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.

Voluven infusion

Product-based AMP prescription. Route method, dose duration, and dose expressed a rate ratio.

Note: The rateRatio could also be modelled using a UCUM unit within a doseQuantity. In this example we are using the slightly more complex rateRatio structure.

e.g.

<doseAndRate>
  <doseQuantity>
    <value value="30"/>
    <unit value="millilitres per kilogram"/>
    <system value="http://unitsofmeasure.org"/>
    <code value="ml/kg"/>
  </doseQuantity>
</doseAndRate>


<MedicationRequest xmlns="http://hl7.org/fhir">
    <id value="10850aa9-133b-4a33-aea7-5bef3b71ab9b" />
    <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="21514511000001103" />
            <display value="Voluven 10% infusion 500ml Freeflex bags (Fresenius Kabi Ltd)" />
        </coding>
    </medicationCodeableConcept>
    <subject>
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="9999999999" />
        </identifier>
    </subject>
    <authoredOn value="2018-09-15T15:00:00Z" />
    <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="Infusion over 10 hours - at a rate of 30 millilitre per kilogram - Intravenous" />
        <timing>
            <repeat>
                <duration value="10" />
                <durationUnit value="h" />
            </repeat>
        </timing>
        <route>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="47625008" />
                <display value="Intravenous" />
            </coding>
        </route>
        <method>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="129330003" />
                <display value="Infusion" />
            </coding>
        </method>
        <doseAndRate>
            <rateRatio>
                <numerator>
                    <value value="30" />
                    <unit value="millilitre" />
                    <system value="http://unitsofmeasure.org" />
                    <code value="mL" />
                </numerator>
                <denominator>
                    <value value="1" />
                    <unit value="kilogram" />
                    <system value="http://unitsofmeasure.org" />
                    <code value="kg" />
                </denominator>
            </rateRatio>
        </doseAndRate>
    </dosageInstruction>
    <substitution>
        <allowedBoolean value="false" />
    </substitution>
</MedicationRequest>

{
    "resourceType": "MedicationRequest",
    "id": "10850aa9-133b-4a33-aea7-5bef3b71ab9b",
    "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": "inpatient",
                    "display": "inpatient"
                }
            ]
        }
    ],
    "medicationCodeableConcept": {
        "coding":  [
            {
                "system": "https://dmd.nhs.uk",
                "code": "21514511000001103",
                "display": "Voluven 10% infusion 500ml Freeflex bags (Fresenius Kabi Ltd)"
            }
        ]
    },
    "subject": {
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9999999999"
        }
    },
    "authoredOn": "2018-09-15T15:00:00Z",
    "requester": {
        "reference": "urn:staff-1112",
        "display": "Dr Maikeu Well"
    },
    "recorder": {
        "reference": "urn:staff-1112",
        "display": "Dr Maikeu Well"
    },
    "dosageInstruction":  [
        {
            "text": "Infusion over 10 hours - at a rate of 30 millilitre per kilogram - Intravenous",
            "timing": {
                "repeat": {
                    "duration": 10,
                    "durationUnit": "h"
                }
            },
            "route": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "47625008",
                        "display": "Intravenous"
                    }
                ]
            },
            "method": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "129330003",
                        "display": "Infusion"
                    }
                ]
            },
            "doseAndRate":  [
                {
                    "rateRatio": {
                        "numerator": {
                            "value": 30,
                            "unit": "millilitre",
                            "system": "http://unitsofmeasure.org",
                            "code": "mL"
                        },
                        "denominator": {
                            "value": 1,
                            "unit": "kilogram",
                            "system": "http://unitsofmeasure.org",
                            "code": "kg"
                        }
                    }
                }
            ]
        }
    ],
    "substitution": {
        "allowedBoolean": false
    }
}
MedicationRequest.id[0]10850aa9-133b-4a33-aea7-5bef3b71ab9b
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]21514511000001103
MedicationRequest.medication[0].coding[0].display[0]Voluven 10% infusion 500ml Freeflex bags (Fresenius Kabi 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]2018-09-15T15:00:00Z
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]Infusion over 10 hours - at a rate of 30 millilitre per kilogram - Intravenous
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].duration[0]10
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].durationUnit[0]h
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
MedicationRequest.dosageInstruction[0].method[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].method[0].coding[0].code[0]129330003
MedicationRequest.dosageInstruction[0].method[0].coding[0].display[0]Infusion
MedicationRequest.dosageInstruction[0].doseAndRate[0].rate[0].numerator[0].value[0]30
MedicationRequest.dosageInstruction[0].doseAndRate[0].rate[0].numerator[0].unit[0]millilitre
MedicationRequest.dosageInstruction[0].doseAndRate[0].rate[0].numerator[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].doseAndRate[0].rate[0].numerator[0].code[0]mL
MedicationRequest.dosageInstruction[0].doseAndRate[0].rate[0].denominator[0].value[0]1
MedicationRequest.dosageInstruction[0].doseAndRate[0].rate[0].denominator[0].unit[0]kilogram
MedicationRequest.dosageInstruction[0].doseAndRate[0].rate[0].denominator[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].doseAndRate[0].rate[0].denominator[0].code[0]kg
MedicationRequest.substitution[0].allowed[0]False
MedicationRequest

Example on-screen presentation:

Voluven 10% infusion 500ml Freeflex bags (Fresenius Kabi Ltd)
Infusion over 10 hours - at a rate of 30 millilitre per kilogram - Intravenous
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