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.

Ceftriaxone continuous infusion

Clinical Scenario

The patient requires 1 gram of Ceftriaxone to be infused over 30 minutes, once a day, for 5 days, for pneumonia.

Prescribing Event

This MedicationRequest is created by the EPMA system for the prescription/order for Ceftriaxone via an infusion. This resource would be made available to the hospital pharmacy.

<MedicationRequest xmlns="http://hl7.org/fhir">
    <id value="34eb3c92-76e6-48c2-9691-aa1f0b58369b" />
    <meta>
        <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest" />
    </meta>
    <medicationCodeableConcept>
        <coding>
            <system value="https://dmd.nhs.uk" />
            <code value="19841008" />
            <display value="Ceftriaxone" />
        </coding>
    </medicationCodeableConcept>
    <subject>
        <reference value="Patient/UKCore-Patient-RichardSmith-Example" />
    </subject>
    <reasonCode>
        <coding>
            <system value="http://snomed.info/sct" />
            <code value="233604007" />
            <display value="Pneumonia" />
        </coding>
    </reasonCode>
    <dosageInstruction>
        <text value="Continuous infusion 1 gram - Intravenous - over 30 minutes - daily - for 5 days" />
        <timing>
            <repeat>
                <boundsDuration>
                    <value value="5" />
                    <unit value="day" />
                    <system value="http://unitsofmeasure.org" />
                    <code value="d" />
                </boundsDuration>
                <duration value="30" />
                <durationUnit value="min" />
                <frequency value="1" />
                <period value="1" />
                <periodUnit value="d" />
            </repeat>
        </timing>
        <route>
            <coding>
                <system value="https://dmd.nhs.uk" />
                <code value="47625008" />
                <display value="Intravenous" />
            </coding>
        </route>
        <method>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="261754007" />
                <display value="Continuous infusion" />
            </coding>
        </method>
        <doseAndRate>
            <doseQuantity>
                <value value="1" />
                <unit value="gram" />
                <system value="http://unitsofmeasure.org" />
                <code value="g" />
            </doseQuantity>
        </doseAndRate>
    </dosageInstruction>
</MedicationRequest>

{
    "resourceType": "MedicationRequest",
    "id": "34eb3c92-76e6-48c2-9691-aa1f0b58369b",
    "meta": {
        "profile":  [
            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest"
        ]
    },
    "subject": {
        "reference": "Patient/UKCore-Patient-RichardSmith-Example"
    },
    "medicationCodeableConcept": {
        "coding":  [
            {
                "system": "https://dmd.nhs.uk",
                "code": "19841008",
                "display": "Ceftriaxone"
            }
        ]
    },
    "reasonCode":  [
        {
            "coding":  [
                {
                    "system": "http://snomed.info/sct",
                    "code": "233604007",
                    "display": "Pneumonia"
                }
            ]
        }
    ],
    "dosageInstruction":  [
        {
            "text": "Continuous infusion 1 gram - Intravenous - over 30 minutes - daily - for 5 days",
            "timing": {
                "repeat": {
                    "boundsDuration": {
                        "value": 5,
                        "unit": "day",
                        "system": "http://unitsofmeasure.org",
                        "code": "d"
                    },
                    "duration": 30,
                    "durationUnit": "min",
                    "frequency": 1,
                    "period": 1,
                    "periodUnit": "d"
                }
            },
            "method": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "261754007",
                        "display": "Continuous infusion"
                    }
                ]
            },
            "route": {
                "coding":  [
                    {
                        "system": "https://dmd.nhs.uk",
                        "code": "47625008",
                        "display": "Intravenous"
                    }
                ]
            },
            "doseAndRate":  [
                {
                    "doseQuantity": {
                        "value": 1,
                        "unit": "gram",
                        "system": "http://unitsofmeasure.org",
                        "code": "g"
                    }
                }
            ]
        }
    ]
}
MedicationRequest.id[0]34eb3c92-76e6-48c2-9691-aa1f0b58369b
MedicationRequest.meta[0].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest
MedicationRequest.medication[0].coding[0].system[0]https://dmd.nhs.uk
MedicationRequest.medication[0].coding[0].code[0]19841008
MedicationRequest.medication[0].coding[0].display[0]Ceftriaxone
MedicationRequest.subject[0].reference[0]Patient/UKCore-Patient-RichardSmith-Example
MedicationRequest.reasonCode[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.reasonCode[0].coding[0].code[0]233604007
MedicationRequest.reasonCode[0].coding[0].display[0]Pneumonia
MedicationRequest.dosageInstruction[0].text[0]Continuous infusion 1 gram - Intravenous - over 30 minutes - daily - for 5 days
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].value[0]5
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].unit[0]day
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].code[0]d
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].duration[0]30
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].durationUnit[0]min
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]d
MedicationRequest.dosageInstruction[0].route[0].coding[0].system[0]https://dmd.nhs.uk
MedicationRequest.dosageInstruction[0].route[0].coding[0].code[0]47625008
MedicationRequest.dosageInstruction[0].route[0].coding[0].display[0]Intravenous
MedicationRequest.dosageInstruction[0].method[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].method[0].coding[0].code[0]261754007
MedicationRequest.dosageInstruction[0].method[0].coding[0].display[0]Continuous infusion
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].value[0]1
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].unit[0]gram
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].code[0]g
MedicationRequest

Dispensing Event: Prepared by Pharmacy

Note: This example is work-in-progress and may be subject to change.

If the infusion is to be prepared by the hospital pharamcy team.

This Bundle is created by the pharmacy system for what has been dispensed. A bundle is used in this example because it contains two resources. A Medication resource details the two ingredients that have been used to prepare the infusion. A MedicationDispense references the Medication and details the dosing instruction for the infusion. This bundle would be made available to the ward EPMA system.

