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: MedicationRequest

Note: Example validated against UKCore, dm+d and SNOMED-CT on 23 May 2025.

Actors

Provider System = Outpatient EPMA system

Consumer System = Hospital pharmacy system

Example

<Bundle xmlns="http://hl7.org/fhir">
<id value="d3f6aa00-24a3-45fe-87fd-877820f5f0e8" />
<identifier>
<system value="urn:[organisation_name]:[system_name]" />
<value value="urn:39920ce3-e585-4ef2-921b-9128fcfd307f" />
</identifier>
<type value="message" />
<timestamp value="2021-05-07T16:15:32+00:00" />
<entry>
<fullUrl value="urn:message-header-167434" />
<resource>
<MessageHeader>
<id value="urn:message-header-167434" />
<eventCoding>
<system value="https://fhir.hl7.org.uk//CodeSystem/message-event" />
<code value="prescription-order" />
<display value="Prescription Order" />
</eventCoding>
<source>
<name value="ACME Clinical Systems" />
<software value="ACME ePMA" />
<version value="3.5.68" />
<endpoint value="urn:nhs-uk:addressing:ods:T48NT" />
</source>
<focus>
<reference value="urn:med-req-342355475687898" />
</focus>
</MessageHeader>
</resource>
</entry>
<entry>
<fullUrl value="urn:patient-3204221854" />
<resource>
<Patient>
<id value="urn:patient-3204221854" />
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="3204221854" />
</identifier>
<name>
<use value="official" />
<text value="Mr Scott Chegg" />
<family value="Chegg" />
<given value="Scott" />
<prefix value="Mr" />
</name>
<gender value="male" />
<birthDate value="1960-04-02" />
</Patient>
</resource>
</entry>
<entry>
<fullUrl value="urn:staff-0001" />
<resource>
<Practitioner>
<id value="urn:staff-0001" />
<name>
<text value="Dr Justin Thyme" />
<family value="Thyme" />
<given value="Justin" />
<prefix value="Dr" />
</name>
<qualification>
<code>
<coding>
<system value="https://fhir.hl7.org.uk/Id/gmc-number" />
<code value="1234567" />
<display value="General Medical Council" />
</coding>
</code>
</qualification>
</Practitioner>
</resource>
</entry>
<entry>
<fullUrl value="urn:staff-0003" />
<resource>
<Practitioner>
<id value="urn:staff-0003" />
<name>
<text value="Levy Tate" />
<family value="Tate" />
<given value="Levy" />
</name>
<qualification>
<code>
<coding>
<system value="https://fhir.hl7.org.uk/Id/nmc-number" />
<code value="71A2998E" />
<display value="Nurse Midwifery Council" />
</coding>
</code>
</qualification>
</Practitioner>
</resource>
</entry>
<entry>
<fullUrl value="urn:medication-327337009" />
<resource>
<Medication>
<id value="urn:medication-327337009" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="42036711000001108" />
<display value="Goserelin 3.6mg implant pre-filled syringes" />
</coding>
</code>
</Medication>
</resource>
</entry>
<entry>
<fullUrl value="urn:med-req-342355475687898" />
<resource>
<MedicationRequest>
<id value="urn:med-req-342355475687898" />
<identifier>
<system value="urn:[organisation_name]:[system_name]" />
<value value="urn:39920ce3-e585-4ef2-921b-9128fcfd307f" />
</identifier>
<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>
<priority value="routine" />
<medicationReference>
<reference value="urn:medication-327337009" />
</medicationReference>
<subject>
<reference value="urn:patient-3204221854" />
<display value="Mr Scott Chegg" />
</subject>
<authoredOn value="2021-05-07T16:15:32+00:00" />
<requester>
<reference value="urn:staff-0001" />
<display value="Dr Justin Thyme" />
</requester>
<recorder>
<reference value="urn:staff-0003" />
<display value="Levy Tate" />
</recorder>
<dosageInstruction>
<timing>
<event value="2020-05-01" />
<repeat>
<count value="1" />
</repeat>
</timing>
<site>
<coding>
<system value="http://snomed.info/sct" />
<code value="59380008" />
<display value="Anterior abdominal wall structure" />
</coding>
</site>
<route>
<coding>
<system value="http://snomed.info/sct" />
<code value="78421000" />
<display value="Intramuscular 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>
</resource>
</entry>
</Bundle>
{
"resourceType": "Bundle",
"id": "d3f6aa00-24a3-45fe-87fd-877820f5f0e8",
"identifier": {
"system": "urn:[organisation_name]:[system_name]",
