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.

Lidocaine plasters

Product-based instruction using a VMP with a period of zero administration.
<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="community" />
<display value="community" />
</coding>
</category>
<medicationCodeableConcept>
<coding>
<system value="https://dmd.nhs.uk" />
<code value="116281000001109" />
<display value="Lidocaine 5% medicated plasters" />
</coding>
</medicationCodeableConcept>
<subject>
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9999999999" />
</identifier>
</subject>
<authoredOn value="2023-01-17T09:30:00Z" />
<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>
<sequence value="1" />
<text value="Apply 2 plasters - once daily - over 12 hours - Applied to intact, dry, non-hairy, non-irritated skin" />
<additionalInstruction>
<text value="Applied to intact, dry, non-hairy, non-irritated skin" />
</additionalInstruction>
<timing>
<repeat>
<duration value="12" />
<durationUnit value="hour" />
<frequency value="1" />
<period value="1" />
<periodUnit value="d" />
</repeat>
</timing>
<method>
<coding>
<system value="http://snomed.info/sct" />
<code value="417924000" />
<display value="Apply" />
</coding>
</method>
<doseAndRate>
<doseQuantity>
<value value="2" />
<unit value="plaster" />
<system value="http://snomed.info/sct" />
<code value="655791000001103" />
</doseQuantity>
</doseAndRate>
</dosageInstruction>
<dosageInstruction>
<sequence value="2" />
<text value="Apply 0 plasters - over 12 hours" />
<timing>
<repeat>
<duration value="12" />
<durationUnit value="hour" />
</repeat>
</timing>
<method>
<coding>
<system value="http://snomed.info/sct" />
<code value="417924000" />
<display value="Apply" />
</coding>
</method>
<doseAndRate>
<doseQuantity>
<value value="0" />
<unit value="plaster" />
<system value="http://snomed.info/sct" />
<code value="655791000001103" />
</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": "community",
"display": "community"
}
]
}
],
"medicationCodeableConcept": {
"coding": [
{
"system": "https://dmd.nhs.uk",
"code": "116281000001109",
"display": "Lidocaine 5% medicated plasters"
}
]
},
"subject": {
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9999999999"
}
},
"authoredOn": "2023-01-17T09:30:00Z",
"requester": {
"reference": "urn:staff-1112",
"display": "Dr Maikeu Well"
},
"recorder": {
"reference": "urn:staff-1112",
"display": "Dr Maikeu Well"
},
"dosageInstruction": [
{
"sequence": 1,
"text": "Apply 2 plasters - once daily - over 12 hours - Applied to intact, dry, non-hairy, non-irritated skin",
"additionalInstruction": [
{
"text": "Applied to intact, dry, non-hairy, non-irritated skin"
}
],
"timing": {
"repeat": {
"frequency": 1,
"period": 1,
"periodUnit": "d",
"duration": 12,
"durationUnit": "hour"
}
},
"method": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "417924000",
"display": "Apply"
}
]
},
"doseAndRate": [
{
"doseQuantity": {
"value": 2,
"unit": "plaster",
"system": "http://snomed.info/sct",
"code": "655791000001103"
}
}
]
},
{
"sequence": 2,
"text": "Apply 0 plasters - over 12 hours",
"timing": {
"repeat": {
"duration": 12,
"durationUnit": "hour"
}
},
"method": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "417924000",
"display": "Apply"
}
]
},
"doseAndRate": [
{
"doseQuantity": {
"value": 0,
"unit": "plaster",
"system": "http://snomed.info/sct",
"code": "655791000001103"
}
}
]
}
],
"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]community
MedicationRequest.category[0].coding[0].display[0]community
MedicationRequest.medication[0].coding[0].system[0]https://dmd.nhs.uk
MedicationRequest.medication[0].coding[0].code[0]116281000001109
MedicationRequest.medication[0].coding[0].display[0]Lidocaine 5% medicated plasters
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]2023-01-17T09:30:00Z
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].sequence[0]1
MedicationRequest.dosageInstruction[0].text[0]Apply 2 plasters - once daily - over 12 hours - Applied to intact, dry, non-hairy, non-irritated skin
MedicationRequest.dosageInstruction[0].additionalInstruction[0].text[0]Applied to intact, dry, non-hairy, non-irritated skin
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].duration[0]12
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].durationUnit[0]hour
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].frequency[0]1
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.dosageInstruction[0].doseAndRate[0].dose[0].value[0]2
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].unit[0]plaster
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].code[0]655791000001103
MedicationRequest.dosageInstruction[1].sequence[0]2
MedicationRequest.dosageInstruction[1].text[0]Apply 0 plasters - over 12 hours
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].duration[0]12
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].durationUnit[0]hour
MedicationRequest.dosageInstruction[1].method[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[1].method[0].coding[0].code[0]417924000
MedicationRequest.dosageInstruction[1].method[0].coding[0].display[0]Apply
MedicationRequest.dosageInstruction[1].doseAndRate[0].dose[0].value[0]0
MedicationRequest.dosageInstruction[1].doseAndRate[0].dose[0].unit[0]plaster
MedicationRequest.dosageInstruction[1].doseAndRate[0].dose[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[1].doseAndRate[0].dose[0].code[0]655791000001103
MedicationRequest.substitution[0].allowed[0]False
MedicationRequest

Example on-screen presentation:

Lidocaine 5% medicated plasters
Apply 2 plasters - once daily - over 12 hours - Applied to intact, dry, non-hairy, non-irritated skin, then Apply 0 plasters - over 12 hours - plaster-free period
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