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.

Salbutamol via a nebuliser

Dose-based VTM prescription using free-text additional instruction for the use of a device.
<MedicationRequest xmlns="http://hl7.org/fhir">
<id value="c4f1f082-75b2-4642-b1da-df15868467d6" />
<profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest" />
</meta>
<status value="active" />
<intent value="order" />
<system value="http://terminology.hl7.org/CodeSystem/medicationrequest-category" />
<code value="inpatient" />
<display value="inpatient" />
</coding>
</category>
<system value="https://dmd.nhs.uk" />
<code value="91143003" />
<display value="Salbutamol" />
</coding>
</medicationCodeableConcept>
<system value="https://fhir.nhs.uk/Id/nhs-number" />
<value value="9999999999" />
</identifier>
</subject>
<authoredOn value="2020-05-15T15:00:00Z" />
<reference value="urn:staff-1112" />
<display value="Dr Maikeu Well" />
</requester>
<reference value="urn:staff-1112" />
<display value="Dr Maikeu Well" />
</recorder>
<text value="Nebulise - 5 milligram - every 20 to 30 minutes - Inhalation - as required" />
<frequency value="1" />
<period value="20" />
<periodMax value="30" />
<periodUnit value="min" />
</repeat>
</timing>
<asNeededBoolean value="true" />
<system value="http://snomed.info/sct" />
<code value="18679011000001101" />
<display value="Inhalation" />
</coding>
</route>
<system value="http://snomed.info/sct" />
<code value="71791000001107" />
<display value="Nebulise" />
</coding>
</method>
<value value="5" />
<unit value="milligram" />
<system value="http://unitsofmeasure.org" />
<code value="mg" />
</doseQuantity>
</doseAndRate>
</dosageInstruction>
<allowedBoolean value="false" />
</substitution>
</MedicationRequest>
{
"resourceType": "MedicationRequest",
"id": "c4f1f082-75b2-4642-b1da-df15868467d6",
"meta": {
"profile": [
"https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest"
]
},
"status": "active",
"intent": "order",
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/medicationrequest-category",
"code": "inpatient",
"display": "inpatient"
}
]
}
],
"coding": [
{
"system": "https://dmd.nhs.uk",
"code": "91143003",
"display": "Salbutamol"
}
]
},
"subject": {
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "9999999999"
}
},
"authoredOn": "2020-05-15T15:00:00Z",
"reference": "urn:staff-1112",
"display": "Dr Maikeu Well"
},
"reference": "urn:staff-1112",
"display": "Dr Maikeu Well"
},
{
"text": "Nebulise - 5 milligram - every 20 to 30 minutes - Inhalation - as required",
"timing": {
"repeat": {
"frequency": 1,
"period": 20,
"periodMax": 30,
"periodUnit": "min"
}
},
"route": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "18679011000001101",
"display": "Inhalation"
}
]
},
"method": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "71791000001107",
"display": "Nebulise"
}
]
},
{
"value": 5,
"unit": "milligram",
"system": "http://unitsofmeasure.org",
"code": "mg"
}
}
]
}
],
}
}
MedicationRequest.id[0]c4f1f082-75b2-4642-b1da-df15868467d6
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]91143003
MedicationRequest.medication[0].coding[0].display[0]Salbutamol
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]Nebulise - 5 milligram - every 20 to 30 minutes - Inhalation - as required
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].frequency[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].period[0]20
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].periodMax[0]30
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].periodUnit[0]min
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]18679011000001101
MedicationRequest.dosageInstruction[0].route[0].coding[0].display[0]Inhalation
MedicationRequest.dosageInstruction[0].method[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].method[0].coding[0].code[0]71791000001107
MedicationRequest.dosageInstruction[0].method[0].coding[0].display[0]Nebulise
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:

Salbutamol
5 milligram - every 20 to 30 minutes - Inhalation - as required - to be given via a nebuliser

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