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.

Hydrocortisone cream

Product-based VMP prescription using a free-text patient instruction for the site as 'area around lips' is not SNOMED coded.
<MedicationRequest xmlns="http://hl7.org/fhir">
<id value="da60a842-d755-4fe6-a7eb-4cda52cf17f7" />
<meta>
<profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest" />
</meta>
<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>
<medicationCodeableConcept>
<coding>
<system value="https://dmd.nhs.uk" />
<code value="331680008" />
<display value="Hydrocortisone 0.1% cream" />
</coding>
</medicationCodeableConcept>
<subject>
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9999999999" />
</identifier>
</subject>
<authoredOn value="2020-05-15T15:00:00Z" />
<requester>
<reference value="urn:staff-1112" />
<display value="Dr Maikeu Well" />
</requester>
<recorder>
<reference value="urn:staff-1112" />
<display value="Dr Maikeu Well" />
</recorder>
<dosageInstruction>
<text value="Apply 2 to 3 times a day - for 7 days - Apply thinly to area around lips" />
<patientInstruction value="Apply thinly to area around lips" />
<timing>
<repeat>
<boundsDuration>
<value value="7" />
<unit value="day" />
<system value="http://unitsofmeasure.org" />
<code value="d" />
</boundsDuration>
<frequency value="2" />
<frequencyMax value="3" />
<period value="1" />
<periodUnit value="d" />
</repeat>
</timing>
<method>
<coding>
<system value="http://snomed.info/sct" />
<code value="417924000" />
<display value="Apply" />
</coding>
</method>
</dosageInstruction>
<substitution>
<allowedBoolean value="false" />
</substitution>
</MedicationRequest>
{
"resourceType": "MedicationRequest",
"id": "da60a842-d755-4fe6-a7eb-4cda52cf17f7",
"meta": {
"profile": [
"https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest"
]
},
"status": "active",
"intent": "order",
"category": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/medicationrequest-category",
"code": "inpatient",
"display": "inpatient"
}
]
}
],
"medicationCodeableConcept": {
"coding": [
{
"system": "https://dmd.nhs.uk",
"code": "331680008",
"display": "Hydrocortisone 0.1% cream"
}
]
},
"subject": {
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9999999999"
}
},
"authoredOn": "2020-05-15T15:00:00Z",
"requester": {
"reference": "urn:staff-1112",
"display": "Dr Maikeu Well"
},
"recorder": {
"reference": "urn:staff-1112",
"display": "Dr Maikeu Well"
},
"dosageInstruction": [
{
"text": "Apply 2 to 3 times a day - for 7 days - Apply thinly to area around lips",
"patientInstruction": "Apply thinly to area around lips",
"timing": {
"repeat": {
"boundsDuration": {
"value": 7,
"unit": "day",
"system": "http://unitsofmeasure.org",
"code": "d"
},
"frequency": 2,
"frequencyMax": 3,
"period": 1,
"periodUnit": "d"
}
},
"method": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "417924000",
"display": "Apply"
}
]
}
}
],
"substitution": {
"allowedBoolean": false
}
}
MedicationRequest.id[0]da60a842-d755-4fe6-a7eb-4cda52cf17f7
MedicationRequest.meta[0].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.category[0].coding[0].system[0]http://terminology.hl7.org/CodeSystem/medicationrequest-category
MedicationRequest.category[0].coding[0].code[0]inpatient
MedicationRequest.category[0].coding[0].display[0]inpatient
MedicationRequest.medication[0].coding[0].system[0]https://dmd.nhs.uk
MedicationRequest.medication[0].coding[0].code[0]331680008
MedicationRequest.medication[0].coding[0].display[0]Hydrocortisone 0.1% cream
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.authoredOn[0]2020-05-15T15:00:00Z
MedicationRequest.requester[0].reference[0]urn:staff-1112
MedicationRequest.requester[0].display[0]Dr Maikeu Well
MedicationRequest.recorder[0].reference[0]urn:staff-1112
MedicationRequest.recorder[0].display[0]Dr Maikeu Well
MedicationRequest.dosageInstruction[0].text[0]Apply 2 to 3 times a day - for 7 days - Apply thinly to area around lips
MedicationRequest.dosageInstruction[0].patientInstruction[0]Apply thinly to area around lips
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].value[0]7
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].unit[0]day
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].code[0]d
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].frequency[0]2
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].frequencyMax[0]3
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].period[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].periodUnit[0]d
MedicationRequest.dosageInstruction[0].method[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].method[0].coding[0].code[0]417924000
MedicationRequest.dosageInstruction[0].method[0].coding[0].display[0]Apply
MedicationRequest.substitution[0].allowed[0]False
MedicationRequest

Example on-screen presentation:

Hydrocortisone 0.1% cream
Apply 2 to 3 times a day - for 7 days - Apply thinly to area around lips
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