<Bundle xmlns="http://hl7.org/fhir">
    <type value="message" />
    <entry>
        <fullUrl value="urn:uuid:682858a9-3942-412d-9ae5-71a2f17f7c5b" />
        <resource>
            <MessageHeader>
                <id value="682858a9-3942-412d-9ae5-71a2f17f7c5b" />
                <eventCoding>
                    <system value="http://snomed.info/sct" />
                    <code value="373784005" />
                    <display value="Dispensing medication" />
                </eventCoding>
                <source>
                    <endpoint value="https://myendpoint.nhs.uk/" />
                </source>
                <focus>
                    <reference value="7b36eb7b-ea3f-44fb-87c9-dfa51e4b6d5b" />
                    <type value="MedicationDispense" />
                </focus>
            </MessageHeader>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:11dc9519-b6e8-41bb-bce5-f6f724b743bc" />
        <resource>
            <Medication>
                <id value="11dc9519-b6e8-41bb-bce5-f6f724b743bc" />
                <meta>
                    <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Medication" />
                </meta>
                <code>
                    <text value="Ceftriaxone 1g in 50mL Sodium chloride 0.9% solution for infusion" />
                </code>
                <form>
                    <coding>
                        <system value="https://dmd.nhs.uk" />
                        <code value="385229008" />
                        <display value="Solution for infusion" />
                    </coding>
                </form>
                <ingredient>
                    <itemCodeableConcept>
                        <coding>
                            <system value="https://dmd.nhs.uk" />
                            <code value="22824911000001102" />
                            <display value="Ceftriaxone 1g powder for solution for infusion vials (Kent Pharma (UK) Ltd)" />
                        </coding>
                    </itemCodeableConcept>
                    <strength>
                        <numerator>
                            <value value="1" />
                            <unit value="gram" />
                            <system value="http://unitsofmeasure.org" />
                            <code value="g" />
                        </numerator>
                        <denominator>
                            <value value="1" />
                        </denominator>
                    </strength>
                </ingredient>
                <ingredient>
                    <itemCodeableConcept>
                        <coding>
                            <system value="https://dmd.nhs.uk" />
                            <code value="4880711000001109" />
                            <display value="Sodium chloride 0.9% infusion 50ml Mini-Bag Viaflex bags (Baxter Healthcare Ltd)" />
                        </coding>
                    </itemCodeableConcept>
                    <strength>
                        <numerator>
                            <value value="50" />
                            <unit value="millilitre" />
                            <system value="http://unitsofmeasure.org" />
                            <code value="ml" />
                        </numerator>
                        <denominator>
                            <value value="1" />
                        </denominator>
                    </strength>
                </ingredient>
            </Medication>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:7b36eb7b-ea3f-44fb-87c9-dfa51e4b6d5b" />
        <resource>
            <MedicationDispense>
                <id value="7b36eb7b-ea3f-44fb-87c9-dfa51e4b6d5b" />
                <meta>
                    <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationDispense" />
                </meta>
                <status value="completed" />
                <medicationReference>
                    <reference value="11dc9519-b6e8-41bb-bce5-f6f724b743bc" />
                    <type value="Medication" />
                </medicationReference>
                <subject>
                    <reference value="Patient/UKCore-Patient-RichardSmith-Example" />
                </subject>
                <authorizingPrescription>
                    <reference value="34eb3c92-76e6-48c2-9691-aa1f0b58369b" />
                    <type value="MedicationRequest" />
                </authorizingPrescription>
                <quantity>
                    <value value="5" />
                    <unit value="bag" />
                    <system value="http://snomed.info/sct" />
                    <code value="428672001" />
                </quantity>
                <dosageInstruction>
                    <text value="Continuous infusion 50 millilitre - Intravenous - over 30 minutes - daily - for 5 days" />
                    <timing>
                        <repeat>
                            <boundsDuration>
                                <value value="5" />
                                <unit value="day" />
                                <system value="http://unitsofmeasure.org" />
                                <code value="d" />
                            </boundsDuration>
                            <duration value="30" />
                            <durationUnit value="min" />
                            <frequency value="1" />
                            <period value="1" />
                            <periodUnit value="d" />
                        </repeat>
                    </timing>
                    <route>
                        <coding>
                            <system value="https://dmd.nhs.uk" />
                            <code value="47625008" />
                            <display value="Intravenous" />
                        </coding>
                    </route>
                    <method>
                        <coding>
                            <system value="http://snomed.info/sct" />
                            <code value="261754007" />
                            <display value="Continuous infusion" />
                        </coding>
                    </method>
                    <doseAndRate>
                        <doseQuantity>
                            <value value="50" />
                            <unit value="millilitre" />
                            <system value="http://unitsofmeasure.org" />
                            <code value="ml" />
                        </doseQuantity>
                    </doseAndRate>
                </dosageInstruction>
            </MedicationDispense>
        </resource>
    </entry>
</Bundle>

