NZ Shared Digital Health Record API - Local Development build (v1.1.3) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
Medications
Overview
This domain provides a clinically focused, longitudinal view of prescribed and dispensed medicines. Medication information is sourced from the Medicines Data Repository (MDR).
FHIR artifacts
FHIR artifacts
Clinical description
Medication requests
Medication Requests represent prescribing intent. They describe medicines that a clinician intended to prescribe but do not establish that the medicine was dispensed or used.
Medication dispenses
Medication Dispenses represent medicines supplied. They are a stronger indicator of supply than prescription information but do not establish collection, ingestion, or adherence.
Clinical interpretation: Prescription information represents clinical intent. Dispensed information represents medicines supplied. Neither confirms that a medicine was taken as directed.
Intended use
- Review what was prescribed and what was dispensed.
- Use medication information with other clinical context, including allergies, laboratory results, observations, and conditions.
- Review longer history where long-term therapy, cumulative exposure, or previous ineffective treatment may be clinically relevant. A recent history of approximately two to three years supports many, though not all, clinical purposes.
- Medication information is sourced from the national Medicines Data Repository (MDR) through its FHIR API.
- MDR contains prescribing and dispensing information from NZePS-integrated systems.
- MDR remains the source system for creation and maintenance of medication information made available through this domain.
- SDHR does not clinically reconcile, amend, or reinterpret medication information sourced from MDR.
- Current NZePS-integrated sources include almost all New Zealand general practices, all New Zealand community pharmacies, several specialist prescribing systems, and an expanding set of secondary-care systems used primarily for outpatient prescribing.
- Source-system implementation and workflow differences affect completeness and behaviour.
- MDR dispense dates reflect pharmacy preparation and may differ from the date the patient received the medicine.
- Administered medicines are not recorded in NZePS, including medicines administered in many inpatient, outpatient, and clinic settings.
Privacy and confidentiality considerations
- MDR may contain confidential records.
- Prescribing and dispensing confidentiality controls are carried through to MDR
- Medication information can reveal sensitive details relating to mental health, oncology, infectious disease, reproductive health, pain management, or substance dependence.
- Inappropriate access, disclosure, or interpretation may contribute to stigma or bias and affect patient trust.
- Access must be auditable and meet the compliance requirements for systems reading data.
Clinical safety considerations
- Medication information should be interpreted in conjunction with medicines reconciliation, clinical context, and direct confirmation with the patient where appropriate.
- Applications should make status, dates, provenance, and related information easy to identify.
- Prescriptions cancelled or invalidated before supply should be excluded where this reduces misinterpretation risk.
- Dispenses prepared and subsequently reversed because they were not collected are omitted.
- Limited historical depth may lead to repetition of an ineffective or inappropriate medicine trial.
Known limitations
- Medication lists may be incomplete and are not necessarily reconciled.
- Data completeness varies with NZePS integration, source-system workflows, and data quality.
- Feedback mechanisms for correcting or annotating inaccurate medication information are limited.
- Administered medicines are outside NZePS coverage.
- Practical historical limits reflect current MDR availability.
