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 2: MedicationDispense

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

Actors

Provider System = Hospital pharmacy system

Consumer System = Outpatient EPMA system

Example

<!--     This xml example is for illustrative purposes only and has not been clinically verified.     -->
<Bundle xmlns="http://hl7.org/fhir">
    <id value="f3374004-b796-4d0d-949d-3574b0103ec9" />
    <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="http://hl7.org/fhir/message-events" />
                    <code value="individual-requirements-1" />
                    <display value="Individual Requirements" />
                </eventCoding>
                <source>
                    <endpoint value="urn:nhs-uk:addressing:ods:T48NT" />
                </source>
                <focus>
                    <reference value="urn:medication-disp-56756345423" />
                </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>
    <!--      Performer associated with the encounter.      -->
    <entry>
        <fullUrl value="urn:staff-0002" />
        <resource>
            <Practitioner>
                <id value="urn:staff-0002" />
                <name>
                    <text value="Dr Allo Kate" />
                    <family value="Kate" />
                    <given value="Allo" />
                    <prefix value="Dr" />
                </name>
                <qualification>
                    <code>
                        <coding>
                            <system value="https://fhir.hl7.org.uk/Id/gpc-number" />
                            <code value="123543" />
                            <display value="General Pharmaceutical Council" />
                        </coding>
                    </code>
                </qualification>
            </Practitioner>
        </resource>
    </entry>
    <!--    Medication   -->
    <entry>
        <fullUrl value="urn:medication-824211000001107" />
        <resource>
            <Medication>
                <id value="urn:medication-824211000001107" />
                <code>
                    <coding>
                        <system value="http://snomed.info/sct" />
                        <code value="824211000001107" />
                        <display value="Zoladex 3.6mg implant SafeSystem pre-filled syringes (AstraZeneca UK Ltd)" />
                    </coding>
                </code>
            </Medication>
        </resource>
    </entry>
    <!--      Medication Dispense      -->
    <entry>
        <fullUrl value="urn:medication-disp-56756345423" />
        <resource>
            <MedicationDispense>
                <id value="urn:medication-disp-56756345423" />
                <identifier>
                    <system value="https://fhir.nhs.uk/Id/nhs-number" />
                    <value value="urn:2aa74d82-ae47-4783-8b7a-ff594bc2929f" />
                </identifier>
                <status value="in-progress" />
                <category>
                    <coding>
                        <system value="http://hl7.org/fhir/medication-request-category" />
                        <code value="outpatient" />
                        <display value="outpatient" />
                    </coding>
                </category>
                <medicationReference>
                    <reference value="urn:medication-824211000001107" />
                    <display value="Zoladex 3.6mg implant SafeSystem pre-filled syringes (AstraZeneca UK Ltd)" />
                </medicationReference>
                <subject>
                    <reference value="urn:patient-3204221854" />
                    <display value="Mr Scott Chegg" />
                </subject>
                <performer>
                    <actor>
                        <reference value="urn:staff-0002" />
                        <display value="Dr Allo Kate" />
                    </actor>
                </performer>
                <authorizingPrescription>
                    <reference value="urn:med-req-342355475687898" />
                </authorizingPrescription>
                <quantity>
                    <value value="1" />
                    <unit value="pre-filled disposable injection" />
                    <system value="http://snomed.info/sct" />
                    <code value="3318611000001103" />
                </quantity>
                <whenPrepared value="2021-05-07T16:15:32Z" />
                <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>
            </MedicationDispense>
        </resource>
    </entry>
</Bundle>

