Inpatient Discharge / Paige Turner
Patient Journey: Paige Turner
- Paige is discharged from hospital following an admission where she was diagnosed as being diabetic. She was prescribed 4 weeks quantity of Metformin 500mg tablets by Dr Makieu Well, to take twice daily on an on-going basis. The
MedicationRequest
was recorded by pharmacist Bill Ding [Example 1]. - Pharmacy dispenses this medication as a
MedicationDispense
[Example 2] which is handed over to Paige before she leaves the hospital.
Example 1: MedicationRequest
Note: Example validated against UKCore, dm+d and SNOMED-CT on 23 May 2025.
Actors
Provider System = Ward EPMA system
Consumer System = Hospital pharmacy system
Example
<MessageHeader>
</eventCoding>
</source>
</focus>
</MessageHeader>
</resource>
</entry>
<Patient>
</identifier>
</name>
</Patient>
</resource>
</entry>
<Practitioner>
</name>
</coding>
</code>
</qualification>
</Practitioner>
</resource>
</entry>
<Medication>
</coding>
</code>
</Medication>
</resource>
</entry>
<MedicationRequest>
</coding>
</category>
</medicationReference>
</subject>
</requester>
</recorder>
</timing>
</coding>
</route>
</doseQuantity>
</doseAndRate>
</dosageInstruction>
</substitution>
</MedicationRequest>
</resource>
</entry>
</Bundle>
{
{
},
},
]
}
},
{
],
{
"Paige"
],
"Miss"
]
}
],
}
},
{
],
{
{
}
]
}
}
]
}
},
{
{
}
]
}
}
},
{
{
{
}
]
}
],
},
},
},
},
{
},
},
{
}
}
]
}
],
}
}
}
]
}
Bundle.id[0] | d0a503d2-6809-4055-be82-308183e64734 |
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] | https://fhir.hl7.org.uk//CodeSystem/message-event |
Bundle.entry[0].resource[0].event[0].code[0] | prescription-order |
Bundle.entry[0].resource[0].event[0].display[0] | Prescription Order |
Bundle.entry[0].resource[0].source[0].name[0] | ACME Clinical Systems |
Bundle.entry[0].resource[0].source[0].software[0] | ACME ePMA |
Bundle.entry[0].resource[0].source[0].version[0] | 3.5.68 |
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:med-req-1023938 |
Bundle.entry[1].fullUrl[0] | urn:patient-013298920 |
Bundle.entry[1].resource[0].id[0] | urn:patient-013298920 |
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] | 2377954310 |
Bundle.entry[1].resource[0].name[0].use[0] | official |
Bundle.entry[1].resource[0].name[0].text[0] | Miss Paige Turner |
Bundle.entry[1].resource[0].name[0].family[0] | Turner |
Bundle.entry[1].resource[0].name[0].given[0] | Paige |
Bundle.entry[1].resource[0].name[0].prefix[0] | Miss |
Bundle.entry[1].resource[0].gender[0] | female |
Bundle.entry[1].resource[0].birthDate[0] | 1990-08-04 |
Bundle.entry[2].fullUrl[0] | urn:staff-1112 |
Bundle.entry[2].resource[0].id[0] | urn:staff-1112 |
Bundle.entry[2].resource[0].name[0].text[0] | Dr Maikeu Well |
Bundle.entry[2].resource[0].name[0].family[0] | Well |
Bundle.entry[2].resource[0].name[0].given[0] | Maikeu |
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] | 2145879 |
Bundle.entry[2].resource[0].qualification[0].code[0].coding[0].display[0] | General Medical Council |
Bundle.entry[3].fullUrl[0] | urn:medication-109081006 |
Bundle.entry[3].resource[0].id[0] | urn:medication-109081006 |
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] | 42084911000001109 |
Bundle.entry[3].resource[0].code[0].coding[0].display[0] | Metformin 500mg tablets |
Bundle.entry[4].fullUrl[0] | urn:med-req-1023938 |
Bundle.entry[4].resource[0].id[0] | urn:med-req-1023938 |
Bundle.entry[4].resource[0].status[0] | active |
Bundle.entry[4].resource[0].intent[0] | order |
Bundle.entry[4].resource[0].category[0].coding[0].system[0] | http://terminology.hl7.org/CodeSystem/medicationrequest-category |
Bundle.entry[4].resource[0].category[0].coding[0].code[0] | discharge |
Bundle.entry[4].resource[0].category[0].coding[0].display[0] | discharge |
