IE Medication Events Implementation Guide
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IE Medication Events Implementation Guide - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Patient Profile & Scenarios (reference)

Reference examples, for illustration only. This material was first published in IE Core 0.2.0 and moved here with the ePrescription and eDispensation profiles (IE Core ADR-009). The scenarios, payloads and foreign product codes are illustrative: all people, organisations and identifiers are fictional, and the cross-border flows are not specified by HIQA. They show how the IE MPD profiles can be used; they are not normative.

Patient Profile — Seán Patrick Murphy

The following patient is used throughout all cross-border ePrescription examples in this guide. He represents a typical Irish patient with multiple chronic conditions travelling across the EU.

Field Value
Name Seán Patrick Murphy
DOB 15 March 1975
Gender Male
Nationality Irish (IE)
PPS Number 1234567T
IHI 210000000099887766
eIDAS ID IE/[CountryCode]/1234567T
Address 14 Grafton Street, Dublin 2, D02 XY45, Ireland
GP Dr. Aoife O'Brien, Grafton Street Medical Practice
GP Number GP-IE-12345

⚠️ Critical Allergy

Penicillin / Amoxicillin — ANAPHYLAXIS (Severe)

Documented 1995. Do NOT dispense penicillin-class antibiotics.

This allergy alert is carried in all cross-border FHIR bundles as an AllergyIntolerance resource with criticality: high and severity: severe.

See: AllergyIntolerance – Penicillin (Example)

Active Conditions

Condition ICD-10 SNOMED CT Active Since
Type 2 Diabetes Mellitus E11 44054006 2018
Essential Hypertension I10 38341003 2019
Hypercholesterolaemia E78.0 13644009 2020

See examples:

Current Medications

Medication Dose Frequency Indication ATC
Metformin 500mg 500mg Twice daily with meals Type 2 Diabetes A10BA02
Lisinopril 10mg 10mg Once daily (morning) Hypertension C09AA03
Atorvastatin 20mg 20mg Once daily (night) Hypercholesterolaemia C10AA05

Medication resources: Lisinopril 10mg

Prescription Lifecycle

stateDiagram-v2
    direction LR
    [*] --> Issued : GP issues ePrescription
    Issued --> Transmitted : NCPeH IE signs & transmits
    Transmitted --> Retrieved : EU pharmacy retrieves via MyHealth@EU
    Retrieved --> Verified : Pharmacy verifies & checks allergies
    Verified --> Dispensed : Medication dispensed
    Dispensed --> Confirmed : eDispensation sent to NCPeH IE
    Confirmed --> [*] : Prescription marked as used

    Verified --> Rejected : Allergy conflict / invalid prescription
    Rejected --> [*]

eIDAS Patient Identifier Format

Cross-border patient identification follows the eIDAS Regulation format:

flowchart LR
    PID["eIDAS Cross-Border Patient ID<br/><b>Origin / Destination / NationalID</b>"]
    PID --> A["**Country of Origin**<br/>ISO 3166-1 alpha-2<br/><i>e.g. IE, FI, BE</i>"]
    PID --> B["**Country of Destination**<br/>ISO 3166-1 alpha-2<br/><i>e.g. DE, ES, FR</i>"]
    PID --> C["**National Identifier**<br/>Home country ID<br/><i>e.g. PPSN: 1234567T</i>"]

    A --> O1["IE/DE/1234567T<br/>Irish patient in Germany"]
    A --> O2["IE/ES/1234567T<br/>Irish patient in Spain"]
    A --> O3["IE/AT/1234567T<br/>Irish patient in Austria"]
    A --> I1["FI/IE/123456-7890<br/>Finnish patient in Ireland"]
    A --> I2["BE/IE/12345678901<br/>Belgian patient in Ireland"]

    style O1 fill:#e8f5e9,stroke:#4caf50
    style O2 fill:#e8f5e9,stroke:#4caf50
    style O3 fill:#e8f5e9,stroke:#4caf50
    style I1 fill:#e3f2fd,stroke:#2196f3
    style I2 fill:#e3f2fd,stroke:#2196f3
Cross-Border Route eIDAS Identifier
Ireland → Germany IE/DE/1234567T
Ireland → Spain IE/ES/1234567T
Ireland → France IE/FR/1234567T
Ireland → Netherlands IE/NL/1234567T
Ireland → Latvia IE/LV/1234567T
Ireland → Portugal IE/PT/1234567T
Ireland → Denmark IE/DK/1234567T
Ireland → Sweden IE/SE/1234567T
Ireland → Austria IE/AT/1234567T
Finland → Ireland FI/IE/123456-7890
Belgium → Ireland BE/IE/12345678901

