Schema: MedicationStatement

Introduction

The headings below list the elements of the MedicationStatement profile and describe how to populate and consume them.

Tip: You’ll find it helpful to read it in conjunction with the underlying MedicationStatement profile definition.

MedicationStatement Elements

id

The logical identifier of the MedicationStatement profile.

meta.profile

The MedicationStatement profile URL.

Fixed value https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-MedicationStatement-1

extension[lastIssueDate]

The date when the latest prescription under this plan was issued. This will not be populated where the Medication/Medical Device is Repeat Dispensed or Prescribed Elsewhere as these do not have issue information recorded in the GP system.

extension[prescribingAgency]

This details the care setting in which the medication or medical device was prescribed.

Currently this field will only support two coded entries, indicating whether the medication/medical device was prescribed by the GP practice or by another organisation. If the providing organisation has more details about the type of prescribing organisation (for example, that it was a dental practice or hospital), this will be included in the CodeableConcept.Text field.

In the future, the coded valueset will be built on to be more specific about where a medication/medical device was prescribed. For instance, if the patient was prescribed a medication by a hospital or bought a medication over the counter then this would be coded as well as in the text.

For repeat and repeat dispensed medications/medical devices, the value identifies the care setting where the medication plan (rather than any specific issue in the plan) was authorised.

identifier

This will be populated with a globally unique and persistent identifier (that is, it doesn’t change between requests and therefore stored with the source data).

basedOn

Link to the MedicationRequest that this MedicationStatement is based on.

Every MedicationStatement will be based on a MedicationRequest with intent set to plan.

context

The Encounter within which the medication/medical device was authorised.

As per base profile guidance.

status

The status of the authorisation.

Use one of active, completed or stopped:

• active represents an active authorisation - used for active repeat medications/medical devices

• stopped represents an authorisation which has been discontinued, cancelled or stopped

• complete represents an authorisation which has run its course

For repeat and repeat dispensed the status refers to the status of the plan (the entire cycle of prescriptions).

For acute, the status refers to the status of the prescription issue.

medicationReference

The medication/medical device the authorisation is for.

The Medication profile provides the coded representation of the medication/medical device.

effective

The period the medication or medical device is authorised under this medication/medical device plan. For items that are repeats and repeat dispensed this refers to the entire cycle of prescriptions made under the authorisation. For acutes, this refers to the period of the prescription issue.

Period.start is MANDATORY.

The date from which the medication or medical device is authorised under this plan.

Use one of the following dates in order of descending preference:

• the authorised date as recorded in the patient record

  • for authorisation that were performed during a consultation this will be the date when the consultation took place

• the date of the first issue under the medication/medical device plan

• the date the medication/medical device plan was recorded onto the system (the audit date)

Period.end is REQUIRED.

The date when the authorisation under this plan ends.

Where the medication/medical device plan is still active, set to null.

Where the medication/medical device plan has ended use one of the following dates in order of descending preference:

• the end date recorded in the patient record

• the end date of the final issue under the medication/medical device plan

• the date the plan was updated to ended

• the Period.start date

  • this option should only occur where data has been lost (for example, during the record transfer between two systems) and is used to ensure that an ended plan will always have an end date

dateAsserted

When this medication statement was believed true.

Unless there is a distinct user-modifiable availability date/time for the authorisation, this is the audit trail date/time for when the authorisation was entered.

informationSource

Person or organization that provided the information about the taking of this medication

subject

Who the medication/medical device is for - that is, to whom it will be administered.

Reference to patient.

taken

Whether a medication/medical device was taken.

note

All notes that are associated with this medication/medical device record.

All patient notes and prescriber notes at authorisation(plan) and issue(order) level will be included in this field. They will be concatenated and indicate the level the notes come from (for example, 1st Issue) and be prefixed with either ‘Patient Notes:’ or ‘Prescriber Notes:’ as appropriate.

dosage.text

Complete dosage instructions as text.

Where the dosage instructions have been changed during the lifetime of the Medication/Medical Device plan append the following warning text to end of the dosage instructions:

• “WARNING – Dosage has changed during the effective period. The latest change was made on DD-Mmm-YYYY”, where DD-Mmm-YYYY is the date the dosage was last changed.

In exceptional cases where for legacy data there is no dosage recorded in the system then this will be populated with the text ‘No information available’.

dosage.patientInstruction

Additional instructions for patient - that is, RHS of prescription label.