Bundle.entry[4].resource[0].medication[0].reference[0] | urn:medication-325278007 |
Bundle.entry[4].resource[0].medication[0].display[0] | Metformin 500mg tablets |
Bundle.entry[4].resource[0].subject[0].reference[0] | urn:patient-013298920 |
Bundle.entry[4].resource[0].subject[0].display[0] | Miss Paige Turner |
Bundle.entry[4].resource[0].authoredOn[0] | 2021-05-07T16:15:32+00:00 |
Bundle.entry[4].resource[0].requester[0].reference[0] | urn:staff-1112 |
Bundle.entry[4].resource[0].requester[0].display[0] | Dr Maikeu Well |
Bundle.entry[4].resource[0].recorder[0].reference[0] | urn:staff-4532 |
Bundle.entry[4].resource[0].recorder[0].display[0] | Bill Ding |
Bundle.entry[4].resource[0].dosageInstruction[0].timing[0].repeat[0].frequency[0] | 2 |
Bundle.entry[4].resource[0].dosageInstruction[0].timing[0].repeat[0].period[0] | 1 |
Bundle.entry[4].resource[0].dosageInstruction[0].timing[0].repeat[0].periodUnit[0] | d |
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] | 26643006 |
Bundle.entry[4].resource[0].dosageInstruction[0].route[0].coding[0].display[0] | Oral |
Bundle.entry[4].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].value[0] | 1 |
Bundle.entry[4].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].unit[0] | tablet |
Bundle.entry[4].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].system[0] | http://unitsofmeasure.org |
Bundle.entry[4].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].code[0] | 428673006 |
Bundle.entry[4].resource[0].substitution[0].allowed[0] | False |
Bundle |
id : d0a503d2-6809-4055-be82-308183e64734 |
type : message |
timestamp : 2021-05-07T16:15:32+00:00 |
entry |
fullUrl : urn:message-header-167434 |
resource |
id : urn:message-header-167434 |
event |
system : https://fhir.hl7.org.uk//CodeSystem/message-event |
code : prescription-order |
display : Prescription Order |
source |
name : ACME Clinical Systems |
software : ACME ePMA |
version : 3.5.68 |
endpoint : urn:nhs-uk:addressing:ods:T48NT |
focus |
reference : urn:med-req-1023938 |
entry |
fullUrl : urn:patient-013298920 |
resource |
id : urn:patient-013298920 |
identifier |
system : https://fhir.nhs.uk/Id/nhs-number |
value : 2377954310 |
name |
use : official |
text : Miss Paige Turner |
family : Turner |
given : Paige |
prefix : Miss |
gender : female |
birthDate : 1990-08-04 |
entry |
fullUrl : urn:staff-1112 |
resource |
id : urn:staff-1112 |
name |
text : Dr Maikeu Well |
family : Well |
given : Maikeu |
prefix : Dr |
qualification |
code |
coding |
system : https://fhir.hl7.org.uk/Id/gmc-number |
code : 2145879 |
display : General Medical Council |
entry |
fullUrl : urn:medication-109081006 |
resource |
id : urn:medication-109081006 |
code |
coding |
system : http://snomed.info/sct |
code : 42084911000001109 |
display : Metformin 500mg tablets |
entry |
fullUrl : urn:med-req-1023938 |
resource |
id : urn:med-req-1023938 |
status : active |
intent : order |
category |
coding |
system : http://terminology.hl7.org/CodeSystem/medicationrequest-category |
code : discharge |
display : discharge |
medication |
reference : urn:medication-325278007 |
display : Metformin 500mg tablets |
subject |
reference : urn:patient-013298920 |
display : Miss Paige Turner |
authoredOn : 2021-05-07T16:15:32+00:00 |
requester |
reference : urn:staff-1112 |
display : Dr Maikeu Well |
recorder |
reference : urn:staff-4532 |
display : Bill Ding |
dosageInstruction |
timing |
repeat |
frequency : 2 |
period : 1 |
periodUnit : d |
route |
coding |
system : http://snomed.info/sct |
code : 26643006 |
display : Oral |
doseAndRate |
dose |
value : 1 |
unit : tablet |
system : http://unitsofmeasure.org |
code : 428673006 |
substitution |
allowed : False |
Example 2: MedicationDispense
Note: Example validated against UKCore, dm+d and SNOMED-CT on 23 May 2025.