"value": "urn:39920ce3-e585-4ef2-921b-9128fcfd307f"
},
"type": "message",
"timestamp": "2021-05-07T16:15:32+00:00",
"entry": [
{
"fullUrl": "urn:message-header-167434",
"resource": {
"resourceType": "MessageHeader",
"id": "urn:message-header-167434",
"eventCoding": {
"system": "https://fhir.hl7.org.uk//CodeSystem/message-event",
"code": "prescription-order",
"display": "Prescription Order"
},
"source": {
"name": "ACME Clinical Systems",
"software": "ACME ePMA",
"version": "3.5.68",
"endpoint": "urn:nhs-uk:addressing:ods:T48NT"
},
"focus": [
{
"reference": "urn:med-req-342355475687898"
}
]
}
},
{
"fullUrl": "urn:patient-3204221854",
"resource": {
"resourceType": "Patient",
"id": "urn:patient-3204221854",
"identifier": [
{
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "3204221854"
}
],
"name": [
{
"use": "official",
"text": "Mr Scott Chegg",
"family": "Chegg",
"given": [
"Scott"
],
"prefix": [
"Mr"
]
}
],
"gender": "male",
"birthDate": "1960-04-02"
}
},
{
"fullUrl": "urn:staff-0001",
"resource": {
"resourceType": "Practitioner",
"id": "urn:staff-0001",
"name": [
{
"text": "Dr Justin Thyme",
"family": "Thyme",
"given": [
"Justin"
],
"prefix": [
"Dr"
]
}
],
"qualification": [
{
"code": {
"coding": [
{
"system": "https://fhir.hl7.org.uk/Id/gmc-number",
"code": "1234567",
"display": "General Medical Council"
}
]
}
}
]
}
},
{
"fullUrl": "urn:staff-0003",
"resource": {
"resourceType": "Practitioner",
"id": "urn:staff-0003",
"name": [
{
"text": "Levy Tate",
"family": "Tate",
"given": [
"Levy"
]
}
],
"qualification": [
{
"code": {
"coding": [
{
"system": "https://fhir.hl7.org.uk/Id/nmc-number",
"code": "71A2998E",
"display": "Nurse Midwifery Council"
}
]
}
}
]
}
},
{
"fullUrl": "urn:medication-327337009",
"resource": {
"resourceType": "Medication",
"id": "urn:medication-327337009",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "42036711000001108",
"display": "Goserelin 3.6mg implant pre-filled syringes"
}
]
}
}
},
{
"fullUrl": "urn:med-req-342355475687898",
"resource": {
"resourceType": "MedicationRequest",
"id": "urn:med-req-342355475687898",
"identifier": [
{
"system": "urn:[organisation_name]:[system_name]",
"value": "urn:39920ce3-e585-4ef2-921b-9128fcfd307f"
}
],
"status": "active",
"intent": "order",
"category": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/medicationrequest-category",
"code": "inpatient",
"display": "inpatient"
}
]
}
],
"priority": "routine",
"medicationReference": {
"reference": "urn:medication-327337009"
},
"subject": {
"reference": "urn:patient-3204221854",
"display": "Mr Scott Chegg"
},
"authoredOn": "2021-05-07T16:15:32+00:00",
"requester": {
"reference": "urn:staff-0001",
"display": "Dr Justin Thyme"
},
"recorder": {
"reference": "urn:staff-0003",
"display": "Levy Tate"
},
"dosageInstruction": [
{
"timing": {
"event": [
"2020-05-01"
],
"repeat": {
"count": 1
}
},
"site": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "59380008",
"display": "Anterior abdominal wall structure"
}
]
},
"route": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "78421000",
"display": "Intramuscular route"
}
]
},
"method": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "422145002",
"display": "Inject"
}
]
}
}
],
"substitution": {
"allowedBoolean": false
}
}
}
]
}
Bundle.id[0]d3f6aa00-24a3-45fe-87fd-877820f5f0e8
Bundle.identifier[0].system[0]urn:[organisation_name]:[system_name]
Bundle.identifier[0].value[0]urn:39920ce3-e585-4ef2-921b-9128fcfd307f
Bundle.type[0]message
Bundle.timestamp[0]2021-05-07T16:15:32+00:00
Bundle.entry[0].fullUrl[0]urn:message-header-167434
Bundle.entry[0].resource[0].id[0]urn:message-header-167434
Bundle.entry[0].resource[0].event[0].system[0]https://fhir.hl7.org.uk//CodeSystem/message-event
Bundle.entry[0].resource[0].event[0].code[0]prescription-order
Bundle.entry[0].resource[0].event[0].display[0]Prescription Order
Bundle.entry[0].resource[0].source[0].name[0]ACME Clinical Systems
Bundle.entry[0].resource[0].source[0].software[0]ACME ePMA
Bundle.entry[0].resource[0].source[0].version[0]3.5.68
Bundle.entry[0].resource[0].source[0].endpoint[0]urn:nhs-uk:addressing:ods:T48NT
