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.

Levothyroxine

Dose-based instruction using an VTM.
<MedicationRequest xmlns="http://hl7.org/fhir">
<id value="18a8ea33-dc5f-4fb7-985e-acc474bf97cd" />
<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="outpatient" />
<display value="outpatient" />
</coding>
</category>
<medicationCodeableConcept>
<coding>
<system value="https://dmd.nhs.uk" />
<code value="10071011000001106" />
<display value="Levothyroxine" />
</coding>
</medicationCodeableConcept>
<subject>
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9999999999" />
</identifier>
</subject>
<authoredOn value="2019-01-15T15:00:00Z" />
<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="150 microgram - daily - during the morning and before breakfast - oral" />
<timing>
<repeat>
<period value="1" />
<periodUnit value="d" />
<when value="MORN" />
<when value="ACM" />
</repeat>
</timing>
<route>
<coding>
<system value="http://snomed.info/sct" />
<code value="26643006" />
<display value="oral" />
</coding>
</route>
<doseAndRate>
<doseQuantity>
<value value="150" />
<unit value="microgram" />
<system value="http://unitsofmeasure.org" />
<code value="ug" />
</doseQuantity>
</doseAndRate>
</dosageInstruction>
<substitution>
<allowedBoolean value="false" />
</substitution>
</MedicationRequest>
{
"resourceType": "MedicationRequest",
"id": "18a8ea33-dc5f-4fb7-985e-acc474bf97cd",
"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": "outpatient",
"display": "outpatient"
}
]
}
],
"medicationCodeableConcept": {
"coding": [
{
"system": "https://dmd.nhs.uk",
"code": "10071011000001106",
"display": "Levothyroxine"
}
]
},
"subject": {
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9999999999"
}
},
"authoredOn": "2019-01-15T15:00:00Z",
"requester": {
"reference": "urn:staff-1112",
"display": "Dr Maikeu Well"
},
"recorder": {
"reference": "urn:staff-1112",
"display": "Dr Maikeu Well"
},
"dosageInstruction": [
{
"text": "150 microgram - daily - during the morning and before breakfast - oral",
"route": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "26643006",
"display": "oral"
}
]
},
"timing": {
"repeat": {
"period": 1,
"periodUnit": "d",
"when": [
"MORN",
"ACM"
]
}
},
"doseAndRate": [
{
"doseQuantity": {
"value": 150,
"unit": "microgram",
"system": "http://unitsofmeasure.org",
"code": "ug"
}
}
]
}
],
"substitution": {
"allowedBoolean": false
}
}
MedicationRequest.id[0]18a8ea33-dc5f-4fb7-985e-acc474bf97cd
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]outpatient
MedicationRequest.category[0].coding[0].display[0]outpatient
MedicationRequest.medication[0].coding[0].system[0]https://dmd.nhs.uk
MedicationRequest.medication[0].coding[0].code[0]10071011000001106
MedicationRequest.medication[0].coding[0].display[0]Levothyroxine
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]2019-01-15T15:00:00Z
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]150 microgram - daily - during the morning and before breakfast - oral
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].period[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].periodUnit[0]d
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].when[0]MORN
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].when[1]ACM
MedicationRequest.dosageInstruction[0].route[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].route[0].coding[0].code[0]26643006
MedicationRequest.dosageInstruction[0].route[0].coding[0].display[0]oral
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].value[0]150
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].unit[0]microgram
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].code[0]ug
MedicationRequest.substitution[0].allowed[0]False
MedicationRequest

Example on-screen presentation:

Levothyroxine
150 microgram - daily - during the morning and before breakfast - oral
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