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.

Loperamide capsules

Product-based instruction using an VMP. 
<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="317378005" />
            <display value="Loperamide 2mg capsules" />
        </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>
        <sequence value="1" />
        <text value="2 capsule - Now" />
        <additionalInstruction>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="421723005" />
                <display value="Now" />
            </coding>
        </additionalInstruction>
        <doseAndRate>
            <doseQuantity>
                <value value="2" />
                <unit value="capsule" />
                <system value="http://snomed.info/sct" />
                <code value="428641000" />
            </doseQuantity>
        </doseAndRate>
    </dosageInstruction>
    <dosageInstruction>
        <sequence value="2" />
        <text value="1 capsule - as required for Diarrhea - up to a maximum of 8 capsule in 1 day" />
        <asNeededCodeableConcept>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="62315008" />
                <display value="Diarrhea" />
            </coding>
        </asNeededCodeableConcept>
        <doseAndRate>
            <doseQuantity>
                <value value="1" />
                <unit value="capsule" />
                <system value="http://snomed.info/sct" />
                <code value="428641000" />
            </doseQuantity>
        </doseAndRate>
        <maxDosePerPeriod>
            <numerator>
                <value value="8" />
                <unit value="capsule" />
                <system value="http://snomed.info/sct" />
                <code value="428641000" />
            </numerator>
            <denominator>
                <value value="1" />
                <unit value="day" />
                <system value="http://unitsofmeasure.org/" />
                <code value="d" />
            </denominator>
        </maxDosePerPeriod>
    </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": "317378005",
                "display": "Loperamide 2mg capsules"
            }
        ]
    },
    "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":  [
        {
            "sequence": 1,
            "text": "2 capsule - Now",
            "additionalInstruction":  [
                {
                    "coding":  [
                        {
                            "system": "http://snomed.info/sct",
                            "code": "421723005",
                            "display": "Now"
                        }
                    ]
                }
            ],
            "doseAndRate":  [
                {
                    "doseQuantity": {
                        "value": 2,
                        "unit": "capsule",
                        "system": "http://snomed.info/sct",
                        "code": "428641000"
                    }
                }
            ]
        },
        {
            "sequence": 2,
            "text": "1 capsule - as required for Diarrhea - up to a maximum of 8 capsule in 1 day",
            "asNeededCodeableConcept": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "62315008",
                        "display": "Diarrhea"
                    }
                ]
            },
            "doseAndRate":  [
                {
                    "doseQuantity": {
                        "value": 1,
                        "unit": "capsule",
                        "system": "http://snomed.info/sct",
                        "code": "428641000"
                    }
                }
            ],
            "maxDosePerPeriod": {
                "numerator": {
                    "value": 8,
                    "unit": "capsule",
                    "system": "http://snomed.info/sct",
                    "code": "428641000"
                },
                "denominator": {
                    "value": 1,
                    "unit": "day",
                    "system": "http://unitsofmeasure.org/",
                    "code": "d"
                }
            }
        }
    ],
    "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]317378005
MedicationRequest.medication[0].coding[0].display[0]Loperamide 2mg capsules
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].sequence[0]1
MedicationRequest.dosageInstruction[0].text[0]2 capsule - Now
MedicationRequest.dosageInstruction[0].additionalInstruction[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].additionalInstruction[0].coding[0].code[0]421723005
MedicationRequest.dosageInstruction[0].additionalInstruction[0].coding[0].display[0]Now
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].value[0]2
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].unit[0]capsule
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].code[0]428641000
MedicationRequest.dosageInstruction[1].sequence[0]2
MedicationRequest.dosageInstruction[1].text[0]1 capsule - as required for Diarrhea - up to a maximum of 8 capsule in 1 day
MedicationRequest.dosageInstruction[1].asNeeded[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[1].asNeeded[0].coding[0].code[0]62315008
MedicationRequest.dosageInstruction[1].asNeeded[0].coding[0].display[0]Diarrhea
MedicationRequest.dosageInstruction[1].doseAndRate[0].dose[0].value[0]1
MedicationRequest.dosageInstruction[1].doseAndRate[0].dose[0].unit[0]capsule
MedicationRequest.dosageInstruction[1].doseAndRate[0].dose[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[1].doseAndRate[0].dose[0].code[0]428641000
MedicationRequest.dosageInstruction[1].maxDosePerPeriod[0].numerator[0].value[0]8
MedicationRequest.dosageInstruction[1].maxDosePerPeriod[0].numerator[0].unit[0]capsule
MedicationRequest.dosageInstruction[1].maxDosePerPeriod[0].numerator[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[1].maxDosePerPeriod[0].numerator[0].code[0]428641000
MedicationRequest.dosageInstruction[1].maxDosePerPeriod[0].denominator[0].value[0]1
MedicationRequest.dosageInstruction[1].maxDosePerPeriod[0].denominator[0].unit[0]day
MedicationRequest.dosageInstruction[1].maxDosePerPeriod[0].denominator[0].system[0]http://unitsofmeasure.org/
MedicationRequest.dosageInstruction[1].maxDosePerPeriod[0].denominator[0].code[0]d
MedicationRequest.substitution[0].allowed[0]False
MedicationRequest

Example on-screen presentation:

Loperamide 2mg capsules
2 capsule - Now, then 1 capsule - as required for Diarrhea - up to a maximum of 8 capsule in 1 day
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