Operation API: Medikationsplan abrufen (eMP)

Seiteninhalt:

Nachricht
Sicherheitsanforderungen

Die Operation Medikationsplan abrufen (eMP) ermöglicht den gezielten Zugriff auf eine konsolidierte FHIR-Darstellung eines elektronischen Medikationsplans (eMP) aus dem Datenraum des Medication Service. Der zurückgegebene eMP umfasst eine Sammlung relevanter Ressourceninstanzen (z.B. MedicationRequest (eMP), MedicationStatement (eML) oder Medication (eMP)), die zu einem definierten Zeitpunkt gemeinsam gültig waren, ergänzt um die zugehörige Patient-Ressource aus dem Patient Service.

Als optionaler Eingabeparameter kann eine Provenance-ID übergeben werden (Provenance.id der EMPChronologyProvenance). Diese ID verweist auf einen eMP-Chronologieeintrag des Medikationsplans und referenziert eine spezifische Version des eMP, wie sie durch die Provenance-Instanz dokumentiert ist. Bei Angabe dieses Parameters liefert die Operation exakt den durch die angegebene Provenance beschriebenen Zustand des Medikationsplans, gegebenenfalls ergänzt durch aktuelle, zugehörige Verschreibungsdaten. Dadurch wird eine Abfrage vergangener Planstände ermöglicht.

Wird keine Provenance-ID übermittelt, gibt die Operation den aktuellen Zustand des eMP zurück – also die zur Abfragezeit gültige Kombination aus aktiven, vorgesehenen und pausierten Medikationsdaten, wie sie systemseitig als letzte Version ermittelt wurde.

Das Operationsergebnis ist ein FHIR Bundle vom Typ collection, das sämtliche zum angegebenen Stand gehörenden Ressourcen enthält.

Nachricht

Die Nachricht zum Abruf der FHIR-Instanzen des eMP wird als HTTP GET-Anfrage an den Medication Service gesendet.

Auslösung

Wenn das ePA-Client-System den eMP als strukturierte FHIR-Daten abrufen möchte, sendet es eine Operation API: Medikationsplan abrufen (eMP)-Anfrage an den Medication Service. Der Medication Service verarbeitet die Anfrage und stellt den Medikationsplan zur Verfügung, damit dieser im ePA-Client-System verarbeitet werden kann.

Das ePA-FdV MUSS es dem Versicherten ermöglichen, einen ICD-10-Code eines eMP-Eintrags mit Informationen des Nationalen Gesundheitsportals [NGP] zu verknüpfen, um eine patientenverständliche Erläuterung des Codes zur Anzeige zu bringen, sodass das Feld reasonCode für den Versicherten nachvollziehbar wird.

FHIR Operation API

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with wrong status"},{"url":"responseType","valueString":"EPAMSOperationOutcome"},{"url":"errorCode","valueString":"MEDSVC_STATUS_INVALID"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"extension":[{"url":"statusCode","valueString":"409"},{"url":"description","valueString":"Mismatch between acknowledged and current eMP chronology ID"},{"url":"responseType","valueString":"EPAMSOperationOutcome"},{"url":"errorCode","valueString":"MEDSVC_EMP_CHRONOLOGY_ID_MISMATCH"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"}],"name":"update-emp-entry","definition":"https://gematik.de/fhir/epa-medication/OperationDefinition/update-emp-entry-op"}]}]}

      {"resourceType":"OperationDefinition","id":"get-medication-plan-op","meta":{"profile":["https://gematik.de/fhir/ti/StructureDefinition/ti-operationdefinition"]},"text":{"status":"generated","div":"<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\">Generated Narrative: OperationDefinition get-medication-plan-op</p><a name=\"get-medication-plan-op\"> </a><a name=\"hcget-medication-plan-op\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"https://gematik.de/fhir/ti/1.1.1-ballot.1/StructureDefinition-ti-operationdefinition.html\">OperationDefinition Profil für TI FHIR Data Service</a></p></div>URL: [base]/$$medication-plan
Parameters
<table class=\"grid\">UseNameScopeCardinalityTypeBindingDocumentationINprovenance0..1<a href=\"http://hl7.org/fhir/R4/datatypes.html#uuid\">uuid</a>Die UUID der Provenance-Instanz, die eine bestimmte Version des elektronischen Medikationsplans (eMP) identifiziert. Diese Provenance-Instanz repräsentiert den Zustand zu einem bestimmten Zeitpunkt und bündelt die zu diesem Zeitpunkt aktiven eMP-Elemente. Wird kein provenance-Parameter angegeben, liefert die Operation den aktuellsten bekannten Zustand des eMP zurück.
\n
OUTreturn1..1<a href=\"http://hl7.org/fhir/R4/bundle.html\">Bundle</a>Ein Bundle vom Typ collection, das alle relevanten Ressourceninstanzen enthält, die zum angegebenen eMP-Zustand gehören. Diese Ressourcen stammen aus dem Datenraum des Medication Service und bilden gemeinsam den logischen Medikationsplan zum gewünschten Stand ab.
\n</table></div>"},"extension":[{"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-method","valueCode":"GET"}],"url":"https://gematik.de/fhir/epa-medication/OperationDefinition/get-medication-plan-op","version":"1.2.0-ballot.1","name":"getMedicationPlan_MedicationSvc","title":"Medication Plan (eMP)","status":"draft","kind":"operation","date":"2025-08-01","publisher":"gematik GmbH","contact":[{"name":"gematik GmbH","telecom":[{"system":"url","value":"https://www.gematik.de"},{"system":"email","value":"patientteam [ at ] gematik.de"}]}],"description":"Diese Operation ermöglicht den gezielten Abruf eines elektronischen Medikationsplans (eMP) aus dem Datenraum des Medication Service. Der zurückgegebene Medikationsplan besteht aus einer Sammlung relevanter Ressourceninstanzen, die zu einem bestimmten Zeitpunkt gemeinsam gültig waren, sowie die zugehörige Versicherteninformation (Patient) aus dem Patient Service. Die Operation akzeptiert optional eine Provenance-Referenz.id als Eingabeparameter. Wird diese übergeben, liefert die Operation exakt den Zustand des Medikationsplans, wie er durch diese Provenance-Version beschrieben ist. So kann auch ein vergangener Stand des eMP nachvollziehbar wiedergegeben werden. Wird keine Provenance angegeben, gibt die Operation den aktuellsten Stand des Medikationsplans zurück - also die derzeit gültige Kombination aus aktiven und pausierten Medikationsdaten. Das Ergebnis ist ein Bundle vom Typ collection, das alle zugehörigen Ressourcendaten enthält.","jurisdiction":[{"coding":[{"system":"urn:iso:std:iso:3166","code":"DE"}]}],"affectsState":false,"code":"medication-plan","system":true,"type":false,"instance":false,"parameter":[{"name":"provenance","use":"in","min":0,"max":"1","documentation":"Die UUID der Provenance-Instanz, die eine bestimmte Version des elektronischen Medikationsplans (eMP) identifiziert. Diese Provenance-Instanz repräsentiert den Zustand zu einem bestimmten Zeitpunkt und bündelt die zu diesem Zeitpunkt aktiven eMP-Elemente. Wird kein provenance-Parameter angegeben, liefert die Operation den aktuellsten bekannten Zustand des eMP zurück.","type":"uuid"},{"name":"return","use":"