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.

Element: sequence

Multi-sequence dosage instructions.

A multi-sequence would be required where a dosage instruction changes over a given time schedule, where a dosage instruction includes optional follow-up doses or where a concurrent dosage instruction is required for the same medication at a different dose.

Examples below include Prednisolone to treat Bell’s palsy where a dose starts at 60 mg per day for a period of time then reduces by 10 mg per day. This would be described as a sequential dosage instruction. A concurrent dosage example is provided to describe a different dose in the morning to that at midday.

Sequential Instructions

Where the value of sequence is an incremental integer it defines a sequential instruction.

Example use of the FHIR R4 Dosage using multiple sequential sequences

<MedicationRequest xmlns="http://hl7.org/fhir">
    <id value="43955772-3136-49be-829e-ac04b56894d5" />
    <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>
    <priority value="routine" />
    <medicationCodeableConcept>
        <coding>
            <system value="https://dmd.nhs.uk" />
            <code value="52388000" />
            <display value="Prednisolone" />
        </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-1112" />
        <display value="Dr Maikeu Well" />
    </requester>
    <recorder>
        <reference value="urn:staff-1112" />
        <display value="Dr Maikeu Well" />
    </recorder>
    <dosageInstruction>
        <sequence value="1" />
        <text value="60 milligram - once a day - for 4 days" />
        <timing>
            <repeat>
                <boundsDuration>
                    <value value="4" />
                    <unit value="day" />
                    <system value="http://unitsofmeasure.org" />
                    <code value="d" />
                </boundsDuration>
                <frequency value="1" />
                <period value="1" />
                <periodUnit value="d" />
            </repeat>
        </timing>
        <doseAndRate>
            <doseQuantity>
                <value value="60" />
                <unit value="milligram" />
                <system value="http://unitsofmeasure.org" />
                <code value="mg" />
            </doseQuantity>
        </doseAndRate>
    </dosageInstruction>
    <dosageInstruction>
        <sequence value="2" />
        <text value="50 milligram - once a day - for 1 day" />
        <timing>
            <repeat>
                <boundsDuration>
                    <value value="1" />
                    <unit value="day" />
                    <system value="http://unitsofmeasure.org" />
                    <code value="d" />
                </boundsDuration>
                <frequency value="1" />
                <period value="1" />
                <periodUnit value="d" />
            </repeat>
        </timing>
        <doseAndRate>
            <doseQuantity>
                <value value="50" />
                <unit value="milligram" />
                <system value="http://unitsofmeasure.org" />
                <code value="mg" />
            </doseQuantity>
        </doseAndRate>
    </dosageInstruction>
    <dosageInstruction>
        <sequence value="3" />
        <text value="40 milligram - once a day - for 1 day" />
        <timing>
            <repeat>
                <boundsDuration>
                    <value value="1" />
                    <unit value="day" />
                    <system value="http://unitsofmeasure.org" />
                    <code value="d" />
                </boundsDuration>
                <frequency value="1" />
                <period value="1" />
                <periodUnit value="d" />
            </repeat>
        </timing>
        <doseAndRate>
            <doseQuantity>
                <value value="40" />
                <unit value="milligram" />
                <system value="http://unitsofmeasure.org" />
                <code value="mg" />
            </doseQuantity>
        </doseAndRate>
    </dosageInstruction>
    <dosageInstruction>
        <sequence value="4" />
        <text value="30 milligram - once a day - for 1 day" />
        <timing>
            <repeat>
                <boundsDuration>
                    <value value="1" />
                    <unit value="day" />
                    <system value="http://unitsofmeasure.org" />
                    <code value="d" />
                </boundsDuration>
                <frequency value="1" />
                <period value="1" />
                <periodUnit value="d" />
            </repeat>
        </timing>
        <doseAndRate>
            <doseQuantity>
                <value value="30" />
                <unit value="milligram" />
                <system value="http://unitsofmeasure.org" />
                <code value="mg" />
