Introduction
Links to the definitions of the Medication resource within the specifications covered within this guidance.
- Medication resource within STU3
- Medication resource within CareConnect
- Medication resource within R4
Minimum Viable Product (MVP)
Elements marked as MVP denote those recommended to be required for an MVP for the target use case.
| Elements | |
|---|---|
| id | MVP |
| text | |
| identifier | |
| code | MVP |
| status | |
| manufacturer | |
| form | |
| amount | |
| ingredient | |
| batch | |
| isBrand | |
| isOverTheCounter | |
| package | |
| image |
Medication elements
id
| Data Type: | Id |
| Required / Cardinality: | Required 0..1 |
| Version Support: | STU3 R4 |
| Description: | Logical id of this artifact. |
It is recommended this is the medication unique dm+d concept id. This use of this identifier will provide a unique mechanism to return a Medication resource in a RESTful implementation anywhere across the NHS.
For example;
<reference value="https://myFHIRserver/medication/87652004"/>
Where 87652004 in this example is the unique dm+d concept id for the Virtual Therapeutic Moiety for Atenolol.
Note: Where a medication is not within the dm+d and therefore does not have a dm+d code then the approach will be a local implementation decision. If you have a local FHIR Medication Resource server that is being used to share drug data locally then using the Medication Reference URL is OK. If the data is being shared outside of the local environment then the Medication resource should only reference dm+d data.
See medication with no dm+d code.
text
| Data Type: | Narrative |
| Required / Cardinality: | Optional 0..1 |
| Version Support: | STU3 R4 |
| Description: | Text summary of the resource, for human interpretation |
The element is not required for an MVP implementation.
identifier
| Data Type: | Identifier |
| Required / Cardinality: | Optional 0..* |
| Version Support: | R4 |
| Description: | Business identifier for this medication. |
The element is not required for an MVP implementation. It could be used to share a local or alternative medication identifier.
code
| Data Type: | CodeableConcept |
| Required / Cardinality: | Required 0..1 |
| Version Support: | STU3 R4 |
| Description: | A code (or set of codes) that specify this medication, or a textual description if no code is available. Usage note: This could be a standard medication code such as a code from RxNorm, SNOMED CT, IDMP etc. It could also be a national or local formulary code, optionally with translations to other code systems. |
All medication must be represented using NHS dm+d terminology.
- The
code.coding.systemmust be “http://snomed.info/sct”. - The
code.coding.codemust be the NHS dm+d concept code. - The
code.coding.displaymust be the NHS dm+d concept description.
status
| Data Type: | code |
| Required / Cardinality: | Optional 0..1 |
| Version Support: | STU3 R4 |
| Description: | A code to indicate if the medication is in active use. |
The element is not required for an MVP implementation.
manufacturer
| Data Type: | Reference |
| Required / Cardinality: | Optional 0..1 |
| Version Support: | STU3 R4 |
| Description: | Describes the details of the manufacturer of the medication product. This is not intended to represent the distributor of a medication product. |
The element is not required for an MVP implementation.
form
| Data Type: | CodeableConcept |
| Required / Cardinality: | Optional 0..1 |
| Version Support: | STU3 R4 |
| Description: | Describes the form of the item, e.g. powder, tablets, capsule etc. |
The element is not required for an MVP implementation.
Within the dm+d terminology, the VMP, AMP, VMPP and AMPP concepts include a coded form.
Where a medication is identified using a VTM concept and the prescriber wishes to qualify with a form then use this element.
Coded forms should be taken from either the dm+d or from the SNOMED-CT hierarchy as a descendant of the concept 736542009 Pharmaceutical dose form.
amount
| Data Type: | Ratio |
| Required / Cardinality: | Optional 0..1 |
| Version Support: | R4 |
| Description: | Specific amount of the drug in the packaged product. For example, when specifying a product that has the same strength (For example, Insulin glargine 100 unit per mL solution for injection), this attribute provides additional clarification of the package amount (For example, 3 mL, 10mL, etc.). |
The element is not required for an MVP implementation.
ingredient
| Data Type: | BackboneElement |
| Required / Cardinality: | Optional 0..* |
| Version Support: | STU3 R4 |
| Description: | Identifies a particular constituent of interest in the product. |
The element is not required for an MVP implementation.
batch
| Data Type: | BackboneElement |
| Required / Cardinality: | Optional 0..1 |
| Version Support: | R4 |
| Description: | Information that only applies to packages (not products). |
The element is not required for an MVP implementation.
isBrand
| Data Type: | boolean |
| Required / Cardinality: | Optional 0..1 |
| Version Support: | STU3 |
| Description: | Set to true if the item is attributable to a specific manufacturer. |
This element has been removed from FHIR R4 so should not be implemented as part of an STU3 or CareConnect implementation.
Within the dm+d terminology, medication that is a brand is identified as an AMP and AMPP concept.
isOverTheCounter
| Data Type: | boolean |
| Required / Cardinality: | Optional 0..1 |
| Version Support: | STU3 |
| Description: | Set to true if the medication can be obtained without an order from a prescriber. |
This element has been removed from FHIR R4 so should not be implemented as part of an STU3 or CareConnect implementation.
package
| Data Type: | BackboneElement |
| Required / Cardinality: | Optional 0..1 |
| Version Support: | STU3 |
| Description: | Information that only applies to packages (not products). |
This element has been removed from FHIR R4 so should not be implemented as part of an STU3 or CareConnect implementation.
image
| Data Type: | Attachment |
| Required / Cardinality: | Optional 0..* |
| Version Support: | STU3 |
| Description: | Photo(s) or graphic representation(s) of the medication. |
This element has been removed from FHIR R4 so should not be implemented as part of an STU3 or CareConnect implementation.