn:staff-1112
Bundle.entry[5].resource[0].informationSource[0].display[0]Dr Maikeu Better
Bundle.entry[5].resource[0].dosage[0].timing[0].repeat[0].frequency[0]4
Bundle.entry[5].resource[0].dosage[0].timing[0].repeat[0].period[0]1
Bundle.entry[5].resource[0].dosage[0].timing[0].repeat[0].periodUnit[0]d
Bundle.entry[5].resource[0].dosage[0].route[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[5].resource[0].dosage[0].route[0].coding[0].code[0]26643006
Bundle.entry[5].resource[0].dosage[0].route[0].coding[0].display[0]oral
Bundle.entry[5].resource[0].dosage[0].doseAndRate[0].dose[0].value[0]2
Bundle.entry[5].resource[0].dosage[0].doseAndRate[0].dose[0].unit[0]tablet
Bundle.entry[5].resource[0].dosage[0].doseAndRate[0].dose[0].system[0]http://snomed.info/sct
Bundle.entry[5].resource[0].dosage[0].doseAndRate[0].dose[0].code[0]428673006
Bundle.entry[6].fullUrl[0]urn:medication-415159003
Bundle.entry[6].resource[0].id[0]urn:medication-415159003
Bundle.entry[6].resource[0].code[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[6].resource[0].code[0].coding[0].code[0]415159003
Bundle.entry[6].resource[0].code[0].coding[0].display[0]Pregabalin
Bundle.entry[7].fullUrl[0]urn:medication-statement-123456
Bundle.entry[7].resource[0].id[0]urn:medication-statement-123456
Bundle.entry[7].resource[0].status[0]active
Bundle.entry[7].resource[0].category[0].coding[0].system[0]http://hl7.org/fhir/medication-request-category
Bundle.entry[7].resource[0].category[0].coding[0].code[0]discharge
Bundle.entry[7].resource[0].category[0].coding[0].display[0]Discharge
Bundle.entry[7].resource[0].medication[0].reference[0]urn:medication-415159003
Bundle.entry[7].resource[0].medication[0].display[0]Pregabalin
Bundle.entry[7].resource[0].subject[0].reference[0]urn:patient-01912
Bundle.entry[7].resource[0].subject[0].display[0]Mr Chris PACKET
Bundle.entry[7].resource[0].dateAsserted[0]2021-05-09T10:12:42Z
Bundle.entry[7].resource[0].informationSource[0].reference[0]urn:staff-0009
Bundle.entry[7].resource[0].informationSource[0].display[0]Mrs Janet Wilson
Bundle.entry[7].resource[0].dosage[0].timing[0].repeat[0].frequency[0]2
Bundle.entry[7].resource[0].dosage[0].timing[0].repeat[0].period[0]1
Bundle.entry[7].resource[0].dosage[0].timing[0].repeat[0].periodUnit[0]d
Bundle.entry[7].resource[0].dosage[0].route[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[7].resource[0].dosage[0].route[0].coding[0].code[0]26643006
Bundle.entry[7].resource[0].dosage[0].route[0].coding[0].display[0]oral
Bundle.entry[7].resource[0].dosage[0].doseAndRate[0].dose[0].value[0]100
Bundle.entry[7].resource[0].dosage[0].doseAndRate[0].dose[0].unit[0]milligram
Bundle.entry[7].resource[0].dosage[0].doseAndRate[0].dose[0].system[0]http://unitsofmeasure.org
Bundle.entry[7].resource[0].dosage[0].doseAndRate[0].dose[0].code[0]mg
Bundle

Example 7: GP MedicationStatement

Note: This example below is a draft and requires clinical verification.

The GP record sharing the Codine medication has been stopped and the Pregabalin medication has been started.