{
    "resourceType": "Bundle",
    "type": "message",
    "entry":  [
        {
            "fullUrl": "urn:uuid:682858a9-3942-412d-9ae5-71a2f17f7c5b",
            "resource": {
                "resourceType": "MessageHeader",
                "id": "682858a9-3942-412d-9ae5-71a2f17f7c5b",
                "eventCoding": {
                    "system": "http://snomed.info/sct",
                    "code": "373784005",
                    "display": "Dispensing medication"
                },
                "source": {
                    "endpoint": "https://myendpoint.nhs.uk/"
                },
                "focus":  [
                    {
                        "reference": "7b36eb7b-ea3f-44fb-87c9-dfa51e4b6d5b",
                        "type": "MedicationDispense"
                    }
                ]
            }
        },
        {
            "fullUrl": "urn:uuid:11dc9519-b6e8-41bb-bce5-f6f724b743bc",
            "resource": {
                "resourceType": "Medication",
                "id": "11dc9519-b6e8-41bb-bce5-f6f724b743bc",
                "meta": {
                    "profile":  [
                        "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Medication"
                    ]
                },
                "form": {
                    "coding":  [
                        {
                            "system": "https://dmd.nhs.uk",
                            "code": "385229008",
                            "display": "Solution for infusion"
                        }
                    ]
                },
                "code": {
                    "text": "Ceftriaxone 1g in 50mL Sodium chloride 0.9% solution for infusion"
                },
                "ingredient":  [
                    {
                        "itemCodeableConcept": {
                            "coding":  [
                                {
                                    "system": "https://dmd.nhs.uk",
                                    "code": "22824911000001102",
                                    "display": "Ceftriaxone 1g powder for solution for infusion vials (Kent Pharma (UK) Ltd)"
                                }
                            ]
                        },
                        "strength": {
                            "numerator": {
                                "value": 1,
                                "unit": "gram",
                                "system": "http://unitsofmeasure.org",
                                "code": "g"
                            },
                            "denominator": {
                                "value": 1
                            }
                        }
                    },
                    {
                        "itemCodeableConcept": {
                            "coding":  [
                                {
                                    "system": "https://dmd.nhs.uk",
                                    "code": "4880711000001109",
                                    "display": "Sodium chloride 0.9% infusion 50ml Mini-Bag Viaflex bags (Baxter Healthcare Ltd)"
                                }
                            ]
                        },
                        "strength": {
                            "numerator": {
                                "value": 50,
                                "unit": "millilitre",
                                "system": "http://unitsofmeasure.org",
                                "code": "ml"
                            },
                            "denominator": {
                                "value": 1
                            }
                        }
                    }
                ]
            }
        },
        {
            "fullUrl": "urn:uuid:7b36eb7b-ea3f-44fb-87c9-dfa51e4b6d5b",
            "resource": {
                "resourceType": "MedicationDispense",
                "id": "7b36eb7b-ea3f-44fb-87c9-dfa51e4b6d5b",
                "meta": {
                    "profile":  [
                        "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationDispense"
                    ]
                },
                "subject": {
                    "reference": "Patient/UKCore-Patient-RichardSmith-Example"
                },
                "status": "completed",
                "medicationReference": {
                    "reference": "11dc9519-b6e8-41bb-bce5-f6f724b743bc",
                    "type": "Medication"
                },
                "authorizingPrescription":  [
                    {
                        "reference": "34eb3c92-76e6-48c2-9691-aa1f0b58369b",
                        "type": "MedicationRequest"
                    }
                ],
                "quantity": {
                    "value": 5,
                    "unit": "bag",
                    "system": "http://snomed.info/sct",
                    "code": "428672001"
                },
                "dosageInstruction":  [
                    {
                        "text": "Continuous infusion 50 millilitre - Intravenous - over 30 minutes - daily - for 5 days",
                        "timing": {
                            "repeat": {
                                "boundsDuration": {
                                    "value": 5,
                                    "unit": "day",
                                    "system": "http://unitsofmeasure.org",
                                    "code": "d"
                                },
                                "duration": 30,
                                "durationUnit": "min",
                                "frequency": 1,
                                "period": 1,
                                "periodUnit": "d"
                            }
                        },
                        "method": {
                            "coding":  [
                                {
                                    "system": "http://snomed.info/sct",
                                    "code": "261754007",
                                    "display": "Continuous infusion"
                                }
                            ]
                        },
                        "route": {
                            "coding":  [
                                {
                                    "system": "https://dmd.nhs.uk",
                                    "code": "47625008",
                                    "display": "Intravenous"
                                }
                            ]
                        },
                        "doseAndRate":  [
                            {
                                "doseQuantity": {
                                    "value": 50,
                                    "unit": "millilitre",
                                    "system": "http://unitsofmeasure.org",
                                    "code": "ml"
                                }
                            }
                        ]
                    }
                ]
            }
        }
    ]
}
Bundle.type[0]message
Bundle.entry[0].fullUrl[0]urn:uuid:682858a9-3942-412d-9ae5-71a2f17f7c5b
Bundle.entry[0].resource[0].id[0]682858a9-3942-412d-9ae5-71a2f17f7c5b
Bundle.entry[0].resource[0].event[0].system[0]http://snomed.info/sct
Bundle.entry[0].resource[0].event[0].code[0]373784005
Bundle.entry[0].resource[0].event[0].display[0]Dispensing medication
Bundle.entry[0].resource[0].source[0].endpoint[0]https://myendpoint.nhs.uk/
Bundle.entry[0].resource[0].focus[0].reference[0]7b36eb7b-ea3f-44fb-87c9-dfa51e4b6d5b
Bundle.entry[0].resource[0].focus[0].type[0]MedicationDispense
Bundle.entry[1].fullUrl[0]urn:uuid:11dc9519-b6e8-41bb-bce5-f6f724b743bc
Bundle.entry[1].resource[0].id[0]11dc9519-b6e8-41bb-bce5-f6f724b743bc
Bundle.entry[1].resource[0].meta[0].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-Medication
Bundle.entry[1].resource[0].code[0].text[0]Ceftriaxone 1g in 50mL Sodium chloride 0.9% solution for infusion
Bundle.entry[1].resource[0].form[0].coding[0].system[0]https://dmd.nhs.uk
Bundle.entry[1].resource[0].form[0].coding[0].code[0]385229008
Bundle.entry[1].resource[0].form[0].coding[0].display[0]Solution for infusion
Bundle.entry[1].resource[0].ingredient[0].item[0].coding[0].system[0]https://dmd.nhs.uk
Bundle.entry[1].resource[0].ingredient[0].item[0].coding[0].code[0]22824911000001102
Bundle.entry[1].resource[0].ingredient[0].item[0].coding[0].display[0]Ceftriaxone 1g powder for solution for infusion vials (Kent Pharma (UK) Ltd)
Bundle.entry[1].resource[0].ingredient[0].strength[0].numerator[0].value[0]1
Bundle.entry[1].resource[0].ingredient[0].strength[0].numerator[0].unit[0]gram
Bundle.entry[1].resource[0].ingredient[0].strength[0].numerator[0].system[0]http://unitsofmeasure.org
Bundle.entry[1].resource[0].ingredient[0].strength[0].numerator[0].code[0]g
Bundle.entry[1].resource[0].ingredient[0].strength[0].denominator[0].value[0]1
Bundle.entry[1].resource[0].ingredient[1].item[0].coding[0].system[0]https://dmd.nhs.uk
Bundle.entry[1].resource[0].ingredient[1].item[0].coding[0].code[0]4880711000001109
Bundle.entry[1].resource[0].ingredient[1].item[0].coding[0].display[0]Sodium chloride 0.9% infusion 50ml Mini-Bag Viaflex bags (Baxter Healthcare Ltd)
Bundle.entry[1].resource[0].ingredient[1].strength[0].numerator[0].value[0]50
Bundle.entry[1].resource[0].ingredient[1].strength[0].numerator[0].unit[0]millilitre
Bundle.entry[1].resource[0].ingredient[1].strength[0].numerator[0].system[0]http://unitsofmeasure.org
Bundle.entry[1].resource[0].ingredient[1].strength[0].numerator[0].code[0]ml
Bundle.entry[1].resource[0].ingredient[1].strength[0].denominator[0].value[0]1
Bundle.entry[2].fullUrl[0]urn:uuid:7b36eb7b-ea3f-44fb-87c9-dfa51e4b6d5b
Bundle.entry[2].resource[0].id[0]7b36eb7b-ea3f-44fb-87c9-dfa51e4b6d5b
Bundle.entry[2].resource[0].meta[0].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationDispense
Bundle.entry[2].resource[0].status[0]completed
Bundle.entry[2].resource[0].medication[0].reference[0]11dc9519-b6e8-41bb-bce5-f6f724b743bc
Bundle.entry[2].resource[0].medication[0].type[0]Medication
Bundle.entry[2].resource[0].subject[0].reference[0]Patient/UKCore-Patient-RichardSmith-Example
Bundle.entry[2].resource[0].authorizingPrescription[0].reference[0]34eb3c92-76e6-48c2-9691-aa1f0b58369b
Bundle.entry[2].resource[0].authorizingPrescription[0].type[0]MedicationRequest
Bundle.entry[2].resource[0].quantity[0].value[0]5
Bundle.entry[2].resource[0].quantity[0].unit[0]bag
Bundle.entry[2].resource[0].quantity[0].system[0]http://snomed.info/sct
Bundle.entry[2].resource[0].quantity[0].code[0]428672001
Bundle.entry[2].resource[0].dosageInstruction[0].text[0]Continuous infusion 50 millilitre - Intravenous - over 30 minutes - daily - for 5 days
Bundle.entry[2].resource[0].dosageInstruction[0].timing[0].repeat[0].bounds[0].value[0]5
Bundle.entry[2].resource[0].dosageInstruction[0].timing[0].repeat[0].bounds[0].unit[0]day
Bundle.entry[2].resource[0].dosageInstruction[0].timing[0].repeat[0].bounds[0].system[0]http://unitsofmeasure.org
Bundle.entry[2].resource[0].dosageInstruction[0].timing[0].repeat[0].bounds[0].code[0]d
Bundle.entry[2].resource[0].dosageInstruction[0].timing[0].repeat[0].duration[0]30
Bundle.entry[2].resource[0].dosageInstruction[0].timing[0].repeat[0].durationUnit[0]min
Bundle.entry[2].resource[0].dosageInstruction[0].timing[0].repeat[0].frequency[0]1
Bundle.entry[2].resource[0].dosageInstruction[0].timing[0].repeat[0].period[0]1
Bundle.entry[2].resource[0].dosageInstruction[0].timing[0].repeat[0].periodUnit[0]d
Bundle.entry[2].resource[0].dosageInstruction[0].route[0].coding[0].system[0]https://dmd.nhs.uk
Bundle.entry[2].resource[0].dosageInstruction[0].route[0].coding[0].code[0]47625008
Bundle.entry[2].resource[0].dosageInstruction[0].route[0].coding[0].display[0]Intravenous
Bundle.entry[2].resource[0].dosageInstruction[0].method[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[2].resource[0].dosageInstruction[0].method[0].coding[0].code[0]261754007
Bundle.entry[2].resource[0].dosageInstruction[0].method[0].coding[0].display[0]Continuous infusion
Bundle.entry[2].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].value[0]50
Bundle.entry[2].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].unit[0]millilitre
Bundle.entry[2].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].system[0]http://unitsofmeasure.org
Bundle.entry[2].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].code[0]ml
Bundle

Dispensing Event: Prepared by Ward

Note: This example is work-in-progress and may be subject to change.

If the infusion is to be prepared by the hospital ward team.

This Bundle is created by the pharmacy system for what has been dispensed. A bundle is used in this example because it contains two MedicationDispense resources. The first is for the Ceftriaxone powder. The second is for the Sodium chloride diluent. This bundle would be made available to the ward EPMA system. The infusion would be prepared on the ward.

