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": "2021-05-07T16:15:32+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": "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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