HL7 Europe Medication Prescription and Dispense
1.0.0 - trial-use 150

HL7 Europe Medication Prescription and Dispense, published by HL7 Europe. 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-eu/mpd-r5/ and changes regularly. See the Directory of published versions

## Examples

All examples in the Artifacts page are equipped with numbers. These numbers provide a reference, but are also created in series to show connection between examples that are connected either by being parts of the same multi-item prescription or being different resources fulfilling the same workflow.

### Medication examples

There are multiple ways to express medication information on a prescription or dispense. Overview of different granularities of medication information can be found in the Medication Concepts page.

#### Generic/virtual products

- 1A - generic product defined by attributes (powder in a vial)
- 1B - generic product defined by a codesystem concept

These two approaches are not mutually exclusive - it is perfectly acceptable to reference a codesystem concept or an identifier and fill in the attributes describing the product, as well.

#### Branded products

- 1C and 1D - branded package (powder in a vial)
- 3B - branded package (solution in ampoules, multiple active ingredients)
- 4A - branded package (powder and solvent in vials, multiple devices)
- 5A - branded package (drops, multiple active ingredients with strength given for 20 drops)

#### Combination packs (multiple products or devices in one packaging)

- 2A - combination pack including a 20g tube of creme (2A1) and 6 pessaries (2A2)
- 4A - package includes multiple administration devices

### Prescription examples

This implementation guide does not consider a prescription or dispense a HL7 FHIR document, but a transactional set of resources. There is no resource called "Prescription" in HL7 FHIR: a prescription may be implemented as a MedicationRequest, multiple MedicationRequests, or a combination of MedicationRequests and RequestOrchestration. These resources may be exchanged in a Bundle. It is also allowed to use Composition for following the document-oriented approach, but it is not normative.

Be aware, that MedicationRequest may sometimes be used as a request NOT to give/prescribe a certain medication to a patient, and MedicationDispense can be used for declining a dispense. Do-not-perform-requests are out of scope for this implementation guide, declining a dispense is only presented in the examples.

Implementations do not have to support multi-item prescriptions or dispense decline reports to be compliant with this implementation guide.

#### Single-line prescriptions

- 400C - single-line prescription, allowing multiple dispenses, uses 'actionable' tag, allows substitution. See corresponding dispense examples 400D-1 and 400D-2 to see the actual substitution.

#### Multi-line prescriptions

Following examples are all formulated using a Bundle of type 'collection'. This is just for the sake of representing the example in this IG - using Bundle is not normative in this guide.

- 100A - prescription with RequestOrchestration representing a 42-day-cycle where three treatments must start at the same time
- 300A - prescription with RequestOrchestration for two products that may be dispensed as one combination product or two separate products
- 200A - prescription where prescription items are only connected by the .groupIdentifier value

Please find more information about multi-item prescription in the implementation notes page.

### Dispense examples

- 400D-1 and 400D-2 - two dispenses for the same prescription (400C). In this example, 400D-1 is not considered a substitution (default value), and 400D-2 is considered a substitution (explicit 'wasSubstituted=true') - actual definition and rules of substitution vary across implementations.
- 300D - one dispense fulfilling two requests. Please note that this may not be supported by all implementations.
- 400E - declining a dispense

### Dosage examples

See additional information about Dosage requirements and usage examples on Dosage Patterns page.