            </doseQuantity>
        </doseAndRate>
    </dosageInstruction>
    <dosageInstruction>
        <sequence value="5" />
        <text value="20 milligram - once a day - for 1 day" />
        <timing>
            <repeat>
                <boundsDuration>
                    <value value="1" />
                    <unit value="day" />
                    <system value="http://unitsofmeasure.org" />
                    <code value="d" />
                </boundsDuration>
                <frequency value="1" />
                <period value="1" />
                <periodUnit value="d" />
            </repeat>
        </timing>
        <doseAndRate>
            <doseQuantity>
                <value value="20" />
                <unit value="milligram" />
                <system value="http://unitsofmeasure.org" />
                <code value="mg" />
            </doseQuantity>
        </doseAndRate>
    </dosageInstruction>
    <dosageInstruction>
        <sequence value="6" />
        <text value="10 milligram - once a day - for 1 day - Then stop" />
        <additionalInstruction>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="422327006" />
                <display value="Then stop" />
            </coding>
        </additionalInstruction>
        <timing>
            <repeat>
                <boundsDuration>
                    <value value="1" />
                    <unit value="day" />
                    <system value="http://unitsofmeasure.org" />
                    <code value="d" />
                </boundsDuration>
                <frequency value="1" />
                <period value="1" />
                <periodUnit value="d" />
            </repeat>
        </timing>
        <doseAndRate>
            <doseQuantity>
                <value value="10" />
                <unit value="milligram" />
                <system value="http://unitsofmeasure.org" />
                <code value="mg" />
            </doseQuantity>
        </doseAndRate>
    </dosageInstruction>
    <substitution>
        <allowedBoolean value="false" />
    </substitution>
</MedicationRequest>
{
    "resourceType": "MedicationRequest",
    "id": "43955772-3136-49be-829e-ac04b56894d5",
    "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"
                }
            ]
        }
    ],
    "priority": "routine",
    "medicationCodeableConcept": {
        "coding":  [
            {
                "system": "https://dmd.nhs.uk",
                "code": "52388000",
                "display": "Prednisolone"
            }
        ]
    },
    "subject": {
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9999999999"
        }
    },
    "authoredOn": "2020-05-15T15:00:00Z",
    "requester": {
        "reference": "urn:staff-1112",
        "display": "Dr Maikeu Well"
    },
    "recorder": {
        "reference": "urn:staff-1112",
        "display": "Dr Maikeu Well"
    },
    "dosageInstruction":  [
        {
            "sequence": 1,
            "text": "60 milligram - once a day - for 4 days",
            "timing": {
                "repeat": {
                    "boundsDuration": {
                        "value": 4,
                        "unit": "day",
                        "system": "http://unitsofmeasure.org",
                        "code": "d"
                    },
                    "frequency": 1,
                    "period": 1,
                    "periodUnit": "d"
                }
            },
            "doseAndRate":  [
                {
                    "doseQuantity": {
                        "value": 60,
                        "unit": "milligram",
                        "system": "http://unitsofmeasure.org",
                        "code": "mg"
                    }
                }
            ]
        },
        {
            "sequence": 2,
            "text": "50 milligram - once a day - for 1 day",
            "timing": {
                "repeat": {
                    "boundsDuration": {
                        "value": 1,
                        "unit": "day",
                        "system": "http://unitsofmeasure.org",
                        "code": "d"
                    },
                    "frequency": 1,
                    "period": 1,
                    "periodUnit": "d"
                }
            },
            "doseAndRate":  [
                {
                    "doseQuantity": {
                        "value": 50,
                        "unit": "milligram",
                        "system": "http://unitsofmeasure.org",
                        "code": "mg"
                    }
                }
            ]
        },
        {
            "sequence": 3,
            "text": "40 milligram - once a day - for 1 day",
            "timing": {
                "repeat": {
                    "boundsDuration": {
                        "value": 1,
