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.

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": "2021-05-07T13:00:25Z",
"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": "2021-05-07T13:00:25Z",
"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": "2021-05-07T13:00:25Z",
"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": "2021-05-07T13:00:25Z",
"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
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