{
    "resourceType": "Bundle",
    "id": "f3374004-b796-4d0d-949d-3574b0103ec9",
    "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": "http://hl7.org/fhir/message-events",
                    "code": "individual-requirements-1",
                    "display": "Individual Requirements"
                },
                "source": {
                    "endpoint": "urn:nhs-uk:addressing:ods:T48NT"
                },
                "focus":  [
                    {
                        "reference": "urn:medication-disp-56756345423"
                    }
                ]
            }
        },
        {
            "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-0002",
            "resource": {
                "resourceType": "Practitioner",
                "id": "urn:staff-0002",
                "name":  [
                    {
                        "text": "Dr Allo Kate",
                        "family": "Kate",
                        "given":  [
                            "Allo"
                        ],
                        "prefix":  [
                            "Dr"
                        ]
                    }
                ],
                "qualification":  [
                    {
                        "code": {
                            "coding":  [
                                {
                                    "system": "https://fhir.hl7.org.uk/Id/gpc-number",
                                    "code": "123543",
                                    "display": "General Pharmaceutical Council"
                                }
                            ]
                        }
                    }
                ]
            }
        },
        {
            "fullUrl": "urn:medication-824211000001107",
            "resource": {
                "resourceType": "Medication",
                "id": "urn:medication-824211000001107",
                "code": {
                    "coding":  [
                        {
                            "system": "http://snomed.info/sct",
                            "code": "824211000001107",
                            "display": "Zoladex 3.6mg implant SafeSystem pre-filled syringes (AstraZeneca UK Ltd)"
                        }
                    ]
                }
            }
        },
        {
            "fullUrl": "urn:medication-disp-56756345423",
            "resource": {
                "resourceType": "MedicationDispense",
                "id": "urn:medication-disp-56756345423",
                "identifier":  [
                    {
                        "system": "https://fhir.nhs.uk/Id/nhs-number",
                        "value": "urn:2aa74d82-ae47-4783-8b7a-ff594bc2929f"
                    }
                ],
                "status": "in-progress",
                "category": {
                    "coding":  [
                        {
                            "system": "http://hl7.org/fhir/medication-request-category",
                            "code": "outpatient",
                            "display": "outpatient"
                        }
                    ]
                },
                "medicationReference": {
                    "reference": "urn:medication-824211000001107",
                    "display": "Zoladex 3.6mg implant SafeSystem pre-filled syringes (AstraZeneca UK Ltd)"
                },
                "subject": {
                    "reference": "urn:patient-3204221854",
                    "display": "Mr Scott Chegg"
                },
                "performer":  [
                    {
                        "actor": {
                            "reference": "urn:staff-0002",
                            "display": "Dr Allo Kate"
                        }
                    }
                ],
                "authorizingPrescription":  [
                    {
                        "reference": "urn:med-req-342355475687898"
                    }
                ],
                "quantity": {
                    "value": 1,
                    "unit": "pre-filled disposable injection",
                    "system": "http://snomed.info/sct",
                    "code": "3318611000001103"
                },
                "whenPrepared": "2021-05-07T16:15:32Z",
                "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"
                                }
                            ]
                        }
                    }
                ]
            }
        }
    ]
}
Bundle.id[0]f3374004-b796-4d0d-949d-3574b0103ec9
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]http://hl7.org/fhir/message-events
Bundle.entry[0].resource[0].event[0].code[0]individual-requirements-1
Bundle.entry[0].resource[0].event[0].display[0]Individual Requirements
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:medication-disp-56756345423
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-0002
Bundle.entry[2].resource[0].id[0]urn:staff-0002
Bundle.entry[2].resource[0].name[0].text[0]Dr Allo Kate
Bundle.entry[2].resource[0].name[0].family[0]Kate
Bundle.entry[2].resource[0].name[0].given[0]Allo
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/gpc-number
Bundle.entry[2].resource[0].qualification[0].code[0].coding[0].code[0]123543
Bundle.entry[2].resource[0].qualification[0].code[0].coding[0].display[0]General Pharmaceutical Council
Bundle.entry[3].fullUrl[0]urn:medication-824211000001107
Bundle.entry[3].resource[0].id[0]urn:medication-824211000001107
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]824211000001107
Bundle.entry[3].resource[0].code[0].coding[0].display[0]Zoladex 3.6mg implant SafeSystem pre-filled syringes (AstraZeneca UK Ltd)
Bundle.entry[4].fullUrl[0]urn:medication-disp-56756345423
Bundle.entry[4].resource[0].id[0]urn:medication-disp-56756345423
Bundle.entry[4].resource[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
Bundle.entry[4].resource[0].identifier[0].value[0]urn:2aa74d82-ae47-4783-8b7a-ff594bc2929f
Bundle.entry[4].resource[0].status[0]in-progress
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]outpatient
Bundle.entry[4].resource[0].category[0].coding[0].display[0]outpatient
Bundle.entry[4].resource[0].medication[0].reference[0]urn:medication-824211000001107
Bundle.entry[4].resource[0].medication[0].display[0]Zoladex 3.6mg implant SafeSystem pre-filled syringes (AstraZeneca UK Ltd)
Bundle.entry[4].resource[0].subject[0].reference[0]urn:patient-3204221854
Bundle.entry[4].resource[0].subject[0].display[0]Mr Scott Chegg
Bundle.entry[4].resource[0].performer[0].actor[0].reference[0]urn:staff-0002
Bundle.entry[4].resource[0].performer[0].actor[0].display[0]Dr Allo Kate
Bundle.entry[4].resource[0].authorizingPrescription[0].reference[0]urn:med-req-342355475687898
Bundle.entry[4].resource[0].quantity[0].value[0]1
Bundle.entry[4].resource[0].quantity[0].unit[0]pre-filled disposable injection
Bundle.entry[4].resource[0].quantity[0].system[0]http://snomed.info/sct
Bundle.entry[4].resource[0].quantity[0].code[0]3318611000001103
Bundle.entry[4].resource[0].whenPrepared[0]2021-05-07T16:15:32Z
Bundle.entry[4].resource[0].dosageInstruction[0].timing[0].event[0]2020-05-01
Bundle.entry[4].resource[0].dosageInstruction[0].timing[0].repeat[0].count[0]1
Bundle.entry[4].resource[0].dosageInstruction[0].site[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[4].resource[0].dosageInstruction[0].site[0].coding[0].code[0]59380008
Bundle.entry[4].resource[0].dosageInstruction[0].site[0].coding[0].display[0]Anterior abdominal wall structure
Bundle.entry[4].resource[0].dosageInstruction[0].route[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[4].resource[0].dosageInstruction[0].route[0].coding[0].code[0]78421000
Bundle.entry[4].resource[0].dosageInstruction[0].route[0].coding[0].display[0]intramuscular route
Bundle.entry[4].resource[0].dosageInstruction[0].method[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[4].resource[0].dosageInstruction[0].method[0].coding[0].code[0]422145002
Bundle.entry[4].resource[0].dosageInstruction[0].method[0].coding[0].display[0]inject
Bundle
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