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

HIQA Alignment

Rules this IG follows

• Trace every element. Each of the 242 HIQA EP data elements maps to an element here, or is recorded as a gap. See HIQA Traceability for the counts and every row.
• Send only the dataset. An ePrescription carries only the HIQA EP patient dataset. See Data Minimisation.
• Invent nothing. SNOMED CT, LOINC and UCUM codes are checked on tx.fhir.org; NMPC codes are checked in the NMPC Meds Catalogue (see Terminology). Where HIQA does not settle a question, the IG uses a clearly named placeholder and logs it in Open Issues.
• Build on Europe. The prescription, dispense and medication profiles derive from HL7 Europe MPD 1.0.0, so an Irish ePrescription is also a valid European one.

How HIQA maps to this IG

HIQA EP	IE MPD
Section 1: Patient	Patient (ePrescription): the EP dataset only
1.6: Clinical information (allergies, weight, height)	Allergy statement required on every prescription; AllergyIntolerance; body weight and body height
Section 2: Health practitioner	Practitioner (IMC, PSI, NMBI, Dental Council), PractitionerRole, Organization (PSI RPB, GMS Panel), Location (GLN)
Section 3: The prescription as a whole (identifier, date of issue, status, presented form)	Prescription Group Header in the Electronic Prescription Group (ePG), which also holds the items, their eDispensations and provenance; see Electronic Prescription Group
Sections 3.5–5: Electronic prescriptions (eP; HIQA prescription items), medication, dosage	MedicationRequest (ePrescription), Medication, Dosage; see Dosage
2.13: Signature, cross-border	Signature Provenance, cross-border ePG
Section 6: Dispensation	MedicationDispense (eDispensation)
Element by element	Logical model HIQAEPrescriptionLM

Rules enforced as invariants

Invariant	Rule	HIQA
ie-bnd-rx-1	A multi-item prescription shares one group identifier	EP 3.1
ie-bnd-rx-2, ie-list-allergy-1, ie-bnd-rx-6	Every item references the allergy statement; it lists allergies or says why none are recorded; every listed allergy is in the Bundle	EP 1.6.1, 1.6.2
ie-bnd-rx-3, ie-rx-age-1	The patient's age is recorded if under 12, or if the date of birth is not a full date	EP 1.4.2
ie-bnd-rx-4	The prescriber has a telephone number	EP 2.10, 2.10.1
ie-bnd-rx-5	Every item and allergy is about the one patient in the Bundle	patient safety
ie-bnd-xb-1, ie-bnd-xb-2	A cross-border prescription gives a secure email and carries the prescriber's signature	EP 2.10.2, 2.13
ie-rx-status-1	A status reason is given unless the item is active, completed or draft	EP 3.5.2.2, 3.5.2.3
ie-rx-dosage-1, ie-dos-1 to ie-dos-4	Structured dosage comes with text; a frequency has its period; as-needed dosing states a maximum (warning); a dose range has both ends	EP 5.1, 5.2.3.1.2, 5.2.4.3
ie-bnd-rx-7 to ie-bnd-rx-10, ie-grp-status-1	The ePG header lists exactly the items; items share its identifier, patient, prescriber and date of issue; its status agrees with theirs (warning); a reason is given unless active, completed or draft	EP 3.1 to 3.5
ie-bnd-rx-12 to ie-bnd-rx-14	Every eDispensation in the ePG is authorised by one of its items and is for its patient; provenance targets the ePG's resources (warning)	EP 6.5
ie-bnd-rx-11	The prescriber's facility has an address line, county, postcode and country	EP 2.9
ie-allergy-2	An allergy's record entry author and date are given together	EP 1.6.2.4.2, 1.6.2.4.3
ie-rx-subst-1	"Do not substitute" gives a reason	EP 3.5.10.3
ie-rx-cd-1, ie-rx-cd-2, ie-rx-cd-3	Controlled drugs: quantity in words and figures; validity period; number of instalments	EP 3.5.7.2, 3.5.9.1, 3.5.12
ie-md-status-1, ie-md-handover-1	A non-dispensation states the reason; a completed dispense records the hand-over time	EP 6.3.2, 6.8
ie-pat-1, ie-pat-ppsn-1, ie-prac-psi-1, ie-loc-gln-1	Identifier formats: IHI, PPSN, PSI number, GLN	EP 1.3.1, 1.3.2, 2.6.2, 2.11

The controlled-drug rules use the conservative readings recorded in open issue OI-027.

Prescribe and dispense

sequenceDiagram
    autonumber
    participant P as Prescriber
    participant N as National ePrescription service
    participant R as Pharmacist
    P->>P: Confirm allergy statement (EP 1.6.1/1.6.2)
    P->>N: Electronic Prescription Group (ePG): header, patient, items (shared group identifier),<br/>allergy statement, prescriber and facility
    R->>N: Retrieve prescription by group identifier
    alt Dispensed (in full, part, or an instalment)
        R->>N: MedicationDispense: completed, quantity, hand-over time
    else Not dispensed
        R->>N: MedicationDispense: declined or stopped, with the reason (ie-md-status-1)
    end
    N-->>P: Dispense records (repeats used = count of repeat dispenses)

The participants are roles, not real systems. The HIQA draft does not specify the national service's interface, so it is out of scope here.

Scenario examples

#	Scenario	Example
1	Acute adult prescription, dispensed	Bundle · dispense
2	Child under 12: age and weight recorded	Bundle
3	Repeat prescription: part fill, balance, first repeat	Bundle · dispenses 1 2 3
4	Schedule 2 controlled drug, in instalments	Bundle · instalment 1
5	Not dispensed: the pharmacist declines because of a recorded penicillin allergy	Bundle · declined dispense
6	Cross-border (IE → EU) with the prescriber's signature	Bundle
7	Dose given (IE-defined)	MedicationAdministration
8	Dose not given, with the reason (IE-defined)	MedicationAdministration
9	Medication statement (as-needed inhaler)	MedicationStatement
10	Prescription cancelled before dispensing: group revoked with a reason	Bundle · group

Scenarios 7–9 are not HIQA EP scenarios; see Administration and Statements. All people, organisations and identifiers are fictional.