Supply of Medication using ADCs
A number of examples have been provided to highlight how the FHIR MedicationRequest resource supports ADC use cases. A summary of the key data differences is provided in this table.
| Example | status | intent | category | other elements |
|---|---|---|---|---|
| Medication unit dose | active | plan | inpatient | |
| Medication put on hold | on-hold | plan | inpatient | doNotPerform = truedispenseRequest.validityPeriod priorPrescription (optional) |
| Click and collect | active | order | inpatient | performer dispenseRequest.quantity (optional) |
| TTO discharge/leave pack | active | plan | discharge or leave | |
| Whole pack dispense | active | plan | inpatient | dispenseRequest.quantity |
| STAT dose | active | plan | inpatient | priority = stat |
| PRN / As Required | active | plan | inpatient | dosage.asNeededBoolean = true |
| Multi-use products | active | plan | inpatient | The ADC uses local configuration to identify multi-use products |
| Multi-dose products | active | plan | inpatient | The ADC uses local configuration to identify multi-dose products |
| Multi-ingredient | active | plan | inpatient | References a Medication resource containing multiple ingredient data items |
Medication unit dose
Atenolol 50mg tablets, 1 tablet, once day
{
"fullUrl": "urn:uuid:34eb3c92-76e6-48c2-9691-aa1f0b58369b",
"resource": {
"resourceType": "MedicationRequest",
"id": "34eb3c92-76e6-48c2-9691-aa1f0b58369b",
"meta": {
"profile": [
"https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest"
]
},
"status": "active",
"intent": "plan",
"category": "inpatient",
"medicationCodeableConcept": {
"coding": [
{
"system": "https://dmd.nhs.uk",
"code": "42370711000001107",
"display": "Atenolol 50mg tablets"
}
]
},
"subject": {
"reference": "Patient/UKCore-Patient-RichardSmith-Example"
},
"authoredOn": "2025-10-01T10:20:00+00:00",
"encounter": {
"reference": "Encounter/UKCore-Encounter-ABC123-Example"
}
},
"dosageInstruction": [
{
"text": "1 tablet daily",
"timing": {
"repeat": {
"frequency": 1,
"period": 1,
"periodUnit": "d"
}
},
"doseAndRate": [
{
"doseQuantity": {
"value": 1,
"unit": "tablet",
"system": "http://snomed.info/sct",
"code": "428673006"
}
}
]
}
],
"substitution": {
"allowedBoolean": false
}
}
}
Medication (VTM) unit dose
Atenolol, 50mg, oral, once a day
{
"fullUrl": "urn:uuid:34eb3c92-76e6-48c2-9691-aa1f0b58369b",
"resource": {
"resourceType": "MedicationRequest",
"id": "34eb3c92-76e6-48c2-9691-aa1f0b58369b",
"meta": {
"profile": [
"https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest"
]
},
"status": "active",
"intent": "plan",
"category": "inpatient",
"medicationCodeableConcept": {
"coding": [
{
"system": "https://dmd.nhs.uk",
"code": "774685003",
"display": "Atenolol"
}
]
},
"subject": {
"reference": "Patient/UKCore-Patient-RichardSmith-Example"
},
"authoredOn": "2025-10-01T10:20:00+00:00",
"encounter": {
"reference": "Encounter/UKCore-Encounter-ABC123-Example"
}
},
"dosageInstruction": [
{
"text": "50mg daily, oral",
"timing": {
"repeat": {
"frequency": 1,
"period": 1,
"periodUnit": "d"
}
},
"route": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "26643006",