<Bundle xmlns="http://hl7.org/fhir">
    <type value="transaction" />
    <entry>
        <fullUrl value="urn:uuid:b74a61af-3a12-4d55-9e7a-949fff9f713a" />
        <resource>
            <MedicationDispense>
                <id value="b74a61af-3a12-4d55-9e7a-949fff9f713a" />
                <meta>
                    <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationDispense" />
                </meta>
                <status value="completed" />
                <medicationCodeableConcept>
                    <coding>
                        <system value="https://dmd.nhs.uk" />
                        <code value="22824911000001102" />
                        <display value="Ceftriaxone 1g powder for solution for infusion vials (Kent Pharma (UK) Ltd)" />
                    </coding>
                </medicationCodeableConcept>
                <subject>
                    <reference value="Patient/UKCore-Patient-RichardSmith-Example" />
                </subject>
                <authorizingPrescription>
                    <reference value="34eb3c92-76e6-48c2-9691-aa1f0b58369b" />
                    <type value="MedicationRequest" />
                </authorizingPrescription>
                <quantity>
                    <value value="5" />
                    <unit value="vial" />
                    <system value="http://snomed.info/sct" />
                    <code value="415818006" />
                </quantity>
                <dosageInstruction>
                    <text value="Continuous infusion 1 gram - Intravenous - over 30 minutes - daily - for 5 days" />
                    <timing>
                        <repeat>
                            <boundsDuration>
                                <value value="5" />
                                <unit value="day" />
                                <system value="http://unitsofmeasure.org" />
                                <code value="d" />
                            </boundsDuration>
                            <duration value="30" />
                            <durationUnit value="min" />
                            <frequency value="1" />
                            <period value="1" />
                            <periodUnit value="d" />
                        </repeat>
                    </timing>
                    <route>
                        <coding>
                            <system value="https://dmd.nhs.uk" />
                            <code value="47625008" />
                            <display value="Intravenous" />
                        </coding>
                    </route>
                    <method>
                        <coding>
                            <system value="http://snomed.info/sct" />
                            <code value="261754007" />
                            <display value="Continuous infusion" />
                        </coding>
                    </method>
                    <doseAndRate>
                        <doseQuantity>
                            <value value="1" />
                            <unit value="gram" />
                            <system value="http://unitsofmeasure.org" />
                            <code value="g" />
                        </doseQuantity>
                    </doseAndRate>
                </dosageInstruction>
            </MedicationDispense>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:0ec3b0f4-91fa-42eb-a324-a29ff01c71b4" />
        <resource>
            <MedicationDispense>
                <id value="0ec3b0f4-91fa-42eb-a324-a29ff01c71b4" />
                <meta>
                    <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationDispense" />
                </meta>
                <status value="completed" />
                <medicationCodeableConcept>
                    <coding>
                        <system value="https://dmd.nhs.uk" />
                        <code value="4880711000001109" />
                        <display value="Sodium chloride 0.9% infusion 50ml Mini-Bag Viaflex bags (Baxter Healthcare Ltd)" />
                    </coding>
                </medicationCodeableConcept>
                <authorizingPrescription>
                    <reference value="34eb3c92-76e6-48c2-9691-aa1f0b58369b" />
                    <type value="MedicationRequest" />
                </authorizingPrescription>
                <quantity>
                    <value value="5" />
                    <unit value="bag" />
                    <system value="http://snomed.info/sct" />
                    <code value="428672001" />
                </quantity>
                <dosageInstruction>
                    <text value="Continuous infusion 100 millilitre - Intravenous - over 30 minutes - daily - for 5 days" />
                    <timing>
                        <repeat>
                            <boundsDuration>
                                <value value="5" />
                                <unit value="day" />
                                <system value="http://unitsofmeasure.org" />
                                <code value="d" />
                            </boundsDuration>
                            <duration value="30" />
                            <durationUnit value="min" />
                            <frequency value="1" />
                            <period value="1" />
                            <periodUnit value="d" />
                        </repeat>
                    </timing>
                    <route>
                        <coding>
                            <system value="https://dmd.nhs.uk" />
                            <code value="47625008" />
                            <display value="Intravenous" />
                        </coding>
                    </route>
                    <method>
                        <coding>
                            <system value="http://snomed.info/sct" />
                            <code value="261754007" />
                            <display value="Continuous infusion" />
                        </coding>
                    </method>
                    <doseAndRate>
                        <doseQuantity>
                            <value value="50" />
                            <unit value="millilitre" />
                            <system value="http://unitsofmeasure.org" />
                            <code value="ml" />
                        </doseQuantity>
                    </doseAndRate>
                </dosageInstruction>
            </MedicationDispense>
        </resource>
    </entry>
</Bundle>

