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 7: GP MedicationStatement

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

The GP record sharing the Codine medication has been stopped and the Pregabalin medication has been started.

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="5e6906dc-e333-4e1a-a638-13ac163ec63d" />
<identifier>
<system value="urn:[organisation_name]:[system_name]" />
<value value="urn:457759fb-ea9e-4f23-9d2e-5387eb4bf23e" />
</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="http://hl7.org/fhir/message-events" />
<code value="medication-statement" />
<display value="Medication Statement" />
</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-5678" />
</focus>
</MessageHeader>
</resource>
</entry>
<!-- // Patient associated with the encounter -->
<entry>
<fullUrl value="urn:patient-01912" />
<resource>
<Patient>
<id value="urn: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:gp-1234" />
<resource>
<Practitioner>
<id value="urn:gp-1234" />
<name>
<text value="Dr Levy Tate" />
<family value="Tate" />
<given value="Levy" />
<prefix value="Dr" />
</name>
<qualification>
<code>
<coding>
<system value="https://fhir.hl7.org.uk/Id/gmc-number" />
<code value="125654" />
<display value="General Medical Council" />
</coding>
</code>
</qualification>
</Practitioner>
</resource>
</entry>
<!-- // Medication -->
<entry>
<fullUrl value="urn:medication-634523423" />
<resource>
<Medication>
<id value="urn:medication-634523423" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="322503009" />
<display value="Codeine 30mg tablets" />
</coding>
</code>
</Medication>
</resource>
</entry>
<!-- // MedicationStatement -->
<entry>
<fullUrl value="urn:medication-statement-1234" />
<resource>
<MedicationStatement>
<id value="urn:medication-statement-1234" />
<status value="stopped" />
<category>
<coding>
<system value="http://hl7.org/fhir/medication-request-category" />
<code value="community" />
<display value="Community" />
</coding>
</category>
<medicationReference>
<reference value="urn:medication-634523423" />
<display value="Codeine 30mg tablets" />
</medicationReference>
<subject>
<reference value="urn:patient-01912" />
<display value="Mr Chris PACKET" />
</subject>
<dateAsserted value="2021-05-09T10:12:42Z" />
<informationSource>
<reference value="urn:gp-1234" />
<display value="Dr Levy Tate" />
</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 -->
<entry>
<fullUrl value="urn:medication-2378976" />
<resource>
<Medication>
<id value="urn:medication-2378976" />
<code>
<coding>
<system value="http://snomed.info/sct" />
<code value="38019511000001108" />
<display value="Pregabalin 100mg tablets" />
</coding>
</code>
</Medication>
</resource>
</entry>
<!-- // MedicationStatement -->
<entry>
<fullUrl value="urn:medication-statement-5678" />
<resource>
<MedicationStatement>
<id value="urn:medication-statement-5678" />
<status value="active" />
<category>
<coding>
<system value="http://hl7.org/fhir/medication-request-category" />
<code value="community" />
<display value="Community" />
</coding>
</category>
<medicationReference>
<reference value="urn:medication-2378976" />
<display value="Pregabalin 100mg tablets" />
</medicationReference>
<subject>
<reference value="urn:patient-01912" />
<display value="Mr Chris PACKET" />
</subject>
<dateAsserted value="2021-05-09T10:12:42Z" />
<informationSource>
<reference value="urn:gp-1234" />
<display value="Dr Levy Tate" />
</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": "5e6906dc-e333-4e1a-a638-13ac163ec63d",
"identifier": {
"system": "urn:[organisation_name]:[system_name]",
"value": "urn:457759fb-ea9e-4f23-9d2e-5387eb4bf23e"
},
"type": "message",
"timestamp": "2021-05-07T16:15:32Z",
"entry": [
{
"fullUrl": "urn:message-header-167434",
"resource": {
"resourceType": "MessageHeader",
"id": "urn:message-header-167434",
"eventCoding": {
"system": "http://hl7.org/fhir/message-events",
"code": "medication-statement",
"display": "Medication Statement"
},
"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-5678"
}
]
}
},
{
"fullUrl": "urn:patient-01912",
"resource": {
"resourceType": "Patient",
"id": "urn: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:gp-1234",
"resource": {
"resourceType": "Practitioner",
"id": "urn:gp-1234",
"name": [
{
"text": "Dr Levy Tate",
"family": "Tate",
"given": [
"Levy"
],
"prefix": [
"Dr"
]
}
],
"qualification": [
{
"code": {
"coding": [
{
"system": "https://fhir.hl7.org.uk/Id/gmc-number",
"code": "125654",
"display": "General Medical Council"
}
]
}
}
]
}
},
{
"fullUrl": "urn:medication-634523423",
"resource": {
"resourceType": "Medication",
"id": "urn:medication-634523423",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "322503009",
