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.

Morphine bolus

Dose-based VTM prescription using a free text additional instructions to specify patient-administered with a 5 minute lockout.
<MedicationRequest xmlns="http://hl7.org/fhir">
<id value="1558295a-9213-44cb-81e1-e1ab8fcc3e81" />
<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="inpatient" />
<display value="inpatient" />
</coding>
</category>
<medicationCodeableConcept>
<coding>
<system value="https://dmd.nhs.uk" />
<code value="73572009" />
<display value="Morphine" />
</coding>
</medicationCodeableConcept>
<subject>
<identifier>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9999999999" />
</identifier>
</subject>
<authoredOn value="2020-05-15T15:00:00Z" />
<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="Intermittent bolus 5 milligram - as required - Intravenous route - Administer via PCA with a 5 minute lockout" />
<additionalInstruction>
<text value="Administer via PCA with a 5 minute lockout" />
</additionalInstruction>
<asNeededBoolean value="true" />
<route>
<coding>
<system value="http://snomed.info/sct" />
<code value="47625008" />
<display value="Intravenous route" />
</coding>
</route>
<method>
<coding>
<system value="http://snomed.info/sct" />
<code value="397884008" />
<display value="Intermittent bolus" />
</coding>
</method>
<doseAndRate>
<doseQuantity>
<value value="5" />
<unit value="milligram" />
<system value="http://unitsofmeasure.org" />
<code value="mg" />
</doseQuantity>
</doseAndRate>
</dosageInstruction>
<substitution>
<allowedBoolean value="false" />
</substitution>
</MedicationRequest>
{
"resourceType": "MedicationRequest",
"id": "1558295a-9213-44cb-81e1-e1ab8fcc3e81",
"meta": {
"profile": [
"https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest"
]
},
"intent": "order",
"status": "active",
"category": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/medicationrequest-category",
"code": "inpatient",
"display": "inpatient"
}
]
}
],
"medicationCodeableConcept": {
"coding": [
{
"system": "https://dmd.nhs.uk",
"code": "73572009",
"display": "Morphine"
}
]
},
"subject": {
"identifier": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9999999999"
}
},
"authoredOn": "2020-05-15T15:00:00Z",
"requester": {
"reference": "urn:staff-1112",
"display": "Dr Maikeu Well"
},
"recorder": {
"reference": "urn:staff-1112",
"display": "Dr Maikeu Well"
},
"dosageInstruction": [
{
"text": "Intermittent bolus 5 milligram - as required - Intravenous route - Administer via PCA with a 5 minute lockout",
"additionalInstruction": [
{
"text": "Administer via PCA with a 5 minute lockout"
}
],
"asNeededBoolean": true,
"route": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "47625008",
"display": "Intravenous route"
}
]
},
"method": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "397884008",
"display": "Intermittent bolus"
}
]
},
"doseAndRate": [
{
"doseQuantity": {
"value": 5,
"unit": "milligram",
"system": "http://unitsofmeasure.org",
"code": "mg"
}
}
]
}
],
"substitution": {
"allowedBoolean": false
}
}
MedicationRequest.id[0]1558295a-9213-44cb-81e1-e1ab8fcc3e81
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]inpatient
MedicationRequest.category[0].coding[0].display[0]inpatient
MedicationRequest.medication[0].coding[0].system[0]https://dmd.nhs.uk
MedicationRequest.medication[0].coding[0].code[0]73572009
MedicationRequest.medication[0].coding[0].display[0]Morphine
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]2020-05-15T15:00:00Z
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]Intermittent bolus 5 milligram - as required - Intravenous route - Administer via PCA with a 5 minute lockout
MedicationRequest.dosageInstruction[0].additionalInstruction[0].text[0]Administer via PCA with a 5 minute lockout
MedicationRequest.dosageInstruction[0].asNeeded[0]True
MedicationRequest.dosageInstruction[0].route[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].route[0].coding[0].code[0]47625008
MedicationRequest.dosageInstruction[0].route[0].coding[0].display[0]Intravenous route
MedicationRequest.dosageInstruction[0].method[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].method[0].coding[0].code[0]397884008
MedicationRequest.dosageInstruction[0].method[0].coding[0].display[0]Intermittent bolus
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].value[0]5
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].unit[0]milligram
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].code[0]mg
MedicationRequest.substitution[0].allowed[0]False
MedicationRequest

Example on-screen presentation:

Morphine
Intermittent bolus 5 milligram - as required - Intravenous route - PCA with a 5 minute lockout
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