Standardized Medication Profile (SMP) FHIR IG
1.0.0 - STU 1

Standardized Medication Profile (SMP) FHIR IG, published by HL7 International / Pharmacy. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/smp-ig/ and changes regularly. See the Directory of published versions

## Standardized Medication Profile Implementation Guide Home Page

Official URL: http://hl7.org/fhir/us/smp/ImplementationGuide/hl7.fhir.us.smp | Version: 1.0.0
IG Standards status: Trial-use | Maturity Level: 1 | Computable Name: StandardizedMedicationProfile

> This specification is currently published as a Standard for Trial Use (STU). Feedback is welcome and may be submitted through the FHIR change tracker indicating "US SMP" as the specification.

> This implementation guide is dependent on other specifications. Please submit any comments you have on these base specifications as follows:

> - Feedback on the FHIR core specification should be submitted to the FHIR change tracker with "FHIR Core" as the specification.
> - Feedback on the US core profiles should be submitted to the FHIR change tracker with "US Core" as the specification.

### Plain Language Summary about HL7 and this Guide

#### About HL7

HL7, which stands for Health Level Seven, creates standards to help different healthcare computer systems talk to each other. These HL7 standards are a special language or set of rules that lets information be shared between hospitals, doctors’ offices (e.g. Electronic Health Record Systems), labs, patients (e.g. via patient portals), pharmacies, and insurers, among others.

One of the HL7 standards is HL7 FHIR (Fast Healthcare Interoperability Resources). It helps connect healthcare systems, making it easier for doctors, nurses, and other healthcare professionals to share important information about patients. For example, if you have a lab test at a hospital, HL7 FHIR helps send the results to your doctor’s office so they can provide the right care.

A goal of HL7 is to make sure everyone involved in your healthcare has the right information at the right time. Our standards help machines and people, including you, work together to make better decisions for your health. HL7 sets rules that computer systems follow, so they can understand and share information in a consistent and reliable way.

To learn more about HL7, you can visit the website hl7.org.

The people at HL7 make guides that explain how to use the rules (standards) for different things. These guides bring the rules together and show how to use them for specific purposes.

#### About this Guide

The HL7 FHIR Standardized Medication Profile (SMP) Implementation Guide defines a way to transmit medication/drug information (as prescription or orders or records of a patient receiving some kind of medication/drug). As a patient travels through the healthcare system (such as from hospital to nursing facility to home) this guide shows how the medication/drug information can be sent electronically with the patient to enable medication reconciliation.

Medication reconciliation is a process performed by healthcare professionals (such as pharmacists) to ensure the patient is receiving the correct medications/drugs for their condition and situation. This guide does not define the medication reconciliation process, the guidelines for the process will be established for the specific healthcare profession as a standard of practice. This guides describes how data can be provided so the medication reconciliation is done with the best data available.

### Overview

This Implementation Guide identifies and defines the components of an interoperable medication profile for clinicians, patients and caregivers to use for the exchange of essential medication information. One of the main drivers is the exchange during transitions of care to and from post-acute care settings, however other use cases may also be served by this guide.

### Content and organization

The implementation guide is organized into the following sections:

- Use Cases and Overview describes the intent of the implementation guide, gives examples of its use and provides a high-level overview of expected process flow
- Domains describes the use, motivation, and approach for implementation.
- Technical Background describes the different specifications this implementation guide relies on and indicates what developers should read and understand prior to implementing this specification
- Formal Specification covers the detailed implementation requirements and conformance expectations
- Artifacts introduces and provides links to the FHIR R4 profiles, operations and other FHIR artifacts used in this implementation guide
- Downloads allows download of this and other specifications as well as other useful files
- References formal reference to quoted publications

### Dependencies

This guide is based on the FHIR R4 specification that is mandated for use in the U.S.

In addition, this guide also relies on a number of parent implementation guides:

Implementation Guide | Version(s) | Reason
--- | --- | ---
Bulk Data Access IG | 2.0.0 | Imported by US Core (and potentially others)
FHIR Extensions Pack | 5.2.0 | Automatically added as a dependency - all IGs depend on the HL7 Extension Pack
1.0.0 | Imported by US Core (and potentially others)
FHIR R4 package : Core | 4.0.1 | Imported by HL7 Terminology (THO) (and potentially others)
HL7 Terminology (THO) | 6.3.0 | Automatically added as a dependency - all IGs depend on HL7 Terminology
5.0.0 | Imported by US Core (and potentially others)
IHE FormatCode Vocabulary | 1.1.0 | Imported by US Core (and potentially others)
Public Health Information Network Vocabulary Access and Distribution System (PHIN VADS) | 0.12.0 | Imported by US Core (and potentially others)
SMART App Launch | 2.1.0 | Imported by US Core (and potentially others)
Structured Data Capture | 3.0.0 | Imported by US Core (and potentially others)
US Core | 6.1.0 |
Value Set Authority Center (VSAC) | 0.21.0 |
0.11.0 | Imported by US Core (and potentially others)

This implementation guide defines additional constraints and usage expectations above and beyond the information found in these base specifications.