"display": "Codeine 30mg tablets"
}
]
}
}
},
{
"fullUrl": "urn:medication-statement-1234",
"resource": {
"resourceType": "MedicationStatement",
"id": "urn:medication-statement-1234",
"status": "stopped",
"category": {
"coding": [
{
"system": "http://hl7.org/fhir/medication-request-category",
"code": "community",
"display": "Community"
}
]
},
"medicationReference": {
"reference": "urn:medication-634523423",
"display": "Codeine 30mg tablets"
},
"subject": {
"reference": "urn:patient-01912",
"display": "Mr Chris PACKET"
},
"dateAsserted": "2021-05-09T10:12:42Z",
"informationSource": {
"reference": "urn:gp-1234",
"display": "Dr Levy Tate"
},
"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-2378976",
"resource": {
"resourceType": "Medication",
"id": "urn:medication-2378976",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "38019511000001108",
"display": "Pregabalin 100mg tablets"
}
]
}
}
},
{
"fullUrl": "urn:medication-statement-5678",
"resource": {
"resourceType": "MedicationStatement",
"id": "urn:medication-statement-5678",
"status": "active",
"category": {
"coding": [
{
"system": "http://hl7.org/fhir/medication-request-category",
"code": "community",
"display": "Community"
}
]
},
"medicationReference": {
"reference": "urn:medication-2378976",
"display": "Pregabalin 100mg tablets"
},
"subject": {
"reference": "urn:patient-01912",
"display": "Mr Chris PACKET"
},
"dateAsserted": "2021-05-09T10:12:42Z",
"informationSource": {
"reference": "urn:gp-1234",
"display": "Dr Levy Tate"
},
"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]5e6906dc-e333-4e1a-a638-13ac163ec63d
Bundle.identifier[0].system[0]urn:[organisation_name]:[system_name]
Bundle.identifier[0].value[0]urn:457759fb-ea9e-4f23-9d2e-5387eb4bf23e
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]medication-statement
Bundle.entry[0].resource[0].event[0].display[0]Medication Statement
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-5678
Bundle.entry[1].fullUrl[0]urn:patient-01912
Bundle.entry[1].resource[0].id[0]urn: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:gp-1234
Bundle.entry[2].resource[0].id[0]urn:gp-1234
Bundle.entry[2].resource[0].name[0].text[0]Dr Levy Tate
Bundle.entry[2].resource[0].name[0].family[0]Tate
Bundle.entry[2].resource[0].name[0].given[0]Levy
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]125654
Bundle.entry[2].resource[0].qualification[0].code[0].coding[0].display[0]General Medical Council
Bundle.entry[3].fullUrl[0]urn:medication-634523423
Bundle.entry[3].resource[0].id[0]urn:medication-634523423
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]322503009
Bundle.entry[3].resource[0].code[0].coding[0].display[0]Codeine 30mg tablets
Bundle.entry[4].fullUrl[0]urn:medication-statement-1234
Bundle.entry[4].resource[0].id[0]urn:medication-statement-1234
Bundle.entry[4].resource[0].status[0]stopped
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]community
Bundle.entry[4].resource[0].category[0].coding[0].display[0]Community
Bundle.entry[4].resource[0].medication[0].reference[0]urn:medication-634523423
Bundle.entry[4].resource[0].medication[0].display[0]Codeine 30mg tablets
Bundle.entry[4].resource[0].subject[0].reference[0]urn:patient-01912
Bundle.entry[4].resource[0].subject[0].display[0]Mr Chris PACKET
Bundle.entry[4].resource[0].dateAsserted[0]2021-05-09T10:12:42Z
Bundle.entry[4].resource[0].informationSource[0].reference[0]urn:gp-1234
Bundle.entry[4].resource[0].informationSource[0].display[0]Dr Levy Tate
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-2378976
Bundle.entry[5].resource[0].id[0]urn:medication-2378976
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]38019511000001108
Bundle.entry[5].resource[0].code[0].coding[0].display[0]Pregabalin 100mg tablets
Bundle.entry[6].fullUrl[0]urn:medication-statement-5678
Bundle.entry[6].resource[0].id[0]urn:medication-statement-5678
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]community
Bundle.entry[6].resource[0].category[0].coding[0].display[0]Community
Bundle.entry[6].resource[0].medication[0].reference[0]urn:medication-2378976
Bundle.entry[6].resource[0].medication[0].display[0]Pregabalin 100mg tablets
Bundle.entry[6].resource[0].subject[0].reference[0]urn:patient-01912
Bundle.entry[6].resource[0].subject[0].display[0]Mr Chris PACKET
Bundle.entry[6].resource[0].dateAsserted[0]2021-05-09T10:12:42Z
Bundle.entry[6].resource[0].informationSource[0].reference[0]urn:gp-1234
Bundle.entry[6].resource[0].informationSource[0].display[0]Dr Levy Tate
Bundle.entry[6].resource[0].dosage[0].timing[0].repeat[0].frequency[0]2
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]1
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
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