{
    "resourceType": "Bundle",
    "type": "transaction",
    "entry":  [
        {
            "fullUrl": "urn:uuid:b74a61af-3a12-4d55-9e7a-949fff9f713a",
            "resource": {
                "resourceType": "MedicationDispense",
                "id": "b74a61af-3a12-4d55-9e7a-949fff9f713a",
                "meta": {
                    "profile":  [
                        "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationDispense"
                    ]
                },
                "subject": {
                    "reference": "Patient/UKCore-Patient-RichardSmith-Example"
                },
                "status": "completed",
                "medicationCodeableConcept": {
                    "coding":  [
                        {
                            "system": "https://dmd.nhs.uk",
                            "code": "22824911000001102",
                            "display": "Ceftriaxone 1g powder for solution for infusion vials (Kent Pharma (UK) Ltd)"
                        }
                    ]
                },
                "authorizingPrescription":  [
                    {
                        "reference": "34eb3c92-76e6-48c2-9691-aa1f0b58369b",
                        "type": "MedicationRequest"
                    }
                ],
                "quantity": {
                    "value": 5,
                    "unit": "vial",
                    "system": "http://snomed.info/sct",
                    "code": "415818006"
                },
                "dosageInstruction":  [
                    {
                        "text": "Continuous infusion 1 gram - Intravenous - over 30 minutes - daily - for 5 days",
                        "timing": {
                            "repeat": {
                                "boundsDuration": {
                                    "value": 5,
                                    "unit": "day",
                                    "system": "http://unitsofmeasure.org",
                                    "code": "d"
                                },
                                "duration": 30,
                                "durationUnit": "min",
                                "frequency": 1,
                                "period": 1,
                                "periodUnit": "d"
                            }
                        },
                        "method": {
                            "coding":  [
                                {
                                    "system": "http://snomed.info/sct",
                                    "code": "261754007",
                                    "display": "Continuous infusion"
                                }
                            ]
                        },
                        "route": {
                            "coding":  [
                                {
                                    "system": "https://dmd.nhs.uk",
                                    "code": "47625008",
                                    "display": "Intravenous"
                                }
                            ]
                        },
                        "doseAndRate":  [
                            {
                                "doseQuantity": {
                                    "value": 1,
                                    "unit": "gram",
                                    "system": "http://unitsofmeasure.org",
                                    "code": "g"
                                }
                            }
                        ]
                    }
                ]
            }
        },
        {
            "fullUrl": "urn:uuid:0ec3b0f4-91fa-42eb-a324-a29ff01c71b4",
            "resource": {
                "resourceType": "MedicationDispense",
                "id": "0ec3b0f4-91fa-42eb-a324-a29ff01c71b4",
                "meta": {
                    "profile":  [
                        "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationDispense"
                    ]
                },
                "status": "completed",
                "medicationCodeableConcept": {
                    "coding":  [
                        {
                            "system": "https://dmd.nhs.uk",
                            "code": "4880711000001109",
                            "display": "Sodium chloride 0.9% infusion 50ml Mini-Bag Viaflex bags (Baxter Healthcare Ltd)"
                        }
                    ]
                },
                "authorizingPrescription":  [
                    {
                        "reference": "34eb3c92-76e6-48c2-9691-aa1f0b58369b",
                        "type": "MedicationRequest"
                    }
                ],
                "quantity": {
                    "value": 5,
                    "unit": "bag",
                    "system": "http://snomed.info/sct",
                    "code": "428672001"
                },
                "dosageInstruction":  [
                    {
                        "text": "Continuous infusion 100 millilitre - Intravenous - over 30 minutes - daily - for 5 days",
                        "timing": {
                            "repeat": {
                                "boundsDuration": {
                                    "value": 5,
                                    "unit": "day",
                                    "system": "http://unitsofmeasure.org",
                                    "code": "d"
                                },
                                "duration": 30,
                                "durationUnit": "min",
                                "frequency": 1,
                                "period": 1,
                                "periodUnit": "d"
                            }
                        },
                        "method": {
                            "coding":  [
                                {
                                    "system": "http://snomed.info/sct",
                                    "code": "261754007",
                                    "display": "Continuous infusion"
                                }
                            ]
                        },
                        "route": {
                            "coding":  [
                                {
                                    "system": "https://dmd.nhs.uk",
                                    "code": "47625008",
                                    "display": "Intravenous"
                                }
                            ]
                        },
                        "doseAndRate":  [
                            {
                                "doseQuantity": {
                                    "value": 50,
                                    "unit": "millilitre",
                                    "system": "http://unitsofmeasure.org",
                                    "code": "ml"
                                }
                            }
                        ]
                    }
                ]
            }
        }
    ]
}
Bundle.type[0]transaction
Bundle.entry[0].fullUrl[0]urn:uuid:b74a61af-3a12-4d55-9e7a-949fff9f713a
Bundle.entry[0].resource[0].id[0]b74a61af-3a12-4d55-9e7a-949fff9f713a
Bundle.entry[0].resource[0].meta[0].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationDispense
Bundle.entry[0].resource[0].status[0]completed
Bundle.entry[0].resource[0].medication[0].coding[0].system[0]https://dmd.nhs.uk
Bundle.entry[0].resource[0].medication[0].coding[0].code[0]22824911000001102
Bundle.entry[0].resource[0].medication[0].coding[0].display[0]Ceftriaxone 1g powder for solution for infusion vials (Kent Pharma (UK) Ltd)
Bundle.entry[0].resource[0].subject[0].reference[0]Patient/UKCore-Patient-RichardSmith-Example
Bundle.entry[0].resource[0].authorizingPrescription[0].reference[0]34eb3c92-76e6-48c2-9691-aa1f0b58369b
Bundle.entry[0].resource[0].authorizingPrescription[0].type[0]MedicationRequest
Bundle.entry[0].resource[0].quantity[0].value[0]5
Bundle.entry[0].resource[0].quantity[0].unit[0]vial
Bundle.entry[0].resource[0].quantity[0].system[0]http://snomed.info/sct
Bundle.entry[0].resource[0].quantity[0].code[0]415818006
Bundle.entry[0].resource[0].dosageInstruction[0].text[0]Continuous infusion 1 gram - Intravenous - over 30 minutes - daily - for 5 days
Bundle.entry[0].resource[0].dosageInstruction[0].timing[0].repeat[0].bounds[0].value[0]5
Bundle.entry[0].resource[0].dosageInstruction[0].timing[0].repeat[0].bounds[0].unit[0]day
Bundle.entry[0].resource[0].dosageInstruction[0].timing[0].repeat[0].bounds[0].system[0]http://unitsofmeasure.org
Bundle.entry[0].resource[0].dosageInstruction[0].timing[0].repeat[0].bounds[0].code[0]d
Bundle.entry[0].resource[0].dosageInstruction[0].timing[0].repeat[0].duration[0]30
Bundle.entry[0].resource[0].dosageInstruction[0].timing[0].repeat[0].durationUnit[0]min
Bundle.entry[0].resource[0].dosageInstruction[0].timing[0].repeat[0].frequency[0]1
Bundle.entry[0].resource[0].dosageInstruction[0].timing[0].repeat[0].period[0]1
Bundle.entry[0].resource[0].dosageInstruction[0].timing[0].repeat[0].periodUnit[0]d
Bundle.entry[0].resource[0].dosageInstruction[0].route[0].coding[0].system[0]https://dmd.nhs.uk
Bundle.entry[0].resource[0].dosageInstruction[0].route[0].coding[0].code[0]47625008
Bundle.entry[0].resource[0].dosageInstruction[0].route[0].coding[0].display[0]Intravenous
Bundle.entry[0].resource[0].dosageInstruction[0].method[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[0].resource[0].dosageInstruction[0].method[0].coding[0].code[0]261754007
Bundle.entry[0].resource[0].dosageInstruction[0].method[0].coding[0].display[0]Continuous infusion
Bundle.entry[0].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].value[0]1
Bundle.entry[0].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].unit[0]gram
Bundle.entry[0].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].system[0]http://unitsofmeasure.org
Bundle.entry[0].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].code[0]g
Bundle.entry[1].fullUrl[0]urn:uuid:0ec3b0f4-91fa-42eb-a324-a29ff01c71b4
Bundle.entry[1].resource[0].id[0]0ec3b0f4-91fa-42eb-a324-a29ff01c71b4
Bundle.entry[1].resource[0].meta[0].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationDispense
Bundle.entry[1].resource[0].status[0]completed
Bundle.entry[1].resource[0].medication[0].coding[0].system[0]https://dmd.nhs.uk
Bundle.entry[1].resource[0].medication[0].coding[0].code[0]4880711000001109
Bundle.entry[1].resource[0].medication[0].coding[0].display[0]Sodium chloride 0.9% infusion 50ml Mini-Bag Viaflex bags (Baxter Healthcare Ltd)
Bundle.entry[1].resource[0].authorizingPrescription[0].reference[0]34eb3c92-76e6-48c2-9691-aa1f0b58369b
Bundle.entry[1].resource[0].authorizingPrescription[0].type[0]MedicationRequest
Bundle.entry[1].resource[0].quantity[0].value[0]5
Bundle.entry[1].resource[0].quantity[0].unit[0]bag
Bundle.entry[1].resource[0].quantity[0].system[0]http://snomed.info/sct
Bundle.entry[1].resource[0].quantity[0].code[0]428672001
Bundle.entry[1].resource[0].dosageInstruction[0].text[0]Continuous infusion 100 millilitre - Intravenous - over 30 minutes - daily - for 5 days
Bundle.entry[1].resource[0].dosageInstruction[0].timing[0].repeat[0].bounds[0].value[0]5
Bundle.entry[1].resource[0].dosageInstruction[0].timing[0].repeat[0].bounds[0].unit[0]day
Bundle.entry[1].resource[0].dosageInstruction[0].timing[0].repeat[0].bounds[0].system[0]http://unitsofmeasure.org
Bundle.entry[1].resource[0].dosageInstruction[0].timing[0].repeat[0].bounds[0].code[0]d
Bundle.entry[1].resource[0].dosageInstruction[0].timing[0].repeat[0].duration[0]30
Bundle.entry[1].resource[0].dosageInstruction[0].timing[0].repeat[0].durationUnit[0]min
Bundle.entry[1].resource[0].dosageInstruction[0].timing[0].repeat[0].frequency[0]1
Bundle.entry[1].resource[0].dosageInstruction[0].timing[0].repeat[0].period[0]1
Bundle.entry[1].resource[0].dosageInstruction[0].timing[0].repeat[0].periodUnit[0]d
Bundle.entry[1].resource[0].dosageInstruction[0].route[0].coding[0].system[0]https://dmd.nhs.uk
Bundle.entry[1].resource[0].dosageInstruction[0].route[0].coding[0].code[0]47625008
Bundle.entry[1].resource[0].dosageInstruction[0].route[0].coding[0].display[0]Intravenous
Bundle.entry[1].resource[0].dosageInstruction[0].method[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[1].resource[0].dosageInstruction[0].method[0].coding[0].code[0]261754007
Bundle.entry[1].resource[0].dosageInstruction[0].method[0].coding[0].display[0]Continuous infusion
Bundle.entry[1].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].value[0]50
Bundle.entry[1].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].unit[0]millilitre
Bundle.entry[1].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].system[0]http://unitsofmeasure.org
Bundle.entry[1].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].code[0]ml
Bundle

Dispensing Event: Dispensed by Pharmacy using a pre-prepared product

Note: This example is work-in-progress and may be subject to change.

Pre-prepared and dm+d coded Ceftriaxone 1g/50ml infusion bags products are dispensed to the ward.