Bundle.entry[0].resource[0].focus[0].reference[0]urn:med-req-342355475687898
Bundle.entry[1].fullUrl[0]urn:patient-3204221854
Bundle.entry[1].resource[0].id[0]urn:patient-3204221854
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]3204221854
Bundle.entry[1].resource[0].name[0].use[0]official
Bundle.entry[1].resource[0].name[0].text[0]Mr Scott Chegg
Bundle.entry[1].resource[0].name[0].family[0]Chegg
Bundle.entry[1].resource[0].name[0].given[0]Scott
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]1960-04-02
Bundle.entry[2].fullUrl[0]urn:staff-0001
Bundle.entry[2].resource[0].id[0]urn:staff-0001
Bundle.entry[2].resource[0].name[0].text[0]Dr Justin Thyme
Bundle.entry[2].resource[0].name[0].family[0]Thyme
Bundle.entry[2].resource[0].name[0].given[0]Justin
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]1234567
Bundle.entry[2].resource[0].qualification[0].code[0].coding[0].display[0]General Medical Council
Bundle.entry[3].fullUrl[0]urn:staff-0003
Bundle.entry[3].resource[0].id[0]urn:staff-0003
Bundle.entry[3].resource[0].name[0].text[0]Levy Tate
Bundle.entry[3].resource[0].name[0].family[0]Tate
Bundle.entry[3].resource[0].name[0].given[0]Levy
Bundle.entry[3].resource[0].qualification[0].code[0].coding[0].system[0]https://fhir.hl7.org.uk/Id/nmc-number
Bundle.entry[3].resource[0].qualification[0].code[0].coding[0].code[0]71A2998E
Bundle.entry[3].resource[0].qualification[0].code[0].coding[0].display[0]Nurse Midwifery Council
Bundle.entry[4].fullUrl[0]urn:medication-327337009
Bundle.entry[4].resource[0].id[0]urn:medication-327337009
Bundle.entry[4].resource[0].code[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[4].resource[0].code[0].coding[0].code[0]42036711000001108
Bundle.entry[4].resource[0].code[0].coding[0].display[0]Goserelin 3.6mg implant pre-filled syringes
Bundle.entry[5].fullUrl[0]urn:med-req-342355475687898
Bundle.entry[5].resource[0].id[0]urn:med-req-342355475687898
Bundle.entry[5].resource[0].identifier[0].system[0]urn:[organisation_name]:[system_name]
Bundle.entry[5].resource[0].identifier[0].value[0]urn:39920ce3-e585-4ef2-921b-9128fcfd307f
Bundle.entry[5].resource[0].status[0]active
Bundle.entry[5].resource[0].intent[0]order
Bundle.entry[5].resource[0].category[0].coding[0].system[0]http://terminology.hl7.org/CodeSystem/medicationrequest-category
Bundle.entry[5].resource[0].category[0].coding[0].code[0]inpatient
Bundle.entry[5].resource[0].category[0].coding[0].display[0]inpatient
Bundle.entry[5].resource[0].priority[0]routine
Bundle.entry[5].resource[0].medication[0].reference[0]urn:medication-327337009
Bundle.entry[5].resource[0].subject[0].reference[0]urn:patient-3204221854
Bundle.entry[5].resource[0].subject[0].display[0]Mr Scott Chegg
Bundle.entry[5].resource[0].authoredOn[0]2021-05-07T16:15:32+00:00
Bundle.entry[5].resource[0].requester[0].reference[0]urn:staff-0001
Bundle.entry[5].resource[0].requester[0].display[0]Dr Justin Thyme
Bundle.entry[5].resource[0].recorder[0].reference[0]urn:staff-0003
Bundle.entry[5].resource[0].recorder[0].display[0]Levy Tate
Bundle.entry[5].resource[0].dosageInstruction[0].timing[0].event[0]2020-05-01
Bundle.entry[5].resource[0].dosageInstruction[0].timing[0].repeat[0].count[0]1
Bundle.entry[5].resource[0].dosageInstruction[0].site[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[5].resource[0].dosageInstruction[0].site[0].coding[0].code[0]59380008
Bundle.entry[5].resource[0].dosageInstruction[0].site[0].coding[0].display[0]Anterior abdominal wall structure
Bundle.entry[5].resource[0].dosageInstruction[0].route[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[5].resource[0].dosageInstruction[0].route[0].coding[0].code[0]78421000
Bundle.entry[5].resource[0].dosageInstruction[0].route[0].coding[0].display[0]Intramuscular route
Bundle.entry[5].resource[0].dosageInstruction[0].method[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[5].resource[0].dosageInstruction[0].method[0].coding[0].code[0]422145002
Bundle.entry[5].resource[0].dosageInstruction[0].method[0].coding[0].display[0]Inject
Bundle.entry[5].resource[0].substitution[0].allowed[0]False
Bundle
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