Actors
Provider System = Hospital pharmacy system
Consumer System = Ward EPMA system
Example
<MessageHeader>
</eventCoding>
</source>
</focus>
</MessageHeader>
</resource>
</entry>
<Patient>
</identifier>
</name>
</Patient>
</resource>
</entry>
<Practitioner>
</name>
</coding>
</code>
</qualification>
</Practitioner>
</resource>
</entry>
<Medication>
</coding>
</code>
</Medication>
</resource>
</entry>
<MedicationDispense>
</identifier>
</medicationReference>
</subject>
</performer>
</authorizingPrescription>
</quantity>
</daysSupply>
</timing>
</coding>
</route>
</doseQuantity>
</doseAndRate>
</dosageInstruction>
</MedicationDispense>
</resource>
</entry>
</Bundle>
{
{
},
},
]
}
},
{
],
{
"Paige"
],
"Ms"
]
}
],
}
},
{
],
{
{
}
]
}
}
]
}
},
{
{
}
]
}
}
},
{
{
}
],
},
},
],
],
},
},
{
},
},
{
}
}
]
}
]
}
}
]
}
Bundle.id[0] | 830a2a41-cca8-46a3-a35c-3237cb9828e4 |
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] | dispense-notification |
Bundle.entry[0].resource[0].event[0].display[0] | Dispense Notification |
Bundle.entry[0].resource[0].source[0].name[0] | ACME Clinical Systems |
Bundle.entry[0].resource[0].source[0].software[0] | ACME Pharmacy |
Bundle.entry[0].resource[0].source[0].version[0] | 4.1.15 |
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:med-disp-324234234 |
Bundle.entry[1].fullUrl[0] | urn:patient-113582401 |
Bundle.entry[1].resource[0].id[0] | urn:patient-113582401 |
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] | 113582401 |
Bundle.entry[1].resource[0].name[0].use[0] | official |
Bundle.entry[1].resource[0].name[0].text[0] | Ms Paige Turner |
Bundle.entry[1].resource[0].name[0].family[0] | Turner |
Bundle.entry[1].resource[0].name[0].given[0] | Paige |
Bundle.entry[1].resource[0].name[0].prefix[0] | Ms |
Bundle.entry[1].resource[0].gender[0] | female |
Bundle.entry[1].resource[0].birthDate[0] | 1982-11-20 |
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-22349811000001106 |
Bundle.entry[3].resource[0].id[0] | urn:medication-22349811000001106 |
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] | 22349811000001106 |
Bundle.entry[3].resource[0].code[0].coding[0].display[0] | Metformin 500mg tablets (Milpharm Ltd) |
Bundle.entry[4].fullUrl[0] | urn:med-disp-324234234 |
Bundle.entry[4].resource[0].id[0] | urn:med-disp-324234234 |
Bundle.entry[4].resource[0].identifier[0].system[0] | urn:[organisation_name]:[system_name] |
Bundle.entry[4].resource[0].identifier[0].value[0] | urn:55b65ae3-c4f3-4da3-8d8a-7a4af42122d47 |
Bundle.entry[4].resource[0].status[0] | in-progress |
Bundle.entry[4].resource[0].medication[0].reference[0] | urn:medication-22349811000001106 |
Bundle.entry[4].resource[0].medication[0].display[0] | Metformin 500mg tablets (Milpharm Ltd) |
Bundle.entry[4].resource[0].subject[0].reference[0] | urn:patient-113582401 |
Bundle.entry[4].resource[0].subject[0].display[0] | Ms Paige Turner |
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-1023938 |
Bundle.entry[4].resource[0].quantity[0].value[0] | 56 |
Bundle.entry[4].resource[0].quantity[0].unit[0] | tablet |
Bundle.entry[4].resource[0].quantity[0].system[0] | http://snomed.info/sct |
Bundle.entry[4].resource[0].quantity[0].code[0] | 428673006 |
Bundle.entry[4].resource[0].daysSupply[0].value[0] | 28 |