                        "unit": "day",
                        "system": "http://unitsofmeasure.org",
                        "code": "d"
                    },
                    "frequency": 1,
                    "period": 1,
                    "periodUnit": "d"
                }
            },
            "doseAndRate":  [
                {
                    "doseQuantity": {
                        "value": 40,
                        "unit": "milligram",
                        "system": "http://unitsofmeasure.org",
                        "code": "mg"
                    }
                }
            ]
        },
        {
            "sequence": 4,
            "text": "30 milligram - once a day - for 1 day",
            "timing": {
                "repeat": {
                    "boundsDuration": {
                        "value": 1,
                        "unit": "day",
                        "system": "http://unitsofmeasure.org",
                        "code": "d"
                    },
                    "frequency": 1,
                    "period": 1,
                    "periodUnit": "d"
                }
            },
            "doseAndRate":  [
                {
                    "doseQuantity": {
                        "value": 30,
                        "unit": "milligram",
                        "system": "http://unitsofmeasure.org",
                        "code": "mg"
                    }
                }
            ]
        },
        {
            "sequence": 5,
            "text": "20 milligram - once a day - for 1 day",
            "timing": {
                "repeat": {
                    "boundsDuration": {
                        "value": 1,
                        "unit": "day",
                        "system": "http://unitsofmeasure.org",
                        "code": "d"
                    },
                    "frequency": 1,
                    "period": 1,
                    "periodUnit": "d"
                }
            },
            "doseAndRate":  [
                {
                    "doseQuantity": {
                        "value": 20,
                        "unit": "milligram",
                        "system": "http://unitsofmeasure.org",
                        "code": "mg"
                    }
                }
            ]
        },
        {
            "sequence": 6,
            "text": "10 milligram - once a day - for 1 day - Then stop",
            "additionalInstruction":  [
                {
                    "coding":  [
                        {
                            "system": "http://snomed.info/sct",
                            "code": "422327006",
                            "display": "Then stop"
                        }
                    ]
                }
            ],
            "timing": {
                "repeat": {
                    "boundsDuration": {
                        "value": 1,
                        "unit": "day",
                        "system": "http://unitsofmeasure.org",
                        "code": "d"
                    },
                    "frequency": 1,
                    "period": 1,
                    "periodUnit": "d"
                }
            },
            "doseAndRate":  [
                {
                    "doseQuantity": {
                        "value": 10,
                        "unit": "milligram",
                        "system": "http://unitsofmeasure.org",
                        "code": "mg"
                    }
                }
            ]
        }
    ],
    "substitution": {
        "allowedBoolean": false
    }
}
MedicationRequest.id[0]43955772-3136-49be-829e-ac04b56894d5
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.priority[0]routine
MedicationRequest.medication[0].coding[0].system[0]https://dmd.nhs.uk
MedicationRequest.medication[0].coding[0].code[0]52388000
MedicationRequest.medication[0].coding[0].display[0]Prednisolone
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].sequence[0]1
MedicationRequest.dosageInstruction[0].text[0]60 milligram - once a day - for 4 days
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].value[0]4
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].unit[0]day
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].code[0]d
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].frequency[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].period[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].periodUnit[0]d
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].value[0]60
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.dosageInstruction[1].sequence[0]2
MedicationRequest.dosageInstruction[1].text[0]50 milligram - once a day - for 1 day
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].bounds[0].value[0]1
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].bounds[0].unit[0]day