<Bundle xmlns="http://hl7.org/fhir">
    <type value="message" />
    <entry>
        <fullUrl value="urn:uuid:ee6f0a35-4e84-4b75-8b22-c2111878e548" />
        <resource>
            <MessageHeader>
                <id value="ee6f0a35-4e84-4b75-8b22-c2111878e548" />
                <eventCoding>
                    <system value="http://snomed.info/sct" />
                    <code value="373784005" />
                    <display value="Dispensing medication" />
                </eventCoding>
                <source>
                    <endpoint value="https://myendpoint.nhs.uk/" />
                </source>
                <focus>
                    <reference value="b74a61af-3a12-4d55-9e7a-949fff9f713a" />
                    <type value="MedicationDispense" />
                </focus>
            </MessageHeader>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:b74a61af-3a12-4d55-9e7a-949fff9f713a" />
        <resource>
            <MedicationDispense>
                <id value="b74a61af-3a12-4d55-9e7a-949fff9f713a" />
                <meta>
                    <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationDispense" />
                </meta>
                <status value="completed" />
                <medicationCodeableConcept>
                    <coding>
                        <system value="https://dmd.nhs.uk" />
                        <code value="22102811000001100" />
                        <display value="Ceftriaxone 1g/50ml infusion bags (Special Order)" />
                    </coding>
                </medicationCodeableConcept>
                <subject>
                    <reference value="Patient/UKCore-Patient-RichardSmith-Example" />
                </subject>
                <authorizingPrescription>
                    <reference value="34eb3c92-76e6-48c2-9691-aa1f0b58369b" />
                    <type value="MedicationRequest" />
                </authorizingPrescription>
                <quantity>
                    <value value="5" />
                    <unit value="bag" />
                    <system value="http://snomed.info/sct" />
                    <code value="428672001" />
                </quantity>
                <dosageInstruction>
                    <text value="Continuous infusion 1 gram - Intravenous - over 30 minutes - daily - for 5 days" />
                    <timing>
                        <repeat>
                            <boundsDuration>
                                <value value="5" />
                                <unit value="day" />
                                <system value="http://unitsofmeasure.org" />
                                <code value="d" />
                            </boundsDuration>
                            <duration value="30" />
                            <durationUnit value="min" />
                            <frequency value="1" />
                            <period value="1" />
                            <periodUnit value="d" />
                        </repeat>
                    </timing>
                    <route>
                        <coding>
                            <system value="https://dmd.nhs.uk" />
                            <code value="47625008" />
                            <display value="Intravenous" />
                        </coding>
                    </route>
                    <method>
                        <coding>
                            <system value="http://snomed.info/sct" />
                            <code value="261754007" />
                            <display value="Continuous infusion" />
                        </coding>
                    </method>
                    <doseAndRate>
                        <doseQuantity>
                            <value value="1" />
                            <unit value="bag" />
                            <system value="http://snomed.info/sct" />
                            <code value="428672001" />
                        </doseQuantity>
                    </doseAndRate>
                </dosageInstruction>
            </MedicationDispense>
        </resource>
    </entry>
</Bundle>

{
    "resourceType": "Bundle",
    "type": "message",
    "entry":  [
        {
            "fullUrl": "urn:uuid:ee6f0a35-4e84-4b75-8b22-c2111878e548",
            "resource": {
                "resourceType": "MessageHeader",
                "id": "ee6f0a35-4e84-4b75-8b22-c2111878e548",
                "eventCoding": {
                    "system": "http://snomed.info/sct",
                    "code": "373784005",
                    "display": "Dispensing medication"
                },
                "source": {
                    "endpoint": "https://myendpoint.nhs.uk/"
                },
                "focus":  [
                    {
                        "reference": "b74a61af-3a12-4d55-9e7a-949fff9f713a",
                        "type": "MedicationDispense"
                    }
                ]
            }
        },
        {
            "fullUrl": "urn:uuid:b74a61af-3a12-4d55-9e7a-949fff9f713a",
            "resource": {
                "resourceType": "MedicationDispense",
                "id": "b74a61af-3a12-4d55-9e7a-949fff9f713a",
                "meta": {
                    "profile":  [
                        "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationDispense"
                    ]
                },
                "status": "completed",
                "subject": {
                    "reference": "Patient/UKCore-Patient-RichardSmith-Example"
                },
                "medicationCodeableConcept": {
                    "coding":  [
                        {
                            "system": "https://dmd.nhs.uk",
                            "code": "22102811000001100",
                            "display": "Ceftriaxone 1g/50ml infusion bags (Special Order)"
                        }
                    ]
                },
                "authorizingPrescription":  [
                    {
                        "reference": "34eb3c92-76e6-48c2-9691-aa1f0b58369b",
                        "type": "MedicationRequest"
                    }
                ],
                "quantity": {
                    "value": 5,
                    "unit": "bag",
                    "system": "http://snomed.info/sct",
                    "code": "428672001"
                },
                "dosageInstruction":  [
                    {
                        "text": "Continuous infusion 1 gram - Intravenous - over 30 minutes - daily - for 5 days",
                        "timing": {
                            "repeat": {
                                "boundsDuration": {
                                    "value": 5,
                                    "unit": "day",
                                    "system": "http://unitsofmeasure.org",
                                    "code": "d"
                                },
                                "duration": 30,
                                "durationUnit": "min",
                                "frequency": 1,
                                "period": 1,
                                "periodUnit": "d"
                            }
                        },
                        "route": {
                            "coding":  [
                                {
                                    "system": "https://dmd.nhs.uk",
                                    "code": "47625008",
                                    "display": "Intravenous"
                                }
                            ]
                        },
                        "method": {
                            "coding":  [
                                {
                                    "system": "http://snomed.info/sct",
                                    "code": "261754007",
                                    "display": "Continuous infusion"
                                }
                            ]
                        },
                        "doseAndRate":  [
                            {
                                "doseQuantity": {
                                    "value": 1,
                                    "unit": "bag",
                                    "system": "http://snomed.info/sct",
                                    "code": "428672001"
                                }
                            }
                        ]
                    }
                ]
            }
        }
    ]
}
Bundle.type[0]message
Bundle.entry[0].fullUrl[0]urn:uuid:ee6f0a35-4e84-4b75-8b22-c2111878e548
Bundle.entry[0].resource[0].id[0]ee6f0a35-4e84-4b75-8b22-c2111878e548
Bundle.entry[0].resource[0].event[0].system[0]http://snomed.info/sct
Bundle.entry[0].resource[0].event[0].code[0]373784005
Bundle.entry[0].resource[0].event[0].display[0]Dispensing medication
Bundle.entry[0].resource[0].source[0].endpoint[0]https://myendpoint.nhs.uk/
Bundle.entry[0].resource[0].focus[0].reference[0]b74a61af-3a12-4d55-9e7a-949fff9f713a
Bundle.entry[0].resource[0].focus[0].type[0]MedicationDispense
Bundle.entry[1].fullUrl[0]urn:uuid:b74a61af-3a12-4d55-9e7a-949fff9f713a
Bundle.entry[1].resource[0].id[0]b74a61af-3a12-4d55-9e7a-949fff9f713a
Bundle.entry[1].resource[0].meta[0].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationDispense
Bundle.entry[1].resource[0].status[0]completed
Bundle.entry[1].resource[0].medication[0].coding[0].system[0]https://dmd.nhs.uk
Bundle.entry[1].resource[0].medication[0].coding[0].code[0]22102811000001100
Bundle.entry[1].resource[0].medication[0].coding[0].display[0]Ceftriaxone 1g/50ml infusion bags (Special Order)
Bundle.entry[1].resource[0].subject[0].reference[0]Patient/UKCore-Patient-RichardSmith-Example
Bundle.entry[1].resource[0].authorizingPrescription[0].reference[0]34eb3c92-76e6-48c2-9691-aa1f0b58369b
Bundle.entry[1].resource[0].authorizingPrescription[0].type[0]MedicationRequest
Bundle.entry[1].resource[0].quantity[0].value[0]5
Bundle.entry[1].resource[0].quantity[0].unit[0]bag
Bundle.entry[1].resource[0].quantity[0].system[0]http://snomed.info/sct
Bundle.entry[1].resource[0].quantity[0].code[0]428672001
Bundle.entry[1].resource[0].dosageInstruction[0].text[0]Continuous infusion 1 gram - Intravenous - over 30 minutes - daily - for 5 days
Bundle.entry[1].resource[0].dosageInstruction[0].timing[0].repeat[0].bounds[0].value[0]5
Bundle.entry[1].resource[0].dosageInstruction[0].timing[0].repeat[0].bounds[0].unit[0]day
Bundle.entry[1].resource[0].dosageInstruction[0].timing[0].repeat[0].bounds[0].system[0]http://unitsofmeasure.org
Bundle.entry[1].resource[0].dosageInstruction[0].timing[0].repeat[0].bounds[0].code[0]d
Bundle.entry[1].resource[0].dosageInstruction[0].timing[0].repeat[0].duration[0]30
Bundle.entry[1].resource[0].dosageInstruction[0].timing[0].repeat[0].durationUnit[0]min
Bundle.entry[1].resource[0].dosageInstruction[0].timing[0].repeat[0].frequency[0]1
Bundle.entry[1].resource[0].dosageInstruction[0].timing[0].repeat[0].period[0]1
Bundle.entry[1].resource[0].dosageInstruction[0].timing[0].repeat[0].periodUnit[0]d
Bundle.entry[1].resource[0].dosageInstruction[0].route[0].coding[0].system[0]https://dmd.nhs.uk
Bundle.entry[1].resource[0].dosageInstruction[0].route[0].coding[0].code[0]47625008
Bundle.entry[1].resource[0].dosageInstruction[0].route[0].coding[0].display[0]Intravenous
Bundle.entry[1].resource[0].dosageInstruction[0].method[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[1].resource[0].dosageInstruction[0].method[0].coding[0].code[0]261754007
Bundle.entry[1].resource[0].dosageInstruction[0].method[0].coding[0].display[0]Continuous infusion
Bundle.entry[1].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].value[0]1
Bundle.entry[1].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].unit[0]bag
Bundle.entry[1].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].system[0]http://snomed.info/sct
Bundle.entry[1].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].code[0]428672001
Bundle