Bundle.entry[4].resource[0].daysSupply[0].unit[0] | Day |
Bundle.entry[4].resource[0].daysSupply[0].system[0] | http://unitsofmeasure.org |
Bundle.entry[4].resource[0].daysSupply[0].code[0] | d |
Bundle.entry[4].resource[0].whenPrepared[0] | 2021-05-07T16:15:32+00:00 |
Bundle.entry[4].resource[0].dosageInstruction[0].timing[0].repeat[0].frequency[0] | 2 |
Bundle.entry[4].resource[0].dosageInstruction[0].timing[0].repeat[0].period[0] | 1 |
Bundle.entry[4].resource[0].dosageInstruction[0].timing[0].repeat[0].periodUnit[0] | d |
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] | 26643006 |
Bundle.entry[4].resource[0].dosageInstruction[0].route[0].coding[0].display[0] | Oral |
Bundle.entry[4].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].value[0] | 1 |
Bundle.entry[4].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].unit[0] | tablet |
Bundle.entry[4].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].system[0] | http://snomed.info/sct |
Bundle.entry[4].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].code[0] | 428673006 |
Bundle |
id : 830a2a41-cca8-46a3-a35c-3237cb9828e4 |
type : message |
timestamp : 2021-05-07T16:15:32+00:00 |
entry |
fullUrl : urn:message-header-167434 |
resource |
id : urn:message-header-167434 |
event |
system : http://hl7.org/fhir/message-events |
code : dispense-notification |
display : Dispense Notification |
source |
name : ACME Clinical Systems |
software : ACME Pharmacy |
version : 4.1.15 |
endpoint : urn:nhs-uk:addressing:ods:T48NT |
focus |
reference : urn:med-disp-324234234 |
entry |
fullUrl : urn:patient-113582401 |
resource |
id : urn:patient-113582401 |
identifier |
system : https://fhir.nhs.uk/Id/nhs-number |
value : 113582401 |
name |
use : official |
text : Ms Paige Turner |
family : Turner |
given : Paige |
prefix : Ms |
gender : female |
birthDate : 1982-11-20 |
entry |
fullUrl : urn:staff-0002 |
resource |
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 |
entry |
fullUrl : urn:medication-22349811000001106 |
resource |
id : urn:medication-22349811000001106 |
code |
coding |
system : http://snomed.info/sct |
code : 22349811000001106 |
display : Metformin 500mg tablets (Milpharm Ltd) |
entry |
fullUrl : urn:med-disp-324234234 |
resource |
id : urn:med-disp-324234234 |
identifier |
system : urn:[organisation_name]:[system_name] |
value : urn:55b65ae3-c4f3-4da3-8d8a-7a4af42122d47 |
status : in-progress |
medication |
reference : urn:medication-22349811000001106 |
display : Metformin 500mg tablets (Milpharm Ltd) |
subject |
reference : urn:patient-113582401 |
display : Ms Paige Turner |
performer |
actor |
reference : urn:staff-0002 |
display : Dr Allo Kate |
authorizingPrescription |
reference : urn:med-req-1023938 |
quantity |
value : 56 |
unit : tablet |
system : http://snomed.info/sct |
code : 428673006 |
daysSupply |
value : 28 |
unit : Day |
system : http://unitsofmeasure.org |
code : d |
whenPrepared : 2021-05-07T16:15:32+00:00 |
dosageInstruction |
timing |
repeat |
frequency : 2 |
period : 1 |
periodUnit : d |
route |
coding |
system : http://snomed.info/sct |
code : 26643006 |
display : Oral |
doseAndRate |
dose |
value : 1 |
unit : tablet |
system : http://snomed.info/sct |
code : 428673006 |