Actors

Provider System = GP System

Consumer System = Any system requiring a view of current medication, including a shared patient record

Example

<Bundle xmlns="http://hl7.org/fhir">
    <id value="5e6906dc-e333-4e1a-a638-13ac163ec63d" />
    <identifier>
        <system value="urn:[organisation_name]:[system_name]" />
        <value value="urn:457759fb-ea9e-4f23-9d2e-5387eb4bf23e" />
    </identifier>
    <type value="message" />
    <timestamp value="2021-05-07T16:15:32Z" />
    <!--     Message Header     -->
    <entry>
        <fullUrl value="urn:message-header-167434" />
        <resource>
            <MessageHeader>
                <id value="urn:message-header-167434" />
                <eventCoding>
                    <system value="http://hl7.org/fhir/message-events" />
                    <code value="medication-statement" />
                    <display value="Medication Statement" />
                </eventCoding>
                <source>
                    <name value="ACME GP Systems" />
                    <software value="ACME GP" />
                    <version value="5.5.00" />
                    <endpoint value="urn:nhs-uk:addressing:ods:M12345" />
                </source>
                <focus>
                    <reference value="urn:medication-statement-1234" />
                </focus>
                <focus>
                    <reference value="urn:medication-statement-5678" />
                </focus>
            </MessageHeader>
        </resource>
    </entry>
    <!--     // Patient associated with the encounter     -->
    <entry>
        <fullUrl value="urn:patient-01912" />
        <resource>
            <Patient>
                <id value="urn:patient-01912" />
                <identifier>
                    <system value="https://fhir.nhs.uk/Id/nhs-number" />
                    <value value="4857773456" />
                </identifier>
                <name>
                    <use value="official" />
                    <text value="Mr Chris Packet" />
                    <family value="Packet" />
                    <given value="Chris" />
                    <prefix value="Mr" />
                </name>
                <gender value="male" />
                <birthDate value="1995-11-12" />
            </Patient>
        </resource>
    </entry>
    <!--     // Prescribing clinician associated with the encounter.      -->
    <entry>
        <fullUrl value="urn:gp-1234" />
        <resource>
            <Practitioner>
                <id value="urn:gp-1234" />
                <name>
                    <text value="Dr Levy Tate" />
                    <family value="Tate" />
                    <given value="Levy" />
                    <prefix value="Dr" />
                </name>
                <qualification>
                    <code>
                        <coding>
                            <system value="https://fhir.hl7.org.uk/Id/gmc-number" />
                            <code value="125654" />
                            <display value="General Medical Council" />
                        </coding>
                    </code>
                </qualification>
            </Practitioner>
        </resource>
    </entry>
    <!--     // Medication     -->
    <entry>
        <fullUrl value="urn:medication-634523423" />
        <resource>
            <Medication>
                <id value="urn:medication-634523423" />
                <code>
                    <coding>
                        <system value="http://snomed.info/sct" />
                        <code value="322503009" />
                        <display value="Codeine 30mg tablets" />
                    </coding>
                </code>
            </Medication>
        </resource>
    </entry>
    <!--     // MedicationStatement     -->
    <entry>
        <fullUrl value="urn:medication-statement-1234" />
        <resource>
            <MedicationStatement>
                <id value="urn:medication-statement-1234" />
                <status value="stopped" />
                <category>
                    <coding>
                        <system value="http://hl7.org/fhir/medication-request-category" />
                        <code value="community" />
                        <display value="Community" />
                    </coding>
                </category>
                <medicationReference>
                    <reference value="urn:medication-634523423" />
                    <display value="Codeine 30mg tablets" />
                </medicationReference>
                <subject>
                    <reference value="urn:patient-01912" />
                    <display value="Mr Chris PACKET" />
