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: This example below is a draft and requires clinical verification.

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="2021-05-07T16:15:32Z" />
    <!--    Message Header    -->
    <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>
    <!-- Patient associated with the encounter. -->
    <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>
    <!-- Prescribing clinician associated with the encounter.  -->
    <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>
    <!-- Ward nurse associated with the encounter.  -->
    <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>
    <!-- Medication prescribed  -->
    <entry>
        <fullUrl value="urn:medication-327337009" />
        <resource>
            <Medication>
                <id value="urn:medication-327337009" />
                <code>
                    <coding>
                        <system value="http://snomed.info/sct" />
                        <code value="327337009" />
                        <display value="Goserelin 3.6mg implant pre-filled syringes" />
                    </coding>
                </code>
            </Medication>
        </resource>
    </entry>
    <!--  Medication Request  -->
    <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="2020-04-30T17:00:00Z" />
                <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": "2021-05-07T16:15:32Z",
    "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": "327337009",
                            "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": "2020-04-30T17:00:00Z",
                "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]327337009
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]2020-04-30T17:00:00Z
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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