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].bounds[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].bounds[0].code[0]d
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].frequency[0]1
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].period[0]1
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].periodUnit[0]d
MedicationRequest.dosageInstruction[1].doseAndRate[0].dose[0].value[0]50
MedicationRequest.dosageInstruction[1].doseAndRate[0].dose[0].unit[0]milligram
MedicationRequest.dosageInstruction[1].doseAndRate[0].dose[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[1].doseAndRate[0].dose[0].code[0]mg
MedicationRequest.dosageInstruction[2].sequence[0]3
MedicationRequest.dosageInstruction[2].text[0]40 milligram - once a day - for 1 day
MedicationRequest.dosageInstruction[2].timing[0].repeat[0].bounds[0].value[0]1
MedicationRequest.dosageInstruction[2].timing[0].repeat[0].bounds[0].unit[0]day
MedicationRequest.dosageInstruction[2].timing[0].repeat[0].bounds[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[2].timing[0].repeat[0].bounds[0].code[0]d
MedicationRequest.dosageInstruction[2].timing[0].repeat[0].frequency[0]1
MedicationRequest.dosageInstruction[2].timing[0].repeat[0].period[0]1
MedicationRequest.dosageInstruction[2].timing[0].repeat[0].periodUnit[0]d
MedicationRequest.dosageInstruction[2].doseAndRate[0].dose[0].value[0]40
MedicationRequest.dosageInstruction[2].doseAndRate[0].dose[0].unit[0]milligram
MedicationRequest.dosageInstruction[2].doseAndRate[0].dose[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[2].doseAndRate[0].dose[0].code[0]mg
MedicationRequest.dosageInstruction[3].sequence[0]4
MedicationRequest.dosageInstruction[3].text[0]30 milligram - once a day - for 1 day
MedicationRequest.dosageInstruction[3].timing[0].repeat[0].bounds[0].value[0]1
MedicationRequest.dosageInstruction[3].timing[0].repeat[0].bounds[0].unit[0]day
MedicationRequest.dosageInstruction[3].timing[0].repeat[0].bounds[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[3].timing[0].repeat[0].bounds[0].code[0]d
MedicationRequest.dosageInstruction[3].timing[0].repeat[0].frequency[0]1
MedicationRequest.dosageInstruction[3].timing[0].repeat[0].period[0]1
MedicationRequest.dosageInstruction[3].timing[0].repeat[0].periodUnit[0]d
MedicationRequest.dosageInstruction[3].doseAndRate[0].dose[0].value[0]30
MedicationRequest.dosageInstruction[3].doseAndRate[0].dose[0].unit[0]milligram
MedicationRequest.dosageInstruction[3].doseAndRate[0].dose[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[3].doseAndRate[0].dose[0].code[0]mg
MedicationRequest.dosageInstruction[4].sequence[0]5
MedicationRequest.dosageInstruction[4].text[0]20 milligram - once a day - for 1 day
MedicationRequest.dosageInstruction[4].timing[0].repeat[0].bounds[0].value[0]1
MedicationRequest.dosageInstruction[4].timing[0].repeat[0].bounds[0].unit[0]day
MedicationRequest.dosageInstruction[4].timing[0].repeat[0].bounds[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[4].timing[0].repeat[0].bounds[0].code[0]d
MedicationRequest.dosageInstruction[4].timing[0].repeat[0].frequency[0]1
MedicationRequest.dosageInstruction[4].timing[0].repeat[0].period[0]1
MedicationRequest.dosageInstruction[4].timing[0].repeat[0].periodUnit[0]d
MedicationRequest.dosageInstruction[4].doseAndRate[0].dose[0].value[0]20
MedicationRequest.dosageInstruction[4].doseAndRate[0].dose[0].unit[0]milligram
MedicationRequest.dosageInstruction[4].doseAndRate[0].dose[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[4].doseAndRate[0].dose[0].code[0]mg
MedicationRequest.dosageInstruction[5].sequence[0]6
MedicationRequest.dosageInstruction[5].text[0]10 milligram - once a day - for 1 day - Then stop
MedicationRequest.dosageInstruction[5].additionalInstruction[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[5].additionalInstruction[0].coding[0].code[0]422327006
MedicationRequest.dosageInstruction[5].additionalInstruction[0].coding[0].display[0]Then stop
MedicationRequest.dosageInstruction[5].timing[0].repeat[0].bounds[0].value[0]1
MedicationRequest.dosageInstruction[5].timing[0].repeat[0].bounds[0].unit[0]day
MedicationRequest.dosageInstruction[5].timing[0].repeat[0].bounds[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[5].timing[0].repeat[0].bounds[0].code[0]d
MedicationRequest.dosageInstruction[5].timing[0].repeat[0].frequency[0]1
MedicationRequest.dosageInstruction[5].timing[0].repeat[0].period[0]1
MedicationRequest.dosageInstruction[5].timing[0].repeat[0].periodUnit[0]d
MedicationRequest.dosageInstruction[5].doseAndRate[0].dose[0].value[0]10
MedicationRequest.dosageInstruction[5].doseAndRate[0].dose[0].unit[0]milligram
MedicationRequest.dosageInstruction[5].doseAndRate[0].dose[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[5].doseAndRate[0].dose[0].code[0]mg
MedicationRequest.substitution[0].allowed[0]False
MedicationRequest