                </subject>
                <dateAsserted value="2021-05-09T10:12:42Z" />
                <informationSource>
                    <reference value="urn:gp-1234" />
                    <display value="Dr Levy Tate" />
                </informationSource>
                <dosage>
                    <timing>
                        <repeat>
                            <frequency value="4" />
                            <period value="1" />
                            <periodUnit value="d" />
                        </repeat>
                    </timing>
                    <route>
                        <coding>
                            <system value="http://snomed.info/sct" />
                            <code value="26643006" />
                            <display value="oral" />
                        </coding>
                    </route>
                    <doseAndRate>
                        <doseQuantity>
                            <value value="2" />
                            <unit value="tablet" />
                            <system value="http://snomed.info/sct" />
                            <code value="428673006" />
                        </doseQuantity>
                    </doseAndRate>
                </dosage>
            </MedicationStatement>
        </resource>
    </entry>
    <!--      // Medication      -->
    <entry>
        <fullUrl value="urn:medication-2378976" />
        <resource>
            <Medication>
                <id value="urn:medication-2378976" />
                <code>
                    <coding>
                        <system value="http://snomed.info/sct" />
                        <code value="38019511000001108" />
                        <display value="Pregabalin 100mg tablets" />
                    </coding>
                </code>
            </Medication>
        </resource>
    </entry>
    <!--      // MedicationStatement      -->
    <entry>
        <fullUrl value="urn:medication-statement-5678" />
        <resource>
            <MedicationStatement>
                <id value="urn:medication-statement-5678" />
                <status value="active" />
                <category>
                    <coding>
                        <system value="http://hl7.org/fhir/medication-request-category" />
                        <code value="community" />
                        <display value="Community" />
                    </coding>
                </category>
                <medicationReference>
                    <reference value="urn:medication-2378976" />
                    <display value="Pregabalin 100mg tablets" />
                </medicationReference>
                <subject>
                    <reference value="urn:patient-01912" />
                    <display value="Mr Chris PACKET" />
                </subject>
                <dateAsserted value="2021-05-09T10:12:42Z" />
                <informationSource>
                    <reference value="urn:gp-1234" />
                    <display value="Dr Levy Tate" />
                </informationSource>
                <dosage>
                    <timing>
                        <repeat>
                            <frequency value="2" />
                            <period value="1" />
                            <periodUnit value="d" />
                        </repeat>
                    </timing>
                    <route>
                        <coding>
                            <system value="http://snomed.info/sct" />
                            <code value="26643006" />
                            <display value="oral" />
                        </coding>
                    </route>
                    <doseAndRate>
                        <doseQuantity>
                            <value value="1" />
                            <unit value="tablet" />
                            <system value="http://snomed.info/sct" />
                            <code value="428673006" />
                        </doseQuantity>
                    </doseAndRate>
                </dosage>
            </MedicationStatement>
        </resource>
    </entry>
</Bundle>

{
    "resourceType": "Bundle",
    "id": "5e6906dc-e333-4e1a-a638-13ac163ec63d",
    "identifier": {
        "system": "urn:[organisation_name]:[system_name]",
        "value": "urn:457759fb-ea9e-4f23-9d2e-5387eb4bf23e"
    },
    "type": "message",
    "timestamp": "05/07/2021 16:15:32",
    "entry":  [
        {
            "fullUrl": "urn:message-header-167434",
            "resource": {
                "resourceType": "MessageHeader",
                "id": "urn:message-header-167434",
                "eventCoding": {
