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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