Concurrent Instructions

Where the same integer value of sequence is defines it means a concurrent instruction.

<MedicationRequest xmlns="http://hl7.org/fhir">
    <id value="79159c4f-13c4-457a-8962-67fa22432c15" />
    <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>
    <priority value="routine" />
    <medicationCodeableConcept>
        <coding>
            <system value="https://dmd.nhs.uk" />
            <code value="317972000" />
            <display value="Furosemide 40mg tablets" />
        </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-1112" />
        <display value="Dr Maikeu Well" />
    </requester>
    <recorder>
        <reference value="urn:staff-1112" />
        <display value="Dr Maikeu Well" />
    </recorder>
    <dosageInstruction>
        <sequence value="1" />
        <text value="2 tablet - daily - at 08:00 - for 1 week" />
        <timing>
            <repeat>
                <boundsDuration>
                    <value value="1" />
                    <unit value="week" />
                    <system value="http://unitsofmeasure.org" />
                    <code value="wk" />
                </boundsDuration>
                <period value="1" />
                <periodUnit value="d" />
                <timeOfDay value="08:00:00" />
            </repeat>
        </timing>
        <doseAndRate>
            <doseQuantity>
                <value value="2" />
                <unit value="tablet" />
                <system value="http://snomed.info/sct" />
                <code value="428673006" />
            </doseQuantity>
        </doseAndRate>
    </dosageInstruction>
    <dosageInstruction>
        <sequence value="1" />
        <text value="1 tablet - daily - at 12:00 - for 1 week" />
        <timing>
            <repeat>
                <boundsDuration>
                    <value value="1" />
                    <unit value="week" />
                    <system value="http://unitsofmeasure.org" />
                    <code value="wk" />
                </boundsDuration>
                <period value="1" />
                <periodUnit value="d" />
                <timeOfDay value="12:00:00" />
            </repeat>
        </timing>
        <doseAndRate>
            <doseQuantity>
                <value value="1" />
                <unit value="tablet" />
                <system value="http://snomed.info/sct" />
                <code value="428673006" />
            </doseQuantity>
        </doseAndRate>
    </dosageInstruction>
    <substitution>
        <allowedBoolean value="false" />
    </substitution>
</MedicationRequest>
{
    "resourceType": "MedicationRequest",
    "id": "79159c4f-13c4-457a-8962-67fa22432c15",
    "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"
                }
            ]
        }
    ],
    "priority": "routine",
    "medicationCodeableConcept": {
        "coding":  [
            {
                "system": "https://dmd.nhs.uk",
                "code": "317972000",
                "display": "Furosemide 40mg tablets"
            }
        ]
    },
    "subject": {
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9999999999"
        }
    },
    "authoredOn": "2020-05-15T15:00:00Z",
    "requester": {
        "reference": "urn:staff-1112",
        "display": "Dr Maikeu Well"
    },
    "recorder": {
        "reference": "urn:staff-1112",
        "display": "Dr Maikeu Well"
    },
    "dosageInstruction":  [
        {
            "sequence": 1,
            "text": "2 tablet - daily - at 08:00 - for 1 week",
            "timing": {
                "repeat": {
                    "boundsDuration": {
                        "value": 1,
                        "unit": "week",
                        "system": "http://unitsofmeasure.org",
                        "code": "wk"
                    },
                    "period": 1,
                    "periodUnit": "d",
                    "timeOfDay":  [
                        "08:00:00"
                    ]
                }
            },
            "doseAndRate":  [
                {
                    "doseQuantity": {
                        "value": 2,
                        "unit": "tablet",
                        "system": "http://snomed.info/sct",
                        "code": "428673006"
                    }
                }
            ]
        },
        {
            "sequence": 1,
            "text": "1 tablet - daily - at 12:00 - for 1 week",
            "timing": {
                "repeat": {
                    "boundsDuration": {
                        "value": 1,
                        "unit": "week",
                        "system": "http://unitsofmeasure.org",
                        "code": "wk"
                    },
                    "period": 1,
                    "periodUnit": "d",
                    "timeOfDay":  [
                        "12:00:00"
                    ]
                }
            },
            "doseAndRate":  [
                {
                    "doseQuantity": {
                        "value": 1,
                        "unit": "tablet",
                        "system": "http://snomed.info/sct",
                        "code": "428673006"
                    }
                }
            ]
        }
    ],
    "substitution": {
        "allowedBoolean": false
    }
}
MedicationRequest.id[0]79159c4f-13c4-457a-8962-67fa22432c15
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.priority[0]routine
MedicationRequest.medication[0].coding[0].system[0]https://dmd.nhs.uk
MedicationRequest.medication[0].coding[0].code[0]317972000
MedicationRequest.medication[0].coding[0].display[0]Furosemide 40mg tablets
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].sequence[0]1
MedicationRequest.dosageInstruction[0].text[0]2 tablet - daily - at 08:00 - for 1 week
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].value[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].unit[0]week
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].code[0]wk
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].period[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].periodUnit[0]d
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].timeOfDay[0]08:00:00
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].value[0]2
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].unit[0]tablet
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].code[0]428673006
MedicationRequest.dosageInstruction[1].sequence[0]1
MedicationRequest.dosageInstruction[1].text[0]1 tablet - daily - at 12:00 - for 1 week
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].bounds[0].value[0]1
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].bounds[0].unit[0]week
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].bounds[0].system[0]http://unitsofmeasure.org
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].bounds[0].code[0]wk
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].period[0]1
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].periodUnit[0]d
MedicationRequest.dosageInstruction[1].timing[0].repeat[0].timeOfDay[0]12:00:00
MedicationRequest.dosageInstruction[1].doseAndRate[0].dose[0].value[0]1
MedicationRequest.dosageInstruction[1].doseAndRate[0].dose[0].unit[0]tablet
MedicationRequest.dosageInstruction[1].doseAndRate[0].dose[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[1].doseAndRate[0].dose[0].code[0]428673006
MedicationRequest.substitution[0].allowed[0]False
MedicationRequest
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