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.

Permitabs tablets

Product-based AMP prescription with text-based patient instruction for the preparation.

Complex because contains a detailed preparation instruction which has to be conveyed as free-text within patientInstruction.

<MedicationRequest xmlns="http://hl7.org/fhir">
    <id value="1f4959a1-4a33-4b0e-bfad-f2ea1fccb2fa" />
    <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="4256811000001101" />
            <display value="Permitabs 400mg tablets for cutaneous solution (Alliance Pharmaceuticals Ltd)" />
        </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-3030" />
        <display value="Dr Callum Lund" />
    </requester>
    <recorder>
        <reference value="urn:staff-3030" />
        <display value="Dr Callum Lund" />
    </recorder>
    <dosageInstruction>
        <text value="Topical - Add one tablet to 500ml of warm water and dissolve. Make the resulting solution up to 8 litres and use to soak feet. Do not ingest." />
        <patientInstruction value="Add one tablet to 500ml of warm water and dissolve. Make the resulting solution up to 8 litres and use to soak feet. Do not ingest." />
        <route>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="6064005" />
                <display value="Topical" />
            </coding>
        </route>
    </dosageInstruction>
    <substitution>
        <allowedBoolean value="false" />
    </substitution>
</MedicationRequest>

{
    "resourceType": "MedicationRequest",
    "id": "1f4959a1-4a33-4b0e-bfad-f2ea1fccb2fa",
    "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": "4256811000001101",
                "display": "Permitabs 400mg tablets for cutaneous solution (Alliance Pharmaceuticals Ltd)"
            }
        ]
    },
    "subject": {
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9999999999"
        }
    },
    "authoredOn": "2020-05-15T15:00:00Z",
    "requester": {
        "reference": "urn:staff-3030",
        "display": "Dr Callum Lund"
    },
    "recorder": {
        "reference": "urn:staff-3030",
        "display": "Dr Callum Lund"
    },
    "dosageInstruction":  [
        {
            "text": "Topical - Add one tablet to 500ml of warm water and dissolve. Make the resulting solution up to 8 litres and use to soak feet. Do not ingest.",
            "patientInstruction": "Add one tablet to 500ml of warm water and dissolve. Make the resulting solution up to 8 litres and use to soak feet. Do not ingest.",
            "route": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "6064005",
                        "display": "Topical"
                    }
                ]
            }
        }
    ],
    "substitution": {
        "allowedBoolean": false
    }
}
MedicationRequest.id[0]1f4959a1-4a33-4b0e-bfad-f2ea1fccb2fa
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]4256811000001101
MedicationRequest.medication[0].coding[0].display[0]Permitabs 400mg tablets for cutaneous solution (Alliance Pharmaceuticals Ltd)
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-3030
MedicationRequest.requester[0].display[0]Dr Callum Lund
MedicationRequest.recorder[0].reference[0]urn:staff-3030
MedicationRequest.recorder[0].display[0]Dr Callum Lund
MedicationRequest.dosageInstruction[0].text[0]Topical - Add one tablet to 500ml of warm water and dissolve. Make the resulting solution up to 8 litres and use to soak feet. Do not ingest.
MedicationRequest.dosageInstruction[0].patientInstruction[0]Add one tablet to 500ml of warm water and dissolve. Make the resulting solution up to 8 litres and use to soak feet. Do not ingest.
MedicationRequest.dosageInstruction[0].route[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].route[0].coding[0].code[0]6064005
MedicationRequest.dosageInstruction[0].route[0].coding[0].display[0]Topical
MedicationRequest.substitution[0].allowed[0]False
MedicationRequest

Example on-screen presentation:

Permitabs 400mg tablets for cutaneous solution (Alliance Pharmaceuticals Ltd)
Add one tablet to 500ml of warm water and dissolve. Make the resulting solution up to 8 litres and use to soak feet. Do not ingest.
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