Cross-Border Scenarios

Outbound: Ireland → EU

Scenario 1: Ireland → Germany 🇩🇪

Field Value
Date 20 January 2025
Pharmacy Apotheke am Brandenburger Tor, Pariser Platz 1, 10117 Berlin
Medications dispensed Metformin 500mg + Lisinopril 10mg
Format FHIR (xt-EHR) + CDA (eHDSI)
Status ✅ Dispensed with generic substitution
Validity rule 90 days (Arzneimittelgesetz §48)

German Product Mapping (PZN):

Irish Medication German Equivalent PZN Code
Metformin 500mg Metformin 500mg Filmtabletten (Ratiopharm) 04823246
Lisinopril 10mg Lisinopril 10mg Tabletten (Hexal) 03990693

FHIR Example: IE→DE ePrescription Bundle · eDispensation: DE eDispensation Response

Scenario 2: Ireland → Spain 🇪🇸

Field Value
Date 10 February 2025
Pharmacy Farmàcia Central, Passeig de Gràcia 45, 08007 Barcelona
Medications dispensed Metformin 500mg + Lisinopril 10mg + Atorvastatin 20mg
Format FHIR (xt-EHR)
Status ✅ All 3 medications dispensed
Validity rule 90 days (Real Decreto 1718/2010)

Spanish Product Mapping (CIMA):

Irish Medication Spanish Equivalent CIMA Code
Metformin 500mg Metformina Cinfa 500mg comprimidos 60918
Lisinopril 10mg Lisinopril Kern Pharma 10mg comprimidos 57552
Atorvastatin 20mg Atorvastatina Cinfa 20mg comprimidos 72242

FHIR Example: IE→ES ePrescription Bundle

Scenario 3: Ireland → France 🇫🇷

Field Value
Date 5 March 2025
Pharmacy Pharmacie de la Madeleine, Place de la Madeleine, 75008 Paris
Medications dispensed Metformin 500mg + Lisinopril 10mg
Format FHIR (xt-EHR)
Status ✅ Dispensed (ordonnance transfrontalière)
Validity rule 3 months (Code de la Santé Publique)

French Product Mapping (CIP):

Irish Medication French Equivalent CIP Code
Metformin 500mg METFORMINE BIOGARAN 500mg comprimé pelliculé 3402895
Lisinopril 10mg LISINOPRIL BIOGARAN 10mg comprimé 3400936

FHIR Example: IE→FR ePrescription Bundle

Scenario 4: Ireland → Netherlands 🇳🇱

Field Value
Date 1 April 2025
Pharmacy Apotheek Dam, Damrak 1, 1012 LG Amsterdam
Medications dispensed Metformin 500mg + Lisinopril 10mg + Atorvastatin 20mg
Format FHIR (xt-EHR)
Status ✅ All 3 medications dispensed
Validity rule 3 months (Geneesmiddelenwet)

Dutch Product Mapping (G-Standaard GNK):

Irish Medication Dutch Equivalent GNK Code
Metformin 500mg Metformine HCl 500mg tabletten 1701410
Lisinopril 10mg Lisinopril 10mg tabletten 1701420
Atorvastatin 20mg Atorvastatine 20mg tabletten 1701430

FHIR Example: IE→NL ePrescription Bundle

Scenario 5: Ireland → Latvia 🇱🇻

Field Value
Date 15 June 2025
Pharmacy Mēs atdot Aptieka, Riga
Medications dispensed Metformin 500mg + Lisinopril 10mg
Format FHIR (MPD)
Status ✅ Dispensed
Validity rule 90 days (LR Farmācijas likums)

Latvian Product Mapping (ZRA):

Irish Medication Latvian Equivalent ZRA Code
Metformin 500mg Metformins 500mg tabletes ZRA-00098432
Lisinopril 10mg Lizinoprils 10mg tabletes ZRA-00102345

