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.

Metformin tablets

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="community" />
<display value="community" />
</coding>
</category>
<medicationCodeableConcept>
<coding>
<system value="https://dmd.nhs.uk" />
<code value="325278007" />
<display value="Metformin 500mg tablets" />
</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="1 tablet - once a day - at breakfast - for 1 week" />
<timing>
<repeat>
<boundsDuration>
<value value="1" />
<unit value="week" />
<system value="http://unitsofmeasure.org" />
<code value="wk" />
</boundsDuration>
<frequency value="1" />
<period value="1" />
<periodUnit value="d" />
<when value="CM" />
</repeat>
</timing>
<doseAndRate>
<doseQuantity>
<value value="1" />
<unit value="tablet" />
<system value="http://snomed.info/sct" />
<code value="428673006" />
</doseQuantity>
</doseAndRate>
</dosageInstruction>
<dosageInstruction>
<sequence value="2" />
<text value="1 tablet - twice a day - at breakfast and at dinner - for 1 week" />
<timing>
<repeat>
<boundsDuration>
<value value="1" />
<unit value="week" />
<system value="http://unitsofmeasure.org" />
<code value="wk" />
</boundsDuration>
<frequency value="2" />
<period value="1" />
<periodUnit value="d" />
<when value="CM" />
<when value="CV" />
</repeat>
</timing>
<doseAndRate>
<doseQuantity>
<value value="1" />
<unit value="tablet" />
<system value="http://snomed.info/sct" />
<code value="428673006" />
</doseQuantity>
</doseAndRate>
</dosageInstruction>
<dosageInstruction>
<sequence value="3" />
<text value="1 tablet - 3 times a day - at breakfast, at dinner and at lunch - for 1 week - up to a maximum of 4 tablet in 1 day" />
<timing>
<repeat>
<boundsDuration>
<value value="1" />
<unit value="week" />
<system value="http://unitsofmeasure.org" />
<code value="wk" />
</boundsDuration>
<frequency value="3" />
<period value="1" />
<periodUnit value="d" />
<when value="CM" />
<when value="CV" />
<when value="CD" />
</repeat>
</timing>
<doseAndRate>
<doseQuantity>
<value value="1" />
<unit value="tablet" />
<system value="http://snomed.info/sct" />
<code value="428673006" />
</doseQuantity>
</doseAndRate>
<maxDosePerPeriod>
<numerator>
<value value="4" />
<unit value="tablet" />
<system value="http://snomed.info/sct" />
<code value="428673006" />
</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": "community",
"display": "community"
}
]
}
],
"medicationCodeableConcept": {
"coding": [
{
"system": "https://dmd.nhs.uk",
"code": "325278007",
"display": "Metformin 500mg tablets"
}
]
},
"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": "1 tablet - once a day - at breakfast - for 1 week",
"timing": {
"repeat": {
"boundsDuration": {
"value": 1,
"unit": "week",
"system": "http://unitsofmeasure.org",
"code": "wk"
},
"frequency": 1,
"period": 1,
"periodUnit": "d",
"when": [
"CM"
]
}
},
"doseAndRate": [
{
"doseQuantity": {
"value": 1,
"unit": "tablet",
"system": "http://snomed.info/sct",
"code": "428673006"
}
}
]
},
{
"sequence": 2,
"text": "1 tablet - twice a day - at breakfast and at dinner - for 1 week",
"timing": {
"repeat": {
"boundsDuration": {
"value": 1,
"unit": "week",
"system": "http://unitsofmeasure.org",
"code": "wk"
},
"frequency": 2,
"period": 1,
"periodUnit": "d",
"when": [
"CM",
"CV"
]
}
},
"doseAndRate": [
{
"doseQuantity": {
"value": 1,
"unit": "tablet",
"system": "http://snomed.info/sct",
"code": "428673006"
}
}
]
},
{
"sequence": 3,
"text": "1 tablet - 3 times a day - at breakfast, at dinner and at lunch - for 1 week - up to a maximum of 4 tablet in 1 day",
"timing": {
"repeat": {
"boundsDuration": {
"value": 1,
"unit": "week",
"system": "http://unitsofmeasure.org",
"code": "wk"
},
"frequency": 3,
"period": 1,
"periodUnit": "d",
"when": [
"CM",
"CV",
"CD"
]
}
},
"doseAndRate": [
{
"doseQuantity": {
"value": 1,
"unit": "tablet",
"system": "http://snomed.info/sct",
"code": "428673006"
}
}
],
"maxDosePerPeriod": {
"numerator": {
"value": 4,
"unit": "tablet",
"system": "http://snomed.info/sct",
"code": "428673006"
},
"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]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]325278007