"display": "Oral"
}
]
},
"doseAndRate": [
{
"doseQuantity": {
"value": 50,
"unit": "milligram",
"system": "http://unitsofmeasure.org",
"code": "mg"
}
}
]
}
],
"substitution": {
"allowedBoolean": false
}
}
}
Medication put on hold
Atenolol 50mg tablets - put on hold from 24th Sept 10:00 to 3rd Oct 15:00
{
"fullUrl": "urn:uuid:643d2f30-f911-4914-bd73-abddea9b9e9f",
"resource": {
"resourceType": "MedicationRequest",
"id": "643d2f30-f911-4914-bd73-abddea9b9e9f",
"meta": {
"profile": [
"https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest"
]
},
"status": "on-hold",
"intent": "plan",
"category": "inpatient",
"doNotPerform": true,
"medicationCodeableConcept": {
"coding": [
{
"system": "https://dmd.nhs.uk",
"code": "42370711000001107",
"display": "Atenolol 50mg tablets"
}
]
},
"subject": {
"reference": "Patient/UKCore-Patient-RichardSmith-Example"
},
"authoredOn": "2025-10-01T10:20:00+00:00",
"encounter": {
"reference": "Encounter/UKCore-Encounter-ABC123-Example"
}
},
"dispenseRequest": {
"validityPeriod": {
"start": "2026-09-24T10:00:00",
"end": "2026-10-03T15:00:00"
}
},
"substitution": {
"allowedBoolean": false
},
"priorPrescription": {
"reference": "MedicationRequest/34eb3c92-76e6-48c2-9691-aa1f0b58369b"
}
}
}
An EPMA to ADC implementation may handle the on-hold use case via two interactions. The first to put the medication on-hold from a given date/time. The second to put the medication back to active from a given date/time.
"status": "on-hold", "dispenseRequest": { "validityPeriod": { "start": "2026-09-24T10:00:00" } }
followed by
"status": "active", "dispenseRequest": { "validityPeriod": { "start": "2026-10-03T15:00:00" } }
Click and Collect order
Paracetamol 500mg tablets, 1 tablet, four times a day, pack of 28 tablets ordered by Chris Boland
{
"fullUrl": "urn:uuid:34eb3c92-76e6-48c2-9691-aa1f0b58369b",
"resource": {
"resourceType": "MedicationRequest",
"id": "34eb3c92-76e6-48c2-9691-aa1f0b58369b",
"meta": {
"profile": [
"https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest"
]
},
"status": "active",
"intent": "order",
"category": "inpatient",
"medicationCodeableConcept": {
"coding": [
{
"system": "https://dmd.nhs.uk",
"code": "42109611000001109",
"display": "Paracetamol 500mg tablets"
}
]
},
"subject": {
"reference": "Patient/UKCore-Patient-RichardSmith-Example"
},
"authoredOn": "2025-10-01T10:20:00+00:00",
"encounter": {
"reference": "Encounter/UKCore-Encounter-ABC123-Example"
}
},
"performer": {
"reference": "Patient/UKCore-Practitioner-ChrisBoland-Example"
}
},
"dosageInstruction": [
{
"text": "1 tablet, 4 times a day",
"timing": {
"repeat": {
"frequency": 4,
"period": 1,
"periodUnit": "d"
}
},
"doseAndRate": [
{
"doseQuantity": {
"value": 1,
"unit": "tablet",
"system": "http://snomed.info/sct",
"code": "428673006"
}
}
]
}
],
"dispenseRequest": {
"quantity": {
"value": 28,
"unit": "tablet",
"system": "http://snomed.info/sct",
"code": "428673006"
}
},
"substitution": {
"allowedBoolean": false
}
}
}
TTO pack for Discharge
Paracetamol 500mg tablets, 1 tablet, four times a day, for 7 days. Optionally a dispenseRequest.quantity for 28 tablets could be included.