FHIR Example: IE→LV ePrescription Bundle · eDispensation: LV eDispensation

Scenario 6: Ireland → Portugal 🇵🇹

Field Value
Date 20 June 2025
Pharmacy Farmácia Central, Lisbon
Medications dispensed Sertraline 50mg + Omeprazole 20mg
Format FHIR (MPD)
Status ✅ Dispensed
Validity rule 90 days (Portaria nº 298/2019)
Substitution note Sertraline dispensed without substitution (psychiatric medication)

Portuguese Product Mapping (INFARMED):

Irish Medication Portuguese Equivalent INFARMED Code
Sertraline 50mg Sertralina 50mg Comprimidos INF-00012345
Omeprazole 20mg Omeprazol 20mg Cápsulas INF-00056789

FHIR Example: IE→PT ePrescription Bundle · eDispensation: PT eDispensation

Scenario 7: Ireland → Denmark 🇩🇰

Field Value
Date 1 July 2025
Pharmacy Apoteket, Copenhagen
Medications dispensed Warfarin 5mg
Format FHIR (MPD)
Status ✅ Dispensed with INR monitoring note
Validity rule 90 days (Danish Medicines Agency)
⚠️ Clinical note Anticoagulant — no substitution. INR target 2.0–3.0. Patient must contact local anticoagulation clinic.

Danish Product Mapping (DKMA/VNR):

Irish Medication Danish Equivalent VNR Code
Warfarin 5mg Warfarin 5mg Tabletter 00892628

FHIR Example: IE→DK ePrescription Bundle

Scenario 8: Ireland → Sweden 🇸🇪

Field Value
Date 10 July 2025
Pharmacy Apoteket Hjärtat, Stockholm
Medications dispensed Insulin Glargine 100u/ml + Insulin Aspart 100u/ml
Format FHIR (MPD)
Status ✅ Dispensed
Validity rule 90 days (Läkemedelslag)
Substitution note No substitution for insulin — dose continuity requires same brand

Swedish Product Mapping (LMV):

Irish Medication Swedish Equivalent LMV Code
Insulin Glargine Insulin Glargine 100 E/ml Injektionsvätska SE-LMV-00892345
Insulin Aspart Insulin Aspart 100 E/ml Injektionsvätska SE-LMV-00892346

FHIR Example: IE→SE ePrescription Bundle

Scenario 9: Ireland → Austria 🇦🇹

Field Value
Date 15 July 2025
Pharmacy Apotheke zur goldenen Kugel, Vienna
Medications dispensed Atorvastatin 80mg + Ramipril 10mg
Format FHIR (MPD)
Status ✅ Dispensed
Validity rule 90 days (Austrian Medicines Act)

Austrian Product Mapping (BASG):

Irish Medication Austrian Equivalent BASG Code
Atorvastatin 80mg Atorvastatin 80mg Filmtabletten AT-BASG-0089234567
Ramipril 10mg Ramipril 10mg Filmtabletten AT-BASG-0089234568

FHIR Example: IE→AT ePrescription Bundle

Inbound Workflow: EU Patient → Ireland (via NePS)

The following sequence diagram shows how a foreign EU prescription is dispensed at an Irish pharmacy using the National ePrescription Service (NePS).

sequenceDiagram
    autonumber
    participant Patient as 👤 EU Patient<br/>(EUDI Wallet / eIDAS)
    participant Pharmacy as 🏥 Irish Pharmacy<br/>(NePS-connected)
    participant NePS as 🇮🇪 NePS<br/>(National ePrescription Service)
    participant NCPeH_IE as NCPeH Ireland<br/>(HSE)
    participant Hub as 🌐 MyHealth@EU Hub
    participant NCPeH_EU as 🇪🇺 Home Country<br/>NCPeH

    Patient->>Pharmacy: Present with eIDAS digital ID
    Pharmacy->>NePS: Query foreign prescription<br/>(cross-border PID)
    NePS->>NCPeH_IE: Forward patient discovery request
    NCPeH_IE->>Hub: XCPD patient discovery<br/>(cross-border PID lookup)
    Hub->>NCPeH_EU: Query home country NCPeH
    NCPeH_EU-->>Hub: Return prescription documents
    Hub-->>NCPeH_IE: Deliver foreign ePrescription
    NCPeH_IE-->>NePS: Prescription + foreign drug codes
    NePS->>NePS: Map foreign codes → Irish NMPC codes
    NePS-->>Pharmacy: Provide mapped prescription
    Pharmacy->>Patient: Dispense medication<br/>(Irish NMPC product codes)
    Pharmacy->>NePS: Record eDispensation
    NePS->>NCPeH_IE: Confirm dispensation
    NCPeH_IE->>Hub: Send eDispensation back
    Hub->>NCPeH_EU: Prescription marked as used

Scenario 10: Finland → Ireland 🇫🇮

Field Value
Date 1 August 2025
Patient Mikko Korhonen (Finnish citizen, eIDAS: FI/IE/123456-7890)
Irish Pharmacy Hickey's Pharmacy, O'Connell Street, Dublin
Medications dispensed Metformin 500mg
Format FHIR (MPD via NePS)
Status ✅ Finnish prescription mapped through NePS
Code mapping Finnish product → Irish NMPC VMP 718271000220105 Metformin hydrochloride 500 mg oral tablet

FHIR Example: FI→IE Dispensation via NePS

Scenario 11: Belgium → Ireland 🇧🇪

Field Value
Date 5 August 2025
Patient Lars Janssen (Belgian citizen, eIDAS: BE/IE/12345678901)
Irish Pharmacy McCauley's Pharmacy, Grafton Street, Dublin
Medications dispensed Atorvastatin 40mg
Format FHIR (MPD via NePS)
Status ✅ Belgian prescription mapped through NePS
Code mapping Belgian product → Irish NMPC VMP 254331000220107 Atorvastatin 40 mg oral tablet

FHIR Example: BE→IE Dispensation via NePS

Drug Code Systems by Country

Not verified. The national product code systems and codes below were in earlier drafts of this IG. Their FHIR system URIs and codes could not be verified, so they were removed from the sample payloads (ADR-007, HZ-10). The payloads now carry SNOMED CT and ATC only. Obtain each Member State's code system from its National Contact Point (eHDSI Master Value Set Catalogue) rather than from this table. For Ireland, see Terminology Services: SNOMED CT Irish Edition, including the NMPC, with system http://snomed.info/sct and version http://snomed.info/sct/1601000220105.

Country System System URI (unverified) Example Code (illustrative)
🇮🇪 Ireland SNOMED CT Irish Edition (incl. NMPC) + ATC http://snomed.info/sct + version http://snomed.info/sct/1601000220105 (NMPC concept ID from the HSE CTS)
🇩🇪 Germany PZN http://fhir.de/CodeSystem/ifa/pzn 04823246
🇪🇸 Spain CIMA http://vocabularies.cesec.org/public-api/v1/codes/cima 60918
🇫🇷 France CIP http://idref.fr/CIP 3402895
🇳🇱 Netherlands G-Standaard GNK http://www.gipdatabank.nl/farmaca 1701410
🇱🇻 Latvia ZRA http://www.zva.gov.lv/zalu-registrs ZRA-00098432
🇵🇹 Portugal INFARMED http://www.infarmed.pt INF-00012345
🇩🇰 Denmark DKMA/VNR http://www.dkma.dk 00892628
🇸🇪 Sweden LMV http://www.lakemedelsverket.se SE-LMV-00892345
🇦🇹 Austria BASG http://www.basg.gv.at AT-BASG-0089234567
🇧🇪 Belgium CNPV http://www.cnpv.be BE-CNPV-XXXX
🇫🇮 Finland Kela/FIN http://www.kela.fi FIN-XXXX
🇪🇺 EU (all) ATC (WHO) http://www.whocc.no/atc A10BA02
🇪🇺 EU (all) SNOMED CT http://snomed.info/sct 372567009

Prescription Validity Rules by Country

Not verified. These periods and legal references come from an earlier draft and have not been checked against the national legislation. Confirm them with each Member State before relying on them.

Country Cross-Border Validity Legal Basis
🇩🇪 Germany 90 days from issue Arzneimittelgesetz §48
🇪🇸 Spain 90 days from issue Real Decreto 1718/2010
🇫🇷 France 3 months (ordonnance) Code de la Santé Publique
🇳🇱 Netherlands 3 months Geneesmiddelenwet
🇱🇻 Latvia 90 days LR Farmācijas likums
🇵🇹 Portugal 90 days Portaria nº 298/2019
🇩🇰 Denmark 90 days Danish Medicines Agency
🇸🇪 Sweden 90 days Läkemedelslag
🇦🇹 Austria 90 days Austrian Medicines Act
🇪🇺 EU (eHDSI) 90 days max eHDSI Technical Specifications