                    "system": "http://hl7.org/fhir/message-events",
                    "code": "medication-statement",
                    "display": "Medication Statement"
                },
                "source": {
                    "name": "ACME GP Systems",
                    "software": "ACME GP",
                    "version": "5.5.00",
                    "endpoint": "urn:nhs-uk:addressing:ods:M12345"
                },
                "focus":  [
                    {
                        "reference": "urn:medication-statement-1234"
                    },
                    {
                        "reference": "urn:medication-statement-5678"
                    }
                ]
            }
        },
        {
            "fullUrl": "urn:patient-01912",
            "resource": {
                "resourceType": "Patient",
                "id": "urn:patient-01912",
                "identifier":  [
                    {
                        "system": "https://fhir.nhs.uk/Id/nhs-number",
                        "value": "4857773456"
                    }
                ],
                "name":  [
                    {
                        "use": "official",
                        "text": "Mr Chris Packet",
                        "family": "Packet",
                        "given":  [
                            "Chris"
                        ],
                        "prefix":  [
                            "Mr"
                        ]
                    }
                ],
                "gender": "male",
                "birthDate": "1995-11-12"
            }
        },
        {
            "fullUrl": "urn:gp-1234",
            "resource": {
                "resourceType": "Practitioner",
                "id": "urn:gp-1234",
                "name":  [
                    {
                        "text": "Dr Levy Tate",
                        "family": "Tate",
                        "given":  [
                            "Levy"
                        ],
                        "prefix":  [
                            "Dr"
                        ]
                    }
                ],
                "qualification":  [
                    {
                        "code": {
                            "coding":  [
                                {
                                    "system": "https://fhir.hl7.org.uk/Id/gmc-number",
                                    "code": "125654",
                                    "display": "General Medical Council"
                                }
                            ]
                        }
                    }
                ]
            }
        },
        {
            "fullUrl": "urn:medication-634523423",
            "resource": {
                "resourceType": "Medication",
                "id": "urn:medication-634523423",
                "code": {
                    "coding":  [
                        {
                            "system": "http://snomed.info/sct",
                            "code": "322503009",
                            "display": "Codeine 30mg tablets"
                        }
                    ]
                }
            }
        },
        {
            "fullUrl": "urn:medication-statement-1234",
            "resource": {
                "resourceType": "MedicationStatement",
                "id": "urn:medication-statement-1234",
                "status": "stopped",
                "category": {
                    "coding":  [
                        {
                            "system": "http://hl7.org/fhir/medication-request-category",
                            "code": "community",
                            "display": "Community"
                        }
                    ]
                },
                "medicationReference": {
                    "reference": "urn:medication-634523423",
                    "display": "Codeine 30mg tablets"
                },
                "subject": {
                    "reference": "urn:patient-01912",
                    "display": "Mr Chris PACKET"
                },
                "dateAsserted": "05/09/2021 10:12:42",
                "informationSource": {
                    "reference": "urn:gp-1234",
                    "display": "Dr Levy Tate"
                },
                "dosage":  [
                    {
                        "timing": {
                            "repeat": {
                                "frequency": 4,
                                "period": 1,
                                "periodUnit": "d"
                            }
                        },
                        "route": {
