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.

Self-Declared / Justin Thyme

Patient Journey: Justin Thyme

  1. Justin self-declares over-the-counter Paracetamol medication and this is recorded in the clinical system and can be shared with a shared medication record as a MedicationStatement.

Example #1: MedicationStatement

Note: This example below is a draft and requires clinical verification.
<!--  This xml example is for illustrative purposes only and has not been clinically verified.  -->
<Bundle xmlns="http://hl7.org/fhir">
    <id value="921dacdd-3a3b-4649-ab03-f0b219486bc4" />
    <type value="message" />
    <timestamp value="2021-05-07T16:15:32Z" />
    <!--    Message Header    -->
    <entry>
        <fullUrl value="urn:message-header-167434" />
        <resource>
            <MessageHeader>
                <id value="urn:message-header-167434" />
                <eventCoding>
                    <system value="https://fhir.hl7.org.uk//CodeSystem/message-event" />
                    <code value="medication-statement" />
                    <display value="Medication Statement" />
                </eventCoding>
                <source>
                    <name value="ACME Patient Facing Application" />
                    <software value="ACME PFA" />
                    <version value="1.2.00" />
                    <endpoint value="urn:nhs-uk:addressing:ods:U4S3A" />
                </source>
                <focus>
                    <reference value="urn:medication-statement-123123124456" />
                </focus>
            </MessageHeader>
        </resource>
    </entry>
    <!--  Patient associated with the encounter.  -->
    <entry>
        <fullUrl value="urn:patient-01020304" />
        <resource>
            <Patient>
                <id value="urn:patient-01020304" />
                <identifier>
                    <system value="https://fhir.nhs.uk/Id/nhs-number" />
                    <value value="4857774567" />
                </identifier>
                <name>
                    <use value="official" />
                    <text value="Mr Justin Thyme" />
                    <family value="Thyme" />
                    <given value="Justin" />
                    <prefix value="Mr" />
                </name>
                <gender value="male" />
                <birthDate value="1979-05-29" />
            </Patient>
        </resource>
    </entry>
    <!--  Medication    -->
    <entry>
        <fullUrl value="urn:medication-123123123" />
        <resource>
            <Medication>
                <id value="urn:medication-123123123" />
                <code>
                    <coding>
                        <system value="http://snomed.info/sct" />
                        <code value="90332006" />
                        <display value="Paracetamol" />
                    </coding>
                </code>
            </Medication>
        </resource>
    </entry>
    <!--   Medication Statement   -->
    <entry>
        <fullUrl value="urn:medication-statement-123123124456" />
        <resource>
            <MedicationStatement>
                <id value="urn:medication-statement-123123124456" />
                <status value="active" />
                <category>
                    <coding>
                        <system value="http://hl7.org/fhir/medication-request-category" />
                        <code value="patientspecified" />
                        <display value="patientspecified" />
                    </coding>
                </category>
                <medicationReference>
                    <reference value="urn:medication-123123123" />
                    <display value="Paracetamol" />
                </medicationReference>
                <subject>
                    <reference value="urn:patient-01020304" />
                    <display value="Mr Justin Thyme" />
                </subject>
                <dosage>
                    <timing>
                        <repeat>
                            <frequency value="2" />
                            <period value="1" />
                            <periodUnit value="d" />
                        </repeat>
                    </timing>
                    <route>
                        <coding>
                            <system value="http://snomed.info/sct" />
                            <code value="26643006" />
                            <display value="oral" />
                        </coding>
                    </route>
                    <doseAndRate>
                        <doseQuantity>
                            <value value="500" />
                            <unit value="milligram" />
                            <system value="http://unitsofmeasure.org" />
                            <code value="mg" />
                        </doseQuantity>
                    </doseAndRate>
                </dosage>
            </MedicationStatement>
        </resource>
    </entry>
</Bundle>

