Overview

Bulk Medication History is the FHIR representation of the medication fill and prescription history returned for a population of patients. It is produced after a customer submits a patient population using one of the Medication History request APIs (patient panel load or bulk file load). The correlationId returned from that original request ties the resulting FHIR data back to the request that produced it. Unlike the Patient Everything and Patient Summary outputs, this data is not wrapped in a single Bundle resource. Instead, following the HL7 Bulk Data Access approach, resources are grouped by resource type and written out as newline-delimited JSON (NDJSON) files — one resource per line, one file per resource type (for example, all MedicationRequest resources for the whole population are written to a single file).

Delivery

Bulk Medication History files are pushed to customer cloud storage using the same mechanisms described in Delivery (S3, Azure, and soon Google Cloud Storage). Webhook notification of delivery completion is planned for this output but is not yet available — today, delivery is push-only with no accompanying webhook event.

Resources Included

Resource	US Core Profile	Description
Patient	US Core Patient	The patient the medication history belongs to, built from the demographics submitted in the request (not from the responding system). One per unique patient.
Practitioner	US Core Practitioner	The prescriber of a medication.
PractitionerRole	US Core PractitionerRole	Links the prescriber to their office location and contact details, and is referenced as the requester on the `MedicationRequest`.
Location	US Core Location	Used twice: once for the prescriber’s office, and once for the pharmacy that dispensed the medication.
Medication	US Core Medication	The drug product itself (code, and form when known).
MedicationRequest	US Core MedicationRequest	The prescription order.
MedicationDispense	US Core MedicationDispense	The fill/dispense event at the pharmacy.
OperationOutcome	(none — base FHIR resource)	Used for two different informational/error situations — see below.

The Patient resource is built from the patient demographic information submitted in the original Medication History request, not from the medication history returned by the responding system. Its demographics reflect what was requested, not what the responding system has on file for the patient. See the Patient resource page for the fields populated.

OperationOutcome usage

OperationOutcome appears in two distinct situations in this output, rather than representing a single consistent concept:

Incomplete medication record — if a medication record from the source system is missing its history source qualifier, it does not contain enough information to build the resources above. An OperationOutcome with severity information is emitted in its place instead of any medication resources for that record.
Patient-level error — if the original patient population request encountered an error while trying to locate or process a specific patient, that error is surfaced as a separate OperationOutcome, unrelated to any specific medication.

See the OperationOutcome resource page for the exact fields populated in each case.

Stable IDs

Unlike the Patient Everything and Patient Summary bundles, IDs in this output are not consistently stable across resource types. The table below summarizes what determines each resource’s ID, and whether that leads to deduplication across the population being processed. See FHIR IDs for background on why stable IDs matter.

Resource	Based on	Deduplicated across the file?
Patient	Provider’s patient identifier system and value	Yes — one `Patient` per unique patient.
Practitioner	The specific medication record	No — the same real-world prescriber appears as a separate resource for every medication they prescribed.
PractitionerRole	The specific medication record	No — same caveat as `Practitioner`.
Location	The specific medication record	No — applies to both the prescriber’s office and the pharmacy; the same address or pharmacy is not deduplicated across medications.
Medication	Product code, drug description, form code, and strength	Yes — identical medications collapse into a single resource, shared across every `MedicationRequest`/`MedicationDispense` that references them.
MedicationRequest	Patient, written date, product code, drug description, directions, strength, refills, and quantity prescribed	Yes, if all of those fields match another record.
MedicationDispense	Patient, last filled date, sold date, product code, drug description, directions, strength, and days supply	Yes, if all of those fields match another record.
OperationOutcome	(not applicable)	No stable ID is assigned; treat each occurrence as a standalone informational/error entry rather than a resource to track over time.

Welcome

Product

FHIR

Implementation

APIs

Bulk Medication History

Overview

Delivery

Resources Included

OperationOutcome usage

Stable IDs

​Overview

​Delivery

​Resources Included

​OperationOutcome usage

​Stable IDs

Overview

Delivery

Resources Included

OperationOutcome usage

Stable IDs