                            "coding":  [
                                {
                                    "system": "http://snomed.info/sct",
                                    "code": "26643006",
                                    "display": "oral"
                                }
                            ]
                        },
                        "doseAndRate":  [
                            {
                                "doseQuantity": {
                                    "value": 2,
                                    "unit": "tablet",
                                    "system": "http://snomed.info/sct",
                                    "code": "428673006"
                                }
                            }
                        ]
                    }
                ]
            }
        },
        {
            "fullUrl": "urn:medication-2378976",
            "resource": {
                "resourceType": "Medication",
                "id": "urn:medication-2378976",
                "code": {
                    "coding":  [
                        {
                            "system": "http://snomed.info/sct",
                            "code": "38019511000001108",
                            "display": "Pregabalin 100mg tablets"
                        }
                    ]
                }
            }
        },
        {
            "fullUrl": "urn:medication-statement-5678",
            "resource": {
                "resourceType": "MedicationStatement",
                "id": "urn:medication-statement-5678",
                "status": "active",
                "category": {
                    "coding":  [
                        {
                            "system": "http://hl7.org/fhir/medication-request-category",
                            "code": "community",
                            "display": "Community"
                        }
                    ]
                },
                "medicationReference": {
                    "reference": "urn:medication-2378976",
                    "display": "Pregabalin 100mg tablets"
                },
                "subject": {
                    "reference": "urn:patient-01912",
                    "display": "Mr Chris PACKET"
                },
                "dateAsserted": "05/09/2021 10:12:42",
                "informationSource": {
                    "reference": "urn:gp-1234",
                    "display": "Dr Levy Tate"
                },
                "dosage":  [
                    {
                        "timing": {
                            "repeat": {
                                "frequency": 2,
                                "period": 1,
                                "periodUnit": "d"
                            }
                        },
                        "route": {
                            "coding":  [
                                {
                                    "system": "http://snomed.info/sct",
                                    "code": "26643006",
                                    "display": "oral"
                                }
                            ]
                        },
                        "doseAndRate":  [
                            {
                                "doseQuantity": {
                                    "value": 1,
                                    "unit": "tablet",
                                    "system": "http://snomed.info/sct",
                                    "code": "428673006"
                                }
                            }
                        ]
                    }
                ]
            }
        }
    ]
}
Bundle.id[0]5e6906dc-e333-4e1a-a638-13ac163ec63d
Bundle.identifier[0].system[0]urn:[organisation_name]:[system_name]
Bundle.identifier[0].value[0]urn:457759fb-ea9e-4f23-9d2e-5387eb4bf23e
Bundle.type[0]message
Bundle.timestamp[0]2021-05-07T16:15:32+00:00
Bundle.entry[0].fullUrl[0]urn:message-header-167434
Bundle.entry[0].resource[0].id[0]urn:message-header-167434
Bundle.entry[0].resource[0].event[0].system[0]http://hl7.org/fhir/message-events
Bundle.entry[0].resource[0].event[0].code[0]medication-statement
Bundle.entry[0].resource[0].event[0].display[0]Medication Statement
Bundle.entry[0].resource[0].source[0].name[0]ACME GP Systems
Bundle.entry[0].resource[0].source[0].software[0]ACME GP
Bundle.entry[0].resource[0].source[0].version[0]5.5.00
Bundle.entry[0].resource[0].source[0].endpoint[0]urn:nhs-uk:addressing:ods:M12345
Bundle.entry[0].resource[0].focus[0].reference[0]urn:medication-statement-1234
Bundle.entry[0].resource[0].focus[1].reference[0]urn:medication-statement-5678
