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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