MedicationRequest.medication[0].coding[0].display[0]Metformin 500mg tablets
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]1 tablet - once a day - at breakfast - for 1 week
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].value[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].unit[0]week
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].code[0]wk
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].timing[0].repeat[0].when[0]CM
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].value[0]1
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].unit[0]tablet
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].code[0]428673006
MedicationRequest.dosageInstruction[1].sequence[0]2
MedicationRequest.dosageInstruction[1].text[0]1 tablet - twice a day - at breakfast and at dinner - for 1 week
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].bounds[0].value[0]1
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].bounds[0].unit[0]week
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].bounds[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].bounds[0].code[0]wk
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].frequency[0]2
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].period[0]1
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].periodUnit[0]d
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].when[0]CM
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].when[1]CV
MedicationRequest.dosageInstruction[1].doseAndRate[0].dose[0].value[0]1
MedicationRequest.dosageInstruction[1].doseAndRate[0].dose[0].unit[0]tablet
MedicationRequest.dosageInstruction[1].doseAndRate[0].dose[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[1].doseAndRate[0].dose[0].code[0]428673006
MedicationRequest.dosageInstruction[2].sequence[0]3
MedicationRequest.dosageInstruction[2].text[0]1 tablet - 3 times a day - at breakfast, at dinner and at lunch - for 1 week - up to a maximum of 4 tablet in 1 day
MedicationRequest.dosageInstruction[2].timing[0].repeat[0].bounds[0].value[0]1
MedicationRequest.dosageInstruction[2].timing[0].repeat[0].bounds[0].unit[0]week
MedicationRequest.dosageInstruction[2].timing[0].repeat[0].bounds[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[2].timing[0].repeat[0].bounds[0].code[0]wk
MedicationRequest.dosageInstruction[2].timing[0].repeat[0].frequency[0]3
MedicationRequest.dosageInstruction[2].timing[0].repeat[0].period[0]1
MedicationRequest.dosageInstruction[2].timing[0].repeat[0].periodUnit[0]d
MedicationRequest.dosageInstruction[2].timing[0].repeat[0].when[0]CM
MedicationRequest.dosageInstruction[2].timing[0].repeat[0].when[1]CV
MedicationRequest.dosageInstruction[2].timing[0].repeat[0].when[2]CD
MedicationRequest.dosageInstruction[2].doseAndRate[0].dose[0].value[0]1
MedicationRequest.dosageInstruction[2].doseAndRate[0].dose[0].unit[0]tablet
MedicationRequest.dosageInstruction[2].doseAndRate[0].dose[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[2].doseAndRate[0].dose[0].code[0]428673006
MedicationRequest.dosageInstruction[2].maxDosePerPeriod[0].numerator[0].value[0]4
MedicationRequest.dosageInstruction[2].maxDosePerPeriod[0].numerator[0].unit[0]tablet
MedicationRequest.dosageInstruction[2].maxDosePerPeriod[0].numerator[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[2].maxDosePerPeriod[0].numerator[0].code[0]428673006
MedicationRequest.dosageInstruction[2].maxDosePerPeriod[0].denominator[0].value[0]1
MedicationRequest.dosageInstruction[2].maxDosePerPeriod[0].denominator[0].unit[0]day
MedicationRequest.dosageInstruction[2].maxDosePerPeriod[0].denominator[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[2].maxDosePerPeriod[0].denominator[0].code[0]d
MedicationRequest.substitution[0].allowed[0]False
MedicationRequest

Example on-screen presentation:

Metformin 500mg tablets
1 tablet - once a day - at breakfast - for 1 week, then 1 tablet - twice a day - at breakfast and at dinner - for 1 week - up to a maximum of 4 tablet in 1 day, then 1 tablet - 3 times a day - at breakfast, at dinner and at lunch - for 1 week - up to a maximum of 4 tablet in 1 day
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