Administration Event: Using infusion prepared by pharmacy or ward

Note: This example is work-in-progress and may be subject to change.

An administration record using an infusion prepared either by the pharmacy or on the ward. There would be five administration records, one for each infusion, on each day.

<Bundle xmlns="http://hl7.org/fhir">
    <type value="message" />
    <entry>
        <fullUrl value="urn:uuid:682858a9-3942-412d-9ae5-71a2f17f7c5b" />
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            <MessageHeader>
                <id value="682858a9-3942-412d-9ae5-71a2f17f7c5b" />
                <eventCoding>
                    <system value="http://snomed.info/sct" />
                    <code value="18629005" />
                    <display value="Administration of medication" />
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                <source>
                    <endpoint value="https://myendpoint.nhs.uk/" />
                </source>
                <focus>
                    <reference value="843b54b7-1479-43a3-9931-99f10d621181" />
                    <type value="MedicationAdministration" />
                </focus>
            </MessageHeader>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:11dc9519-b6e8-41bb-bce5-f6f724b743bc" />
        <resource>
            <Medication>
                <id value="11dc9519-b6e8-41bb-bce5-f6f724b743bc" />
                <meta>
                    <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Medication" />
                </meta>
                <code>
                    <text value="Ceftriaxone 1g in 50mL Sodium chloride 0.9% solution for infusion" />
                </code>
                <form>
                    <coding>
                        <system value="https://dmd.nhs.uk" />
                        <code value="385229008" />
                        <display value="Solution for infusion" />
                    </coding>
                </form>
                <ingredient>
                    <itemCodeableConcept>
                        <coding>
                            <system value="https://dmd.nhs.uk" />
                            <code value="22824911000001102" />
                            <display value="Ceftriaxone 1g powder for solution for infusion vials (Kent Pharma (UK) Ltd)" />
                        </coding>
                    </itemCodeableConcept>
                    <strength>
                        <numerator>
                            <value value="1" />
                            <unit value="gram" />
                            <system value="http://unitsofmeasure.org" />
                            <code value="g" />
                        </numerator>
                        <denominator>
                            <value value="1" />
                        </denominator>
                    </strength>
                </ingredient>
                <ingredient>
                    <itemCodeableConcept>
                        <coding>
                            <system value="https://dmd.nhs.uk" />
                            <code value="4880711000001109" />
                            <display value="Sodium chloride 0.9% infusion 50ml Mini-Bag Viaflex bags (Baxter Healthcare Ltd)" />
                        </coding>
                    </itemCodeableConcept>
                    <strength>
                        <numerator>
                            <value value="50" />
                            <unit value="millilitre" />
                            <system value="http://unitsofmeasure.org" />
                            <code value="ml" />
                        </numerator>
                        <denominator>
                            <value value="1" />
                        </denominator>
                    </strength>
                </ingredient>
            </Medication>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:7b36eb7b-ea3f-44fb-87c9-dfa51e4b6d5b" />
        <resource>
            <MedicationAdministration>
                <id value="843b54b7-1479-43a3-9931-99f10d621181" />
                <meta>
                    <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationAdministration" />
                </meta>
                <status value="completed" />
                <medicationReference>
                    <reference value="11dc9519-b6e8-41bb-bce5-f6f724b743bc" />
                    <type value="Medication" />
                </medicationReference>
                <subject>
                    <reference value="Patient/UKCore-Patient-RichardSmith-Example" />
                </subject>
                <effectiveDateTime value="2022-02-28T17:06:00+00:00" />
                <request>
                    <reference value="34eb3c92-76e6-48c2-9691-aa1f0b58369b" />
                    <type value="MedicationRequest" />
                </request>
                <dosage>
                    <route>
                        <coding>
                            <system value="https://dmd.nhs.uk" />
                            <code value="47625008" />
                            <display value="Intravenous" />
                        </coding>
                    </route>
                    <method>
                        <coding>
                            <system value="http://snomed.info/sct" />
                            <code value="261754007" />
                            <display value="Continuous infusion" />
                        </coding>
                    </method>
                    <dose>
                        <value value="100" />
                        <unit value="millilitre" />
                        <system value="http://unitsofmeasure.org" />
                        <code value="ml" />
                    </dose>
                </dosage>
            </MedicationAdministration>
        </resource>
    </entry>
</Bundle>

