- The Pharmacy Digital Minor Illness Referral Service care communication has been renamed to Minor Illness Referral Consultation (MIRC).
- New heading Referrer Details has been added to the Minor Illness Referral Consultation section.
- Existing headings for Minor Illness Referral Consultation have been updated - these are Clinical narrative, Medications and medical devices and Presenting complaint or issues.
- Minor Illness Referral Consultation (MIRC) guidance has been added to Common Headings pages for Attendance details, Consent and Patient demographics.
- New Common Heading page added for Observations, which includes details on how to form coded entry data for the Minor Illness Referral Consultation document.
- New Example Scenario added Jack Smith Minor Illness Referral Consultation (MIRC).
Note: At the time of publication, FHIR profile development to support the Minor Illness Referral Consultation (MIRC) care communication has not been completed. This development is planned for the future and will include:
- A new MessageDefinition FHIR profile for the Minor Illness Referral Consultation (MIRC) care communication, with StructureDefinition URL ‘https://fhir.nhs.uk/STU3/MessageDefinition/ITK-DM-MIRC-MessageDefinition-1’.
- A new code and display ‘ITK013D - ITK Digital Medicine Minor Illness Referral Consultation’ to be added to the CodeSystem ITK-MessageEvent-2.
- Changes to CareConnect-ITK-DM-DMIRS-Composition:
- Add new Composition.section for ‘Referrer Details’ with SNOMED CT representation ‘1052891000000108 - Referrer details’
- Add new Composition.section for ‘Observations’ with SNOMED CT representation ‘11102421000000108 - Observations’
- Correction to Composition.section.title for ‘presentingComplaintOrIssues’, from ‘Presentin complaint or issues’ to ‘Presenting complaint or issues’.
Corrections to existing example scenarios - SNOMED CT representations in the following examples have been updated:
- Jack Dawkins Vaccinations COVID Vaccination Given
- Hettie Winters Vaccinations COVID Vaccination Not Given
- Vaccinations: ‘Vaccine procedure’ updated to align with the Version 1.2 update to the ValueSet CareConnect-VaccinationProcedure-1
- New example scenarios: The example scenarios are:
Note: These examples are for demonstrating FHIR representation only. They do not imply business requirements in terms of the ITK Wrapper population, or clinical requirements for SNOMED CT representations.
- Added DaysSupply as required and changed Indication to optional within Medications and Medical devices headings
- Added DaysSupply as required to Medication Dispense List
- Updated examples on Medication Dispense List
- Added MedicationDispense.quantity coded data requirements
- Clarification on use of Medication.form
- Amendments to the Emergency Supply example scenario, including supply of both insulin and needles, and amendements to the ITK Header example
- Added requirement to reference an CareConnect-ITK-Header-Organization-1 resource within the
<sender>element of the ITK Header
- Added relevant MESH WorkflowIDs
Examples - Banners added clarifying that examples are illustrative, and have not been formally clinically assured Examples aligned with specification to correctly show Composition.section.text content:
- Location of event - FHIR Target changed to additional freetext added to Composition.section.text
- Serialisation code - optional field. Removed from examples.
- Vaccine procedure - examples changed to 955691000000108 | Seasonal influenza vaccination given by pharmacist
- Vaccine product - examples changed to 35727111000001109 | Influvac sub-unit Tetra vaccine suspension for injection 0.5ml pre-filled syringes (Mylan)
Replaced SNOMED code:
SNOMED CT Concept ID : 820261000000101
Synonym: Controlled drug dispensing record
With new SNOMED code:
SNOMED CT Concept ID :1218611000000102
Synonym : Urgent supply of prescription items by community pharmacy
Added four new areas to the Specification:
- New Medicine Service
- Medication Review
- Digital Minor Illness Refferal Service (DMIRS)
- Appliance Use Review
This produces four new compositions profiles, Messaging Architecture and Message Headings
- Message Definitions section has been removed
- All examples have the
<xml>tag which was shown at the beginning and the end, now put into a comments wrapper
<!--<xml>--> Text <!--</xml>-->
- Added new section Design & Build > Document Replacement
- Added new section Messaging Architecture>Document Profiles>Digital Medicines Document Profiles has been created and now encapsulates all information
- Added new section Message Headings > Overview of Headings has been created and now encapsulates all information
- A “FHIR Target” column has been added to every Message Heading page showing the FHIR mapping
- An in-correct SNOMED code was used in the previous release.
886721000000107 Referral details
1052891000000108 Referrer details
- All Optional elements have been highlighted in red within the Message Headings to avoid confusion when implementing
The two scenario examples contained errors which have now been fixed and run against the Test Harness. They should now correctly validate and help suppliers with more guidance.
A patch release to correct SNOMED codes for Consent and Eligibility Criteria from temp codes to actual provided values:
New codes added: 61871000000107 | Eligibility for treatment 61861000000100 | Consent
Profiles changed: Consent and Eligibility Criteria Section https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-ITK-DM-Immunization-Composition-1
Consent Section https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-ITK-DM-EmergencySupply-Composition-1
- All gist linked examples have now been embedded into the spec as inline coding
- All gist linked Message Definition examples embedded into the spec as inline coding
- “Assure” menu section has been removed
- “Deploy” menu section has been removed
- New section “Distribution list” added to the specification
- Immunizations references renamed to Vaccinations to match PRSB headings
- Referrer details renamed to Referral Details in all sections to match PRSB headings
- Following sections updated and checked to match the PRSB headings following review (Click on the links to see a change comparison)
Alpha release supporting the following for Immunizations and Emergency Medication Supply:
- FHIR profiles developed using the FHIR Release STU3 specification
- SNOMED CT coding support where applicable
This draft version includes implementation guidance to support the development of the Digital Medicines specification in preparation for an Alpha release, supporting the following for Immunizations and Emergency Medication Supply: