IE (Ireland) Core Implementation Guide
0.3.0 - draft Ireland flag

IE (Ireland) Core Implementation Guide - Local Development build (v0.3.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Medication List

Medication List Guidance

IE Core provides generic medication profiles that other guides build on:

Profile Use Case
IE Core Medication Medication definitions and details
IE Core MedicationStatement What a patient is taking or has taken (the medication list, HIQA PS 6.3)

Irish ePrescription and eDispensation (the HIQA Draft National Standard for Electronic Prescriptions and Electronic Dispensations, HL7 Europe MPD, cross-border ePrescription) are profiled in IE Medication Events (nostalgic-ie.fhir.medication-events), not in IE Core (ADR-009). Prescriptions and dispense records are profiled there.

Active Medication List

To retrieve a patient's active medication list:

GET [base]/MedicationStatement?patient=[id]&status=active

Medication Terminology Standards (HIQA)

In IE Core medication resources, the National Medicinal Product Catalogue (NMPC) is the preferred primary medication code wherever available. SNOMED CT Irish Edition is the preferred secondary medication coding wherever available, supporting semantic interoperability and cross-border exchange. This aligns the IG with Irish medicines standardisation efforts while continuing to use SNOMED International and the Irish National Release Centre for secondary clinical terminology.

Code System Status Use Notes
NMPC (via CTS) Preferred primary Primary Irish medicinal product code NMPC products are SNOMED CT concepts in the Irish Extension (module 1601000220105). Query the HSE Central Terminology Server (CTS) at https://nmpc.hse.ie/production1/fhir. Use VMP concepts for generic prescribing; AMP/AMPP for branded products and dispensing.
SNOMED CT Irish Edition Preferred secondary Secondary clinical drug terminology System URL: http://snomed.info/sct/1601000220105. Carry as an additional coding wherever available. Use concepts under 373873005 \| Pharmaceutical / biologic product hierarchy.
ATC (WHO) Recommended International classification of drugs Use alongside NMPC/SNOMED where needed for international classification and EU cross-border interoperability (EHDS/MyHealth@EU). Mapped from NMPC via CTS ConceptMap.
LOINC Recommended Laboratory-related medication observations Used for observation codes related to medication monitoring.
ICD-10 Optional Indication coding May be used for diagnosis/indication alongside SNOMED CT.

Preferred Coding Pattern

Use the following coding order wherever possible:

  1. NMPC (SNOMED CT Irish Edition concept) as the primary coding — retrieve from the CTS using the appropriate product level (VMP for generic, AMP for branded, AMPP for dispensing)
  2. SNOMED CT Irish Edition as a secondary coding where available (typically the same concept as the NMPC code, with the SNOMED IE system URL)
  3. ATC as an additional coding where needed for classification or EU exchange

See the Terminology Services (CTS & NMPC) page for detailed coding examples, FHIR $expand queries, PCRS filtering, and HPRA mapping guidance.

Why Not RxNorm?

RxNorm is a US-specific drug terminology maintained by the National Library of Medicine (NLM). It is not recommended for Irish implementations because:

  • It covers only US-marketed drug products
  • It does not include Irish or European medicinal product identifiers
  • SNOMED CT provides equivalent (and broader) clinical drug coverage with international applicability
  • EU cross-border exchange (EHDS) uses SNOMED CT and ATC, not RxNorm

Irish Medication Schemes

Ireland has several medication reimbursement schemes:

Scheme Description IE Core Support
GMS (General Medical Services) Medical card covering the cost of prescribed medicines Patient.identifier, type medical-card
DPS (Drugs Payment Scheme) Limits monthly expenditure per household Patient.identifier, type dps
LTI (Long-Term Illness) Covers medicines for specified long-term conditions Patient.identifier, type lti
Health (Amendment) Act card Covers people who contracted Hepatitis C from blood products Patient.identifier, type haa
PCRS (Primary Care Reimbursement Service) Processes claims for the community drug schemes Scheme numbers as above

Scheme numbers are HIQA PS 1.3.3 "other identifiers". They are carried as Patient.identifier entries whose type comes from IECorePCRSSchemeType (a placeholder code system, Requires Clarification). No number formats are enforced because HIQA gives none (ADR-006). Scheme membership for reimbursement can also be recorded as IE Core Coverage.

Medication Adherence

The IE Core Medication Adherence Extension can be used on MedicationRequest to capture adherence information:

  • Whether the patient is adhering to the prescribed regimen
  • The source of the adherence information (patient self-report, pharmacy records, etc.)