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.

Avloclor tablets

Product-based prescription (AMP) using patient instruction for start and duration.

Complex because the instruction to “start one week before travel and continue until 4 weeks after return” cannot be a coded instruction so is conveyed as free-text within patientlInstruction.

<MedicationRequest xmlns="http://hl7.org/fhir">
    <id value="1d0bc824-f2bf-42c8-b7f9-954e7f6bbd98" />
    <meta>
        <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest" />
    </meta>
    <status value="active" />
    <intent value="order" />
    <category>
        <coding>
            <system value="http://terminology.hl7.org/CodeSystem/medicationrequest-category" />
            <code value="outpatient" />
            <display value="outpatient" />
        </coding>
    </category>
    <medicationCodeableConcept>
        <coding>
            <system value="https://dmd.nhs.uk" />
            <code value="3727711000001102" />
            <display value="Avloclor 250mg tablets (Alliance Pharmaceuticals Ltd)" />
        </coding>
    </medicationCodeableConcept>
    <subject>
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="9999999999" />
        </identifier>
    </subject>
    <authoredOn value="2020-05-15T15:00:00Z" />
    <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>
        <text value="2 tablet - once a week - Start one week before travel and continue until 4 weeks after return" />
        <patientInstruction value="2 tablet - once a week - Start one week before travel and continue until 4 weeks after return" />
        <timing>
            <repeat>
                <frequency value="1" />
                <period value="1" />
                <periodUnit value="wk" />
            </repeat>
        </timing>
        <doseAndRate>
            <doseQuantity>
                <value value="2" />
                <unit value="tablet" />
                <system value="http://snomed.info/sct" />
                <code value="428673006" />
            </doseQuantity>
        </doseAndRate>
    </dosageInstruction>
    <dispenseRequest>
        <quantity>
            <value value="20" />
            <unit value="tablet" />
            <system value="http://snomed.info/sct" />
            <code value="428673006" />
        </quantity>
    </dispenseRequest>
    <substitution>
        <allowedBoolean value="false" />
    </substitution>
</MedicationRequest>

{
    "resourceType": "MedicationRequest",
    "id": "1d0bc824-f2bf-42c8-b7f9-954e7f6bbd98",
    "meta": {
        "profile":  [
            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest"
        ]
    },
    "status": "active",
    "intent": "order",
    "category":  [
        {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/medicationrequest-category",
                    "code": "outpatient",
                    "display": "outpatient"
                }
            ]
        }
    ],
    "medicationCodeableConcept": {
        "coding":  [
            {
                "system": "https://dmd.nhs.uk",
                "code": "3727711000001102",
                "display": "Avloclor 250mg tablets (Alliance Pharmaceuticals Ltd)"
            }
        ]
    },
    "subject": {
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9999999999"
        }
    },
    "authoredOn": "2020-05-15T15:00:00Z",
    "requester": {
        "reference": "urn:staff-1112",
        "display": "Dr Maikeu Well"
    },
    "recorder": {
        "reference": "urn:staff-1112",
        "display": "Dr Maikeu Well"
    },
    "dosageInstruction":  [
        {
            "text": "2 tablet - once a week - Start one week before travel and continue until 4 weeks after return",
            "patientInstruction": "2 tablet - once a week - Start one week before travel and continue until 4 weeks after return",
            "timing": {
                "repeat": {
                    "frequency": 1,
                    "period": 1,
                    "periodUnit": "wk"
                }
            },
            "doseAndRate":  [
                {
                    "doseQuantity": {
                        "value": 2,
                        "unit": "tablet",
                        "system": "http://snomed.info/sct",
                        "code": "428673006"
                    }
                }
            ]
        }
    ],
    "dispenseRequest": {
        "quantity": {
            "value": 20,
            "unit": "tablet",
            "system": "http://snomed.info/sct",
            "code": "428673006"
        }
    },
    "substitution": {
        "allowedBoolean": false
    }
}
MedicationRequest.id[0]1d0bc824-f2bf-42c8-b7f9-954e7f6bbd98
MedicationRequest.meta[0].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.category[0].coding[0].system[0]http://terminology.hl7.org/CodeSystem/medicationrequest-category
MedicationRequest.category[0].coding[0].code[0]outpatient
MedicationRequest.category[0].coding[0].display[0]outpatient
MedicationRequest.medication[0].coding[0].system[0]https://dmd.nhs.uk
MedicationRequest.medication[0].coding[0].code[0]3727711000001102
MedicationRequest.medication[0].coding[0].display[0]Avloclor 250mg tablets (Alliance Pharmaceuticals Ltd)
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.authoredOn[0]2020-05-15T15:00:00Z
MedicationRequest.requester[0].reference[0]urn:staff-1112
MedicationRequest.requester[0].display[0]Dr Maikeu Well
MedicationRequest.recorder[0].reference[0]urn:staff-1112
MedicationRequest.recorder[0].display[0]Dr Maikeu Well
MedicationRequest.dosageInstruction[0].text[0]2 tablet - once a week - Start one week before travel and continue until 4 weeks after return
MedicationRequest.dosageInstruction[0].patientInstruction[0]2 tablet - once a week - Start one week before travel and continue until 4 weeks after return
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].frequency[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].period[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].periodUnit[0]wk
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].value[0]2
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].unit[0]tablet
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].code[0]428673006
MedicationRequest.dispenseRequest[0].quantity[0].value[0]20
MedicationRequest.dispenseRequest[0].quantity[0].unit[0]tablet
MedicationRequest.dispenseRequest[0].quantity[0].system[0]http://snomed.info/sct
MedicationRequest.dispenseRequest[0].quantity[0].code[0]428673006
MedicationRequest.substitution[0].allowed[0]False
MedicationRequest

Example on-screen presentation:

Avloclor 250mg tablets (Alliance Pharmaceuticals Ltd)
2 tablet - once a week - start one week before travel and continue until 4 weeks after return
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