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.

Eprex solution for injection pre-filled syringes

Product-based AMP prescription where the instruction 'with dialysis' is free-text. 
<MedicationRequest xmlns="http://hl7.org/fhir">
    <id value="808e7672-cf8d-48d8-885b-694c9bb9a417" />
    <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="inpatient" />
            <display value="inpatient" />
        </coding>
    </category>
    <medicationCodeableConcept>
        <coding>
            <system value="https://dmd.nhs.uk" />
            <code value="2971511000001101" />
            <display value="Eprex 2,000units/0.5ml solution for injection pre-filled syringes (Janssen-Cilag 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="Inject once a day - on Monday and Thursday - Subcutaneous route - with dialysis" />
        <additionalInstruction>
            <text value="with dialysis" />
        </additionalInstruction>
        <timing>
            <repeat>
                <frequency value="1" />
                <period value="1" />
                <periodUnit value="d" />
                <dayOfWeek value="mon" />
                <dayOfWeek value="thu" />
            </repeat>
        </timing>
        <route>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="34206005" />
                <display value="Subcutaneous route" />
            </coding>
        </route>
        <method>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="422145002" />
                <display value="Inject" />
            </coding>
        </method>
    </dosageInstruction>
    <substitution>
        <allowedBoolean value="false" />
    </substitution>
</MedicationRequest>

{
    "resourceType": "MedicationRequest",
    "id": "808e7672-cf8d-48d8-885b-694c9bb9a417",
    "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": "inpatient",
                    "display": "inpatient"
                }
            ]
        }
    ],
    "medicationCodeableConcept": {
        "coding":  [
            {
                "system": "https://dmd.nhs.uk",
                "code": "2971511000001101",
                "display": "Eprex 2,000units/0.5ml solution for injection pre-filled syringes (Janssen-Cilag 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": "Inject once a day - on Monday and Thursday - Subcutaneous route - with dialysis",
            "additionalInstruction":  [
                {
                    "text": "with dialysis"
                }
            ],
            "timing": {
                "repeat": {
                    "frequency": 1,
                    "period": 1,
                    "periodUnit": "d",
                    "dayOfWeek":  [
                        "mon",
                        "thu"
                    ]
                }
            },
            "route": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "34206005",
                        "display": "Subcutaneous route"
                    }
                ]
            },
            "method": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "422145002",
                        "display": "Inject"
                    }
                ]
            }
        }
    ],
    "substitution": {
        "allowedBoolean": false
    }
}
MedicationRequest.id[0]808e7672-cf8d-48d8-885b-694c9bb9a417
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]inpatient
MedicationRequest.category[0].coding[0].display[0]inpatient
MedicationRequest.medication[0].coding[0].system[0]https://dmd.nhs.uk
MedicationRequest.medication[0].coding[0].code[0]2971511000001101
MedicationRequest.medication[0].coding[0].display[0]Eprex 2,000units/0.5ml solution for injection pre-filled syringes (Janssen-Cilag 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]Inject once a day - on Monday and Thursday - Subcutaneous route - with dialysis
MedicationRequest.dosageInstruction[0].additionalInstruction[0].text[0]with dialysis
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].timing[0].repeat[0].dayOfWeek[0]mon
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].dayOfWeek[1]thu
MedicationRequest.dosageInstruction[0].route[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].route[0].coding[0].code[0]34206005
MedicationRequest.dosageInstruction[0].route[0].coding[0].display[0]Subcutaneous route
MedicationRequest.dosageInstruction[0].method[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].method[0].coding[0].code[0]422145002
MedicationRequest.dosageInstruction[0].method[0].coding[0].display[0]Inject
MedicationRequest.substitution[0].allowed[0]False
MedicationRequest

Example on-screen presentation:

Eprex 2,000units/0.5ml solution for injection pre-filled syringes (Janssen-Cilag Ltd)
Inject once a day - on Monday and Thursday - Subcutaneous route - with dialysis
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