### Intellectual Property Considerations

This implementation guide and the underlying FHIR specification are licensed as public domain under the FHIR license. The license page also describes rules for the use of the FHIR name and logo.

This publication includes IP covered under the following statements.

- ISO Maintains the copyright on the country codes, and controls it's use carefully. For futher details see the ISO 3166 web page: https://www.iso.org/iso-3166-country-codes.html
  Show Usage
  - ISO 3166-1 Codes for the representation of names of countries and their subdivisions — Part 1: Country code: SMPBundle, SMPBundleTransaction... Show 13 more, SMPMedication, SMPMedicationAdministration, SMPMedicationList, SMPMedicationStatement, SMPOperationRetrieve, SMPOperationSubmit, SMPParametersOutcome, SMPParametersQuery, SMPParametersResponse, SMPParametersSubmit, SMP_Client, SMP_Server and StandardizedMedicationProfile
- The UCUM codes, UCUM table (regardless of format), and UCUM Specification are copyright 1999-2009, Regenstrief Institute, Inc. and the Unified Codes for Units of Measures (UCUM) Organization. All rights reserved. https://ucum.org/trac/wiki/TermsOfUse
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  - Unified Code for Units of Measure (UCUM): MedicationAdministration/smp-medadm-1
- This material contains content from LOINC. LOINC is copyright © 1995-2020, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and is available at no cost under the license. LOINC® is a registered United States trademark of Regenstrief Institute, Inc.
  Show Usage
  - LOINC: Bundle/smp-bundle-1, Bundle/smp-bundle-tx-1... Show 5 more, List/smp-medlist-1, Parameters/smp-history-input-parameters-1, Parameters/smp-history-output-parameters-1, Parameters/smp-submit-input-parameters-1 and SMPMedicationList
- This material contains content that is copyright of SNOMED International. Implementers of these specifications must have the appropriate SNOMED CT Affiliate license - for more information contact https://www.snomed.org/get-snomed or info@snomed.org.
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  - SNOMED Clinical Terms&reg; (SNOMED CT&reg;): Bundle/smp-bundle-1, Bundle/smp-bundle-tx-1... Show 6 more, Medication/smp-med-1, MedicationAdministration/smp-medadm-1, MedicationStatement/smp-medstmt-1, MedicationStatement/smp-medstmt-2, Parameters/smp-history-output-parameters-1 and Parameters/smp-submit-input-parameters-1
- This material derives from the HL7 Terminology (THO). THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license.html
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  - identifierType: Parameters/smp-history-input-parameters-1
- Using RxNorm codes of type SAB=RXNORM as this specification describes does not require a UMLS license. Access to the full set of RxNorm definitions, and/or additional use of other RxNorm structures and information requires a UMLS license. The use of RxNorm in this specification is pursuant to HL7's status as a licensee of the NLM UMLS. HL7's license does not convey the right to use RxNorm to any users of this specification; implementers must acquire a license to use RxNorm in their own right.
  Show Usage
  - RxNorm: Bundle/smp-bundle-1, Bundle/smp-bundle-tx-1... Show 5 more, MedicationAdministration/smp-medadm-1, MedicationStatement/smp-medstmt-1, MedicationStatement/smp-medstmt-2, Parameters/smp-history-output-parameters-1 and Parameters/smp-submit-input-parameters-1

### Acknowledgements

This implementation guide was created under the supervision and review of the HL7 Pharmacy Work Group (sponsor) with Patient Care (co-sponsor) and EHR (co-sponsor) work groups.

This implementation guide was co-developed and balloted with the National Council for Prescription Drug Programs (NCPDP)

Organizational participants included: The participants of the NCPDP WG14/WG10 Standardized Medication Profile Task Group

Our thanks to these and to the many others who contributed their time, enthusiasm and expertise to this work.

#### Authors

Primary authors:

name | organization | contact
--- | --- | ---
Andy Stechishin | CANA Software & Services Ltd. | andy@canasoftware.ca

Guide Author Support:

name | organization | contact
--- | --- | ---
Rachelle (Shelly) Spiro | Pharmacy HIT Collaborative | shelly@pharmacyhit.org

Supporting Resources Provided by the Department of Veterans Affairs:

name | department | contact
--- | --- | ---
Mary Kay McDaniel | Health System Specialist, KBS Standards and Interoperability | marykay.mcdaniel@va.gov