Committee Approval Date:

Publishing Lead:

Scott M. Robertson 

Contributing or Reviewing Work Groups:

Pharmacy WG

Structured Documents WG

FHIR Development Project Insight ID:


revision of project from a guidance document to FHIR IG is in progress

Scope of coverage:

This IG will address pharmacist- and pharmacy-specific requirements and terminologies relative to the C-CDA on FHIR IG, specifically the Consultation Note.  This IG will also provide information on the C-CDA version of Pharmacist Consultant Note including mapping between the C-CDA and FHIR presentation.  This IG builds upon an existing NCPDP Consultant Pharmacist Consult Note Guidance Document, specifically to add FHIR as an optional (or preferred) implementation.  This is a joint NCPDP/HL7 project to publish under joint copyright.   

Content location: 

Proposed IG Title:

Pharmacists Consultation Note IG

Proposed IG realm and code:


FHIR Core version(s):

R4, since C-CDA on FHIR IG STU 1.1 is based on R4

Maintenance Plan:

Joint maintenance between HL7 Pharmacy WG and NCPDP WG14 Long Term Post Acute Care (LTPAC) Clinical Pharmacist Interoperability Task Group.

Short Description:

This IG provides pharmacist- and pharmacy-specific guidance and requirements for the use of C-CDA on FHIR IG (STU 1.1) Consultation Note for a Pharmacist Consultation Note.  This addresses sections that are required or recommended for a Pharmacist Consultation Note, which may differ from C-CDA on FHIR IG and US Core.  Identifies required or recommended code sets/value sets for pharmacy use cases.

Long Description:

The Pharmacist Consultation Note IG provides requirements and recommendations for using C-CDA on FHIR IG (STU 1.1) Consultation Note in pharmacy use cases.  The audience for this IG are system vendors, especially pharmacy system vendors, where the system/application supports pharmacists with medication review and other consulting services.  Examples include:  a pharmacist's medication regimen review for LTPAC patients; reporting of evaluations performed in a pharmacist-run clinic; and a pharmacist responding to a provider-requested review and recommendations for a patient's medications relative to their conditions, allergies, etc.

This IG also provides guidance on the use of C-CDA R2.1 for Pharmacist Consultation Notes.  At the present time, C-CDA documents are widely used and previous guidance described C-CDA implementation for consulting pharmacists.  This IG updates that prior guidance and includes material to facilitate the Pharmacist Consultation Note transition from C-CDA to FHIR (C-CDA on FHIR IG).

Involved parties:


Pharmacy HIT Collaborative

National Community Pharmacists Association (NCPA) Innovation Center

American Society of Clinical Pharmacists (ASCP)

Expected implementations:

in discussion with

TabulaRasa HealthCare


Content sources:

Requirements from subject matter experts in NCPDP, TabulaRasa, GeriMed, ASCP, PharmHIT

NCPDP Recommendations for Pharmacists on the Use of HL7 Consolidated CDA Templates - Consultant Pharmacist Consult Note

Example Scenarios:

CMS-required Pharmacist Medication Regimen Review (MRR) for patients in Long Term and Post-Acute Care (LTPAC) facilities.

Provider-requested Pharmacist assessment of a patient's current medications.  Common request in LTPAC and integrated medical systems.

IG Relationships:

dependent on C-CDA on FHIR IG 1.1.0 - (FHIR R4) STU Release 1.1 and its dependencies

no expected dependencies on this IG


Sept 2022 ballot

FMG Notes