Bundle.entry[1].fullUrl[0]urn:patient-01912
Bundle.entry[1].resource[0].id[0]urn:patient-01912
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]4857773456
Bundle.entry[1].resource[0].name[0].use[0]official
Bundle.entry[1].resource[0].name[0].text[0]Mr Chris Packet
Bundle.entry[1].resource[0].name[0].family[0]Packet
Bundle.entry[1].resource[0].name[0].given[0]Chris
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]1995-11-12
Bundle.entry[2].fullUrl[0]urn:gp-1234
Bundle.entry[2].resource[0].id[0]urn:gp-1234
Bundle.entry[2].resource[0].name[0].text[0]Dr Levy Tate
Bundle.entry[2].resource[0].name[0].family[0]Tate
Bundle.entry[2].resource[0].name[0].given[0]Levy
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]125654
Bundle.entry[2].resource[0].qualification[0].code[0].coding[0].display[0]General Medical Council
Bundle.entry[3].fullUrl[0]urn:medication-634523423
Bundle.entry[3].resource[0].id[0]urn:medication-634523423
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]322503009
Bundle.entry[3].resource[0].code[0].coding[0].display[0]Codeine 30mg tablets
Bundle.entry[4].fullUrl[0]urn:medication-statement-1234
Bundle.entry[4].resource[0].id[0]urn:medication-statement-1234
Bundle.entry[4].resource[0].status[0]stopped
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]community
Bundle.entry[4].resource[0].category[0].coding[0].display[0]Community
Bundle.entry[4].resource[0].medication[0].reference[0]urn:medication-634523423
Bundle.entry[4].resource[0].medication[0].display[0]Codeine 30mg tablets
Bundle.entry[4].resource[0].subject[0].reference[0]urn:patient-01912
Bundle.entry[4].resource[0].subject[0].display[0]Mr Chris PACKET
Bundle.entry[4].resource[0].dateAsserted[0]2021-05-09T10:12:42Z
Bundle.entry[4].resource[0].informationSource[0].reference[0]urn:gp-1234
Bundle.entry[4].resource[0].informationSource[0].display[0]Dr Levy Tate
Bundle.entry[4].resource[0].dosage[0].timing[0].repeat[0].frequency[0]4
Bundle.entry[4].resource[0].dosage[0].timing[0].repeat[0].period[0]1
Bundle.entry[4].resource[0].dosage[0].timing[0].repeat[0].periodUnit[0]d
Bundle.entry[4].resource[0].dosage[0].route[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[4].resource[0].dosage[0].route[0].coding[0].code[0]26643006
Bundle.entry[4].resource[0].dosage[0].route[0].coding[0].display[0]oral
Bundle.entry[4].resource[0].dosage[0].doseAndRate[0].dose[0].value[0]2
Bundle.entry[4].resource[0].dosage[0].doseAndRate[0].dose[0].unit[0]tablet
Bundle.entry[4].resource[0].dosage[0].doseAndRate[0].dose[0].system[0]http://snomed.info/sct
Bundle.entry[4].resource[0].dosage[0].doseAndRate[0].dose[0].code[0]428673006
Bundle.entry[5].fullUrl[0]urn:medication-2378976
Bundle.entry[5].resource[0].id[0]urn:medication-2378976
Bundle.entry[5].resource[0].code[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[5].resource[0].code[0].coding[0].code[0]38019511000001108
Bundle.entry[5].resource[0].code[0].coding[0].display[0]Pregabalin 100mg tablets
Bundle.entry[6].fullUrl[0]urn:medication-statement-5678
Bundle.entry[6].resource[0].id[0]urn:medication-statement-5678
Bundle.entry[6].resource[0].status[0]active
Bundle.entry[6].resource[0].category[0].coding[0].system[0]http://hl7.org/fhir/medication-request-category
Bundle.entry[6].resource[0].category[0].coding[0].code[0]community
Bundle.entry[6].resource[0].category[0].coding[0].display[0]Community
Bundle.entry[6].resource[0].medication[0].reference[0]urn:medication-2378976
Bundle.entry[6].resource[0].medication[0].display[0]Pregabalin 100mg tablets
Bundle.entry[6].resource[0].subject[0].reference[0]urn:patient-01912
Bundle.entry[6].resource[0].subject[0].display[0]Mr Chris PACKET
Bundle.entry[6].resource[0].dateAsserted[0]2021-05-09T10:12:42Z
Bundle.entry[6].resource[0].informationSource[0].reference[0]urn:gp-1234
Bundle.entry[6].resource[0].informationSource[0].display[0]Dr Levy Tate
Bundle.entry[6].resource[0].dosage[0].timing[0].repeat[0].frequency[0]2
Bundle.entry[6].resource[0].dosage[0].timing[0].repeat[0].period[0]1
Bundle.entry[6].resource[0].dosage[0].timing[0].repeat[0].periodUnit[0]d
Bundle.entry[6].resource[0].dosage[0].route[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[6].resource[0].dosage[0].route[0].coding[0].code[0]26643006
Bundle.entry[6].resource[0].dosage[0].route[0].coding[0].display[0]oral
Bundle.entry[6].resource[0].dosage[0].doseAndRate[0].dose[0].value[0]1
Bundle.entry[6].resource[0].dosage[0].doseAndRate[0].dose[0].unit[0]tablet
Bundle.entry[6].resource[0].dosage[0].doseAndRate[0].dose[0].system[0]http://snomed.info/sct
Bundle.entry[6].resource[0].dosage[0].doseAndRate[0].dose[0].code[0]428673006
Bundle
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