{
"fullUrl": "urn:uuid:34eb3c92-76e6-48c2-9691-aa1f0b58369b",
"resource": {
"resourceType": "MedicationRequest",
"id": "34eb3c92-76e6-48c2-9691-aa1f0b58369b",
"meta": {
"profile": [
"https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest"
]
},
"status": "active",
"intent": "plan",
"category": "discharge",
"medicationCodeableConcept": {
"coding": [
{
"system": "https://dmd.nhs.uk",
"code": "42109611000001109",
"display": "Paracetamol 500mg tablets"
}
]
},
"subject": {
"reference": "Patient/UKCore-Patient-RichardSmith-Example"
},
"authoredOn": "2025-10-01T10:20:00+00:00",
"encounter": {
"reference": "Encounter/UKCore-Encounter-ABC123-Example"
}
},
"dosageInstruction": [
{
"text": "1 tablet, 4 times a day, for 7 days",
"timing": {
"repeat": {
"frequency": 4,
"period": 1,
"periodUnit": "d",
"boundsDuration": {
"value": 7,
"unit": "day",
"system": "http://unitsofmeasure.org",
"code": "d"
}
}
},
"doseAndRate": [
{
"doseQuantity": {
"value": 1,
"unit": "tablet",
"system": "http://snomed.info/sct",
"code": "428673006"
}
}
]
}
],
"substitution": {
"allowedBoolean": false
}
}
}
An EPMA to ADC implementation will likely support the definition of the duration for medication in three different ways; as a duration of time, between two dates (or times), or as a number of doses.
// for a duration of time "repeat": { "boundsDuration": { "value": 7, "unit": "day", "system": "http://unitsofmeasure.org", "code": "d" } }
// between two dates "repeat": { "boundsPeriod": { "start": "2026-10-01", "end": "2026-10-07" } }
// for a number of doses "repeat": { "count": 7 }
Whole pack PRN for inpatient use
Paracetamol 500mg tablets, 1 tablet, PRN, maximum 8 tablets in 24 hours. If labelled for the patient, the medication could be kept in a patient bedside locker for either nurse or self administration.
{
"fullUrl": "urn:uuid:34eb3c92-76e6-48c2-9691-aa1f0b58369b",
"resource": {
"resourceType": "MedicationRequest",
"id": "34eb3c92-76e6-48c2-9691-aa1f0b58369b",
"meta": {
"profile": [
"https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest"
]
},
"status": "active",
"intent": "order",
"category": "inpatient",
"medicationCodeableConcept": {
"coding": [
{
"system": "https://dmd.nhs.uk",
"code": "42109611000001109",
"display": "Paracetamol 500mg tablets"
}
]
},
"subject": {
"reference": "Patient/UKCore-Patient-RichardSmith-Example"
},
"authoredOn": "2025-10-01T10:20:00+00:00",
"encounter": {
"reference": "Encounter/UKCore-Encounter-ABC123-Example"
}
},
"dosageInstruction": [
{
"text": "1 tablet, PRN, maximum 8 tablets in 24 hours",
"asNeededBoolean": true,
"doseAndRate": [
{
"doseQuantity": {
"value": 1,
"unit": "tablet",
"system": "http://snomed.info/sct",
"code": "428673006"
}
}
],
"maxDosePerPeriod": {
"numerator": {
"value": 8,
"unit": "tablet",
"system": "http://snomed.info/sct",
"code": "428673006"
},
"denominator": {
"value": 24,
"unit": "hour",
"system": "http://unitsofmeasure.org",
"code": "h"
}
}
}
],
"dispenseRequest": {
"quantity": {
"value": 28,
"unit": "tablet",
"system": "http://snomed.info/sct",
"code": "428673006"
}
},
"substitution": {
"allowedBoolean": false
}
}
}
STAT dose example
Morphine sulfate 1mg/1ml solution for injection ampoules, 1 ampoule, Bolus, Intravenous, stat
{
"fullUrl": "urn:uuid:34eb3c92-76e6-48c2-9691-aa1f0b58369b",
"resource": {
"resourceType": "MedicationRequest",
"id": "34eb3c92-76e6-48c2-9691-aa1f0b58369b",
"meta": {
"profile": [
"https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest"