{
    "resourceType": "Bundle",
    "type": "message",
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            "fullUrl": "urn:uuid:682858a9-3942-412d-9ae5-71a2f17f7c5b",
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                                "system": "http://snomed.info/sct",
                                "code": "261754007",
                                "display": "Continuous infusion"
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                    "dose": {
                        "value": 100,
                        "unit": "millilitre",
                        "system": "http://unitsofmeasure.org",
                        "code": "ml"
                    }
                }
            }
        }
    ]
}
Bundle.type[0]message
Bundle.entry[0].fullUrl[0]urn:uuid:682858a9-3942-412d-9ae5-71a2f17f7c5b
Bundle.entry[0].resource[0].id[0]682858a9-3942-412d-9ae5-71a2f17f7c5b
Bundle.entry[0].resource[0].event[0].system[0]http://snomed.info/sct
Bundle.entry[0].resource[0].event[0].code[0]18629005
Bundle.entry[0].resource[0].event[0].display[0]Administration of medication
Bundle.entry[0].resource[0].source[0].endpoint[0]https://myendpoint.nhs.uk/
Bundle.entry[0].resource[0].focus[0].reference[0]843b54b7-1479-43a3-9931-99f10d621181
Bundle.entry[0].resource[0].focus[0].type[0]MedicationAdministration
Bundle.entry[1].fullUrl[0]urn:uuid:11dc9519-b6e8-41bb-bce5-f6f724b743bc
Bundle.entry[1].resource[0].id[0]11dc9519-b6e8-41bb-bce5-f6f724b743bc
Bundle.entry[1].resource[0].meta[0].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-Medication
Bundle.entry[1].resource[0].code[0].text[0]Ceftriaxone 1g in 50mL Sodium chloride 0.9% solution for infusion
Bundle.entry[1].resource[0].form[0].coding[0].system[0]https://dmd.nhs.uk
Bundle.entry[1].resource[0].form[0].coding[0].code[0]385229008
Bundle.entry[1].resource[0].form[0].coding[0].display[0]Solution for infusion
Bundle.entry[1].resource[0].ingredient[0].item[0].coding[0].system[0]https://dmd.nhs.uk
Bundle.entry[1].resource[0].ingredient[0].item[0].coding[0].code[0]22824911000001102
Bundle.entry[1].resource[0].ingredient[0].item[0].coding[0].display[0]Ceftriaxone 1g powder for solution for infusion vials (Kent Pharma (UK) Ltd)
Bundle.entry[1].resource[0].ingredient[0].strength[0].numerator[0].value[0]1
Bundle.entry[1].resource[0].ingredient[0].strength[0].numerator[0].unit[0]gram
Bundle.entry[1].resource[0].ingredient[0].strength[0].numerator[0].system[0]http://unitsofmeasure.org
Bundle.entry[1].resource[0].ingredient[0].strength[0].numerator[0].code[0]g
Bundle.entry[1].resource[0].ingredient[0].strength[0].denominator[0].value[0]1
Bundle.entry[1].resource[0].ingredient[1].item[0].coding[0].system[0]https://dmd.nhs.uk
Bundle.entry[1].resource[0].ingredient[1].item[0].coding[0].code[0]4880711000001109
Bundle.entry[1].resource[0].ingredient[1].item[0].coding[0].display[0]Sodium chloride 0.9% infusion 50ml Mini-Bag Viaflex bags (Baxter Healthcare Ltd)
Bundle.entry[1].resource[0].ingredient[1].strength[0].numerator[0].value[0]50
Bundle.entry[1].resource[0].ingredient[1].strength[0].numerator[0].unit[0]millilitre
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Bundle.entry[1].resource[0].ingredient[1].strength[0].numerator[0].code[0]ml
Bundle.entry[1].resource[0].ingredient[1].strength[0].denominator[0].value[0]1
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Bundle.entry[2].resource[0].id[0]843b54b7-1479-43a3-9931-99f10d621181
Bundle.entry[2].resource[0].meta[0].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationAdministration
Bundle.entry[2].resource[0].status[0]completed
Bundle.entry[2].resource[0].medication[0].reference[0]11dc9519-b6e8-41bb-bce5-f6f724b743bc
Bundle.entry[2].resource[0].medication[0].type[0]Medication
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Bundle.entry[2].resource[0].effective[0]2022-02-28T17:06:00+00:00
Bundle.entry[2].resource[0].request[0].reference[0]34eb3c92-76e6-48c2-9691-aa1f0b58369b
Bundle.entry[2].resource[0].request[0].type[0]MedicationRequest
Bundle.entry[2].resource[0].dosage[0].route[0].coding[0].system[0]https://dmd.nhs.uk
Bundle.entry[2].resource[0].dosage[0].route[0].coding[0].code[0]47625008
Bundle.entry[2].resource[0].dosage[0].route[0].coding[0].display[0]Intravenous
Bundle.entry[2].resource[0].dosage[0].method[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[2].resource[0].dosage[0].method[0].coding[0].code[0]261754007
Bundle.entry[2].resource[0].dosage[0].method[0].coding[0].display[0]Continuous infusion
Bundle.entry[2].resource[0].dosage[0].dose[0].value[0]100
Bundle.entry[2].resource[0].dosage[0].dose[0].unit[0]millilitre
Bundle.entry[2].resource[0].dosage[0].dose[0].system[0]http://unitsofmeasure.org
Bundle.entry[2].resource[0].dosage[0].dose[0].code[0]ml
Bundle

Administration Event: Using a pre-prepared infusion product

Note: This example is work-in-progress and may be subject to change.

An administration record using a pre-prepared and dm+d coded Ceftriaxone 1g/50ml infusion bags product. There would be five administration records, one for each infusion, on each day.

<MedicationAdministration xmlns="http://hl7.org/fhir">
    <id value="cc191603-72c0-4e65-86ee-a149a2dc81d4" />
    <meta>
        <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationAdministration" />
    </meta>
    <status value="completed" />
    <medicationCodeableConcept>
        <coding>
            <system value="https://dmd.nhs.uk" />
            <code value="22102811000001100" />
            <display value="Ceftriaxone 1g/50ml infusion bags (Special Order)" />
        </coding>
    </medicationCodeableConcept>
    <subject>
        <reference value="Patient/UKCore-Patient-RichardSmith-Example" />
    </subject>
    <effectiveDateTime value="2022-02-28T16:52:00+00:00" />
    <request>
        <reference value="34eb3c92-76e6-48c2-9691-aa1f0b58369b" />
        <type value="MedicationRequest" />
    </request>
    <dosage>
        <route>
            <coding>
                <system value="https://dmd.nhs.uk" />
                <code value="47625008" />
                <display value="Intravenous" />
            </coding>
        </route>
        <method>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="261754007" />
                <display value="Continuous infusion" />
            </coding>
        </method>
        <dose>
            <value value="1" />
            <unit value="bag" />
            <system value="http://snomed.info/sct" />
            <code value="428672001" />
        </dose>
    </dosage>
</MedicationAdministration>

{
    "resourceType": "MedicationAdministration",
    "id": "cc191603-72c0-4e65-86ee-a149a2dc81d4",
    "meta": {
        "profile":  [
            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationAdministration"
        ]
    },
    "status": "completed",
    "medicationCodeableConcept": {
        "coding":  [
            {
                "system": "https://dmd.nhs.uk",
                "code": "22102811000001100",
                "display": "Ceftriaxone 1g/50ml infusion bags (Special Order)"
            }
        ]
    },
    "subject": {
        "reference": "Patient/UKCore-Patient-RichardSmith-Example"
    },
    "effectiveDateTime": "2022-02-28T16:52:00+00:00",
    "request": {
        "reference": "34eb3c92-76e6-48c2-9691-aa1f0b58369b",
        "type": "MedicationRequest"
    },
    "dosage": {
        "route": {
            "coding":  [
                {
                    "system": "https://dmd.nhs.uk",
                    "code": "47625008",
                    "display": "Intravenous"
                }
            ]
        },
        "method": {
            "coding":  [
                {
                    "system": "http://snomed.info/sct",
                    "code": "261754007",
                    "display": "Continuous infusion"
                }
            ]
        },
        "dose": {
            "value": 1,
            "unit": "bag",
            "system": "http://snomed.info/sct",
            "code": "428672001"
        }
    }
}
MedicationAdministration.id[0]cc191603-72c0-4e65-86ee-a149a2dc81d4
MedicationAdministration.meta[0].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationAdministration
MedicationAdministration.status[0]completed
MedicationAdministration.medication[0].coding[0].system[0]https://dmd.nhs.uk
MedicationAdministration.medication[0].coding[0].code[0]22102811000001100
MedicationAdministration.medication[0].coding[0].display[0]Ceftriaxone 1g/50ml infusion bags (Special Order)
MedicationAdministration.subject[0].reference[0]Patient/UKCore-Patient-RichardSmith-Example
MedicationAdministration.effective[0]2022-02-28T16:52:00+00:00
MedicationAdministration.request[0].reference[0]34eb3c92-76e6-48c2-9691-aa1f0b58369b
MedicationAdministration.request[0].type[0]MedicationRequest
MedicationAdministration.dosage[0].route[0].coding[0].system[0]https://dmd.nhs.uk
MedicationAdministration.dosage[0].route[0].coding[0].code[0]47625008
MedicationAdministration.dosage[0].route[0].coding[0].display[0]Intravenous
MedicationAdministration.dosage[0].method[0].coding[0].system[0]http://snomed.info/sct
MedicationAdministration.dosage[0].method[0].coding[0].code[0]261754007
MedicationAdministration.dosage[0].method[0].coding[0].display[0]Continuous infusion
MedicationAdministration.dosage[0].dose[0].value[0]1
MedicationAdministration.dosage[0].dose[0].unit[0]bag
MedicationAdministration.dosage[0].dose[0].system[0]http://snomed.info/sct
MedicationAdministration.dosage[0].dose[0].code[0]428672001
MedicationAdministration
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