HL7 FHIR Implementation Guide - New Zealand Formulary/NZULM IG
0.1.0 - ci-build

HL7 FHIR Implementation Guide - New Zealand Formulary/NZULM IG, published by New Zealand Medicines Formulary LP. This is not an authorized publication; it is the continuous build for version 0.1.0). This version is based on the current content of https://github.com/HL7NZ/nzf/ and changes regularly. See the Directory of published versions

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This IG is to support retrieving formulary and medication information in New Zealand. This is part of a project by the NZULM/NZ Formulary to provide the information we produce and collate in a standards-based form. As an organisation we want to make it as easy as possible to retrieve the medication information that you require in a timely manner.

The key resource for this implementation is the Medication resource. For those that are familiar with the New Zealand Medicines Terminology (NZMT) we will provide a medication resource for the key types of medications in the NZMT. These are:

  • Medicinal Product (MP) e.g. paracetamol
  • Trade Product (TP) e.g. panadol
  • Medicinal Product Unit of Use (MPUU) e.g. paracetamol 500 mg tablet
  • Trade Product Unit of Use (TPUU) e.g. Panadol (paracetamol 500 mg) tablet: film-coated, 1 tablet
  • Container Trade Product Pack (CTPP) e.g. Panadol 500 mg tablet: film-coated, 1000 tablets, blister pack
  • Medicinal Product Pack (MPP) e.g. paracetamol 120 mg/5 mL oral liquid, 200 mL
  • Trade Product Pack (TPP) e.g. Panadol 500 mg tablet: film-coated, 12 tablets

The standard Medication resource provides the key information needed for integration however we have defined several extensions to allow for the addition of specific NZULM/Formulary information. The following table describes these extensions and shows which extensions apply to which medication type.

Extension Description MP TP MPUU TPUU MPP TPP CTPP
Type Type of NZMT reference (e.g. CTPP, MPUU) etc. Yes Yes Yes Yes Yes Yes
Cautionary and Advisory Labels (CALs) List of all Cautionary and Advisory labels associated with the medication Yes Yes Yes Yes Yes
ATC The Anatomical Therapeutic Chemical Classification code(s) Yes Yes Yes Yes Yes Yes Yes
Unapproved True if the medication has not been approved by Medsafe and can be prescribed under section 29 Yes
Legal Classification Medsafe legal classification Yes Yes Yes
Medsafe Status Medsafe product status Yes
Prescribe by Brand Whether the medication should be prescribed by brand or not Yes
Funding NZ specific funding information provided by pharmac Yes
Funding rules The rules and constraints around funding for the given medicine provided by pharmac Yes
Pharmac Supply Information Pharmac provided information detailing medication supply issues Yes Yes Yes Yes Yes Yes Yes
Links Links to associated resources, such as monographs, datasheets and patient information leaflets Yes Yes Yes Yes Yes Yes Yes

The medication resources will also link to several documents (using the link extension). To facilitate this, we use DocumentReference resources.

We provide document references for the following data:

Data Description
Adult monographs A reference to all adult monographs - this allows for integrating systems to determine which monograph(s) to link to for a given medication
Child monographs A reference to all children monographs - this allows for integrating systems to determine which monograph(s) to link to for a given medication
Patient information leaflets A link to all patient information leaflets - these contain a number of extensions to provide extra information about the PIL (see mapping tab)
Medsafe Datasheets A reference to all medsafe datasheet URLs
Medsafe CMIs A reference to all medsafe CMI URLs
Pharmac Special Authority Forms A reference to all pharmac special authority forms, including the form XML

Funding information

Funding information is added to Container Trade Product Packs where applicable. The funding information is derived from both the Pharmac community schedule as well as the HML.

There are two extensions added that store this information. The first is nzf-funding. This stores the general information around funding for a specific product, including some of the community schedule details (price etc.) - see extension details To cater for the existence of multiple schedules this extension can be added to a product multiple times, once per schedule. This allows vendors to see both the current schedule information as well as an upcoming schedule. To determine which set of information to use the 'scheduleDate' field can be used. The second extension is nzf-funding-rule. This extension once again has a schedule date so vendors can determine which schedule they would like to look at. The purpose of this extension is to provide the pharmac funding rules that apply to the given product. Most of the data here comes from the ps_rule table (in the NZMT releases) however a number of attribute rules are also added. These are:

Name Condition Rule Type Rule value Rule text
Sole subsidy When a CTPP associated with a ps_brand entry has the sole_supply flag set SoleSupply Sole Subsided Supply
Principal Sole Supply When a CTPP associated with a ps_brand entry has the pss flag set PrincipalSoleSupply Principal Sole Supply
Cost Brand Source When a CTPP associated with ps_pack entry has cost brand source = 1 CostBrandSource CBS
Original Pack When a CTPP associated with ps_pack entry has originalPack = 1 OriginalPack Original Pack
Hospital Supply Status When a CTPP associated with a ps_brand entry has the hss set HospitalSupplyStatus Hospital Supply Status
Safety: Uncompounded ps_formulary.safety = Uncompounded Safety Uncompounded Safety cap required
Safety: Compounded ps_formulary.safety = compounded Safety Compounded Safety cap required for extemporaneously compounded oral liquid preparations
Statim ps_formulary.statim = Must Statim Must Statim: Three months or six months, as applicable, dispensed all-at-once.
Statim ps_formulary.statim = Must Statim Must Statim: Three months or six months, as applicable, dispensed all-at-once.

See see extension details

As we stated we want this to be as useful as possible so please get in touch if you have any feedback.