]
},
"status": "active",
"intent": "plan",
"category": "inpatient",
"priority": "stat",
"medicationCodeableConcept": {
"coding": [
{
"system": "https://dmd.nhs.uk",
"code": "22401911000001100",
"display": "Morphine sulfate 1mg/1ml solution for injection ampoules"
}
]
},
"subject": {
"reference": "Patient/UKCore-Patient-RichardSmith-Example"
},
"authoredOn": "2025-10-01T10:20:00+00:00",
"encounter": {
"reference": "Encounter/UKCore-Encounter-ABC123-Example"
}
},
"dosageInstruction": [
{
"text": "Bolus - Intravenous - stat",
"timing": {
"repeat": {
"frequency": 2,
"period": 1,
"periodUnit": "d"
}
},
"method": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "13283801000001100",
"display": "Bolus"
}
]
},
"route": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "47625008",
"display": "Intravenous"
}
]
},
"doseAndRate": [
{
"doseQuantity": {
"value": 1,
"unit": "ampoule",
"system": "http://snomed.info/sct",
"code": "413516001"
}
}
]
}
],
"substitution": {
"allowedBoolean": false
}
}
}
PRN / As Required example
Paracetamol 500mg tablets, 1 tablet, As Required
{
"fullUrl": "urn:uuid:34eb3c92-76e6-48c2-9691-aa1f0b58369b",
"resource": {
"resourceType": "MedicationRequest",
"id": "34eb3c92-76e6-48c2-9691-aa1f0b58369b",
"meta": {
"profile": [
"https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest"
]
},
"status": "active",
"intent": "plan",
"category": "inpatient",
"medicationCodeableConcept": {
"coding": [
{
"system": "https://dmd.nhs.uk",
"code": "42109611000001109",
"display": "Paracetamol 500mg tablets"
}
]
},
"subject": {
"reference": "Patient/UKCore-Patient-RichardSmith-Example"
},
"authoredOn": "2025-10-01T10:20:00+00:00",
"encounter": {
"reference": "Encounter/UKCore-Encounter-ABC123-Example"
}
},
"dosageInstruction": [
{
"text": "1 tablet - As Required",
"asNeededBoolean": true,
"doseAndRate": [
{
"doseQuantity": {
"value": 1,
"unit": "tablet",
"system": "http://snomed.info/sct",
"code": "428673006"
}
}
]
}
],
"substitution": {
"allowedBoolean": false
}
}
}
Multi-use products
Beclometasone 100micrograms/dose inhaler CFC free, 2 puffs, twice a day. The ADC will have this type of product configured as a "multi-use" product retained for use by this patient, often stored in a bedside locker.
{
"fullUrl": "urn:uuid:34eb3c92-76e6-48c2-9691-aa1f0b58369b",
"resource": {
"resourceType": "MedicationRequest",
"id": "34eb3c92-76e6-48c2-9691-aa1f0b58369b",
"meta": {
"profile": [
"https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest"
]
},
"status": "active",
"intent": "plan",
"category": "inpatient",
"medicationCodeableConcept": {
"coding": [
{
"system": "https://dmd.nhs.uk",
"code": "35908111000001105",
"display": "Beclometasone 100micrograms/dose inhaler CFC free"
}
]
},
"subject": {
"reference": "Patient/UKCore-Patient-RichardSmith-Example"
},
"authoredOn": "2025-10-01T10:20:00+00:00",
"encounter": {
"reference": "Encounter/UKCore-Encounter-ABC123-Example"
}
},
"dosageInstruction": [
{
"text": "2 puffs, twice a day",
"timing": {
"repeat": {
"frequency": 2,
"period": 1,
"periodUnit": "d"
}
},
"doseAndRate": [
{
"doseQuantity": {
"value": 2,
"unit": "puff",
"system": "http://snomed.info/sct",
"code": "415215001"
}
}
]
}
],
"substitution": {
"allowedBoolean": false
}
}
}
Multi-dose products
Paracetamol 500mg/5ml oral solution sugar free, 5ml, twice a day. The ADC will have this type of product configured as a "multi-dose" product so that it can be returned to the ADC for another patient use.
{
"fullUrl": "urn:uuid:34eb3c92-76e6-48c2-9691-aa1f0b58369b",
"resource": {
"resourceType": "MedicationRequest",
"id": "34eb3c92-76e6-48c2-9691-aa1f0b58369b",
"meta": {
"profile": [
"https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest"
]
},
"status": "active",
"intent": "plan",
"category": "inpatient",
"medicationCodeableConcept": {
"coding": [
{
"system": "https://dmd.nhs.uk",
"code": "24014911000001102",
"display": "Paracetamol 500mg/5ml oral solution sugar free"
}
]
},
"subject": {
"reference": "Patient/UKCore-Patient-RichardSmith-Example"
},
"authoredOn": "2025-10-01T10:20:00+00:00",
"encounter": {
"reference": "Encounter/UKCore-Encounter-ABC123-Example"
}
},
"dosageInstruction": [
{
"text": "5 millilitres, twice a day",
"timing": {
"repeat": {
"frequency": 2,
"period": 1,
"periodUnit": "d"
}
},
"doseAndRate": [
{
"doseQuantity": {
"value": 5,
"unit": "millilitre",
"system": "http://unitsofmeasure.org",
"code": "ml"
}
}
]
}
],
"substitution": {
"allowedBoolean": false
}
}
}
Multi-ingredient
Gentamicin 400mg in 100ml sodium chloride 0.9% infusion bags, for a total quantity of 200ml infusion fluid, for continuous infusion over 60 minutes, 3 times a day, intravenous. The instruction for the ADC is to dispense Gentamicin in a suitable form as the active ingredient along with 2 x 100ml infusion bags.
The MedicationRequest resource.
{
"fullUrl": "urn:uuid:34eb3c92-76e6-48c2-9691-aa1f0b58369b",
"resource": {
"resourceType": "MedicationRequest",
"id": "34eb3c92-76e6-48c2-9691-aa1f0b58369b",
"meta": {
"profile": [
"https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest"
]
},
"status": "active",
"intent": "plan",
"category": "inpatient",
"medicationReference": {
"reference": "11dc9519-b6e8-41bb-bce5-f6f724b743bc",
"type": "Medication"
},
"subject": {
"reference": "Patient/UKCore-Patient-RichardSmith-Example"
},
"authoredOn": "2025-10-01T10:20:00+00:00",
"encounter": {
"reference": "Encounter/UKCore-Encounter-ABC123-Example"
}
},
"dosageInstruction": [
{
"text": "Continuous infusion 200 millilitre - over 60 minutes - 3 times a day - Intravenous",
"timing": {
"repeat": {
"duration": 60,
"durationUnit": "min",
"frequency": 3,
"period": 1,
"periodUnit": "d"
}
},
"route": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "47625008",
"display": "Intravenous"
}
]
},
"method": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "261754007",
"display": "Continuous infusion"
}
]
},
"doseAndRate": [
{
"doseQuantity": {
"value": 200,
"unit": "millilitre",
"system": "http://unitsofmeasure.org",
"code": "ml"
}
}
]
}
],
"substitution": {
"allowedBoolean": false
}
}
}
The referenced Medication resource.
{
"fullUrl": "urn:uuid:11dc9519-b6e8-41bb-bce5-f6f724b743bc",
"resource": {
"resourceType": "Medication",
"id": "11dc9519-b6e8-41bb-bce5-f6f724b743bc",
"meta": {
"profile": [
"https://fhir.hl7.org.uk/StructureDefinition/UKCore-Medication"
]
},
"code": {
"text": "Gentamicin 400 milligram in Sodium chloride 0.9% infusion 100ml bags - Solution for infusion"
},
"form": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "385229008",
"display": "Solution for infusion"
}
]
},
"ingredient": [
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://dmd.nhs.uk",
"code": "387321007",
"display": "Gentamicin"
}
]
},
"strength": {
"numerator": {
"value": 400,
"unit": "milligram",
"system": "http://unitsofmeasure.org",
"code": "mg"
},
"denominator": {
"value": 1
}
}
},
{
"itemCodeableConcept": {
"coding": [
{
"system": "https://dmd.nhs.uk",
"code": "4898311000001108",
"display": "Sodium chloride 0.9% infusion 100ml bags"
}
]
}
}
]
}
}