{
    "resourceType": "Bundle",
    "id": "921dacdd-3a3b-4649-ab03-f0b219486bc4",
    "type": "message",
    "timestamp": "2021-05-07T16:15:32+00:00",
    "entry":  [
        {
            "fullUrl": "urn:message-header-167434",
            "resource": {
                "resourceType": "MessageHeader",
                "id": "urn:message-header-167434",
                "eventCoding": {
                    "system": "https://fhir.hl7.org.uk//CodeSystem/message-event",
                    "code": "medication-statement",
                    "display": "Medication Statement"
                },
                "source": {
                    "name": "ACME Patient Facing Application",
                    "software": "ACME PFA",
                    "version": "1.2.00",
                    "endpoint": "urn:nhs-uk:addressing:ods:U4S3A"
                },
                "focus":  [
                    {
                        "reference": "urn:medication-statement-123123124456"
                    }
                ]
            }
        },
        {
            "fullUrl": "urn:patient-01020304",
            "resource": {
                "resourceType": "Patient",
                "id": "urn:patient-01020304",
                "identifier":  [
                    {
                        "system": "https://fhir.nhs.uk/Id/nhs-number",
                        "value": "4857774567"
                    }
                ],
                "name":  [
                    {
                        "use": "official",
                        "text": "Mr Justin Thyme",
                        "family": "Thyme",
                        "given":  [
                            "Justin"
                        ],
                        "prefix":  [
                            "Mr"
                        ]
                    }
                ],
                "gender": "male",
                "birthDate": "1979-05-29"
            }
        },
        {
            "fullUrl": "urn:medication-123123123",
            "resource": {
                "resourceType": "Medication",
                "id": "urn:medication-123123123",
                "code": {
                    "coding":  [
                        {
                            "system": "http://snomed.info/sct",
                            "code": "90332006",
                            "display": "Paracetamol"
                        }
                    ]
                }
            }
        },
        {
            "fullUrl": "urn:medication-statement-123123124456",
            "resource": {
                "resourceType": "MedicationStatement",
                "id": "urn:medication-statement-123123124456",
                "status": "active",
                "category": {
                    "coding":  [
                        {
                            "system": "http://hl7.org/fhir/medication-request-category",
                            "code": "patientspecified",
                            "display": "patientspecified"
                        }
                    ]
                },
                "medicationReference": {
                    "reference": "urn:medication-123123123",
                    "display": "Paracetamol"
                },
                "subject": {
                    "reference": "urn:patient-01020304",
                    "display": "Mr Justin Thyme"
                },
                "dosage":  [
                    {
                        "timing": {
                            "repeat": {
                                "frequency": 2,
                                "period": 1,
                                "periodUnit": "d"
                            }
                        },
                        "route": {
                            "coding":  [
                                {
                                    "system": "http://snomed.info/sct",
                                    "code": "26643006",
                                    "display": "oral"
                                }
                            ]
                        },
                        "doseAndRate":  [
                            {
                                "doseQuantity": {
                                    "value": 500,
                                    "unit": "milligram",
                                    "system": "http://unitsofmeasure.org",
                                    "code": "mg"
                                }
                            }
                        ]
                    }
                ]
            }
        }
    ]
}
Bundle.id[0]921dacdd-3a3b-4649-ab03-f0b219486bc4
Bundle.type[0]message
Bundle.timestamp[0]2021-05-07T16:15:32+00:00
Bundle.entry[0].fullUrl[0]urn:message-header-167434
Bundle.entry[0].resource[0].id[0]urn:message-header-167434
Bundle.entry[0].resource[0].event[0].system[0]https://fhir.hl7.org.uk//CodeSystem/message-event
Bundle.entry[0].resource[0].event[0].code[0]medication-statement
Bundle.entry[0].resource[0].event[0].display[0]Medication Statement
Bundle.entry[0].resource[0].source[0].name[0]ACME Patient Facing Application
Bundle.entry[0].resource[0].source[0].software[0]ACME PFA
Bundle.entry[0].resource[0].source[0].version[0]1.2.00
Bundle.entry[0].resource[0].source[0].endpoint[0]urn:nhs-uk:addressing:ods:U4S3A
Bundle.entry[0].resource[0].focus[0].reference[0]urn:medication-statement-123123124456
Bundle.entry[1].fullUrl[0]urn:patient-01020304
Bundle.entry[1].resource[0].id[0]urn:patient-01020304
Bundle.entry[1].resource[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
Bundle.entry[1].resource[0].identifier[0].value[0]4857774567
Bundle.entry[1].resource[0].name[0].use[0]official
Bundle.entry[1].resource[0].name[0].text[0]Mr Justin Thyme
Bundle.entry[1].resource[0].name[0].family[0]Thyme
Bundle.entry[1].resource[0].name[0].given[0]Justin
Bundle.entry[1].resource[0].name[0].prefix[0]Mr
Bundle.entry[1].resource[0].gender[0]male
Bundle.entry[1].resource[0].birthDate[0]1979-05-29
Bundle.entry[2].fullUrl[0]urn:medication-123123123
Bundle.entry[2].resource[0].id[0]urn:medication-123123123
Bundle.entry[2].resource[0].code[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[2].resource[0].code[0].coding[0].code[0]90332006
Bundle.entry[2].resource[0].code[0].coding[0].display[0]Paracetamol
Bundle.entry[3].fullUrl[0]urn:medication-statement-123123124456
Bundle.entry[3].resource[0].id[0]urn:medication-statement-123123124456
Bundle.entry[3].resource[0].status[0]active
Bundle.entry[3].resource[0].category[0].coding[0].system[0]http://hl7.org/fhir/medication-request-category
Bundle.entry[3].resource[0].category[0].coding[0].code[0]patientspecified
Bundle.entry[3].resource[0].category[0].coding[0].display[0]patientspecified
Bundle.entry[3].resource[0].medication[0].reference[0]urn:medication-123123123
Bundle.entry[3].resource[0].medication[0].display[0]Paracetamol
Bundle.entry[3].resource[0].subject[0].reference[0]urn:patient-01020304
Bundle.entry[3].resource[0].subject[0].display[0]Mr Justin Thyme
Bundle.entry[3].resource[0].dosage[0].timing[0].repeat[0].frequency[0]2
Bundle.entry[3].resource[0].dosage[0].timing[0].repeat[0].period[0]1
Bundle.entry[3].resource[0].dosage[0].timing[0].repeat[0].periodUnit[0]d
Bundle.entry[3].resource[0].dosage[0].route[0].coding[0].system[0]http://snomed.info/sct
Bundle.entry[3].resource[0].dosage[0].route[0].coding[0].code[0]26643006
Bundle.entry[3].resource[0].dosage[0].route[0].coding[0].display[0]oral
Bundle.entry[3].resource[0].dosage[0].doseAndRate[0].dose[0].value[0]500
Bundle.entry[3].resource[0].dosage[0].doseAndRate[0].dose[0].unit[0]milligram
Bundle.entry[3].resource[0].dosage[0].doseAndRate[0].dose[0].system[0]http://unitsofmeasure.org
Bundle.entry[3].resource[0].dosage[0].doseAndRate[0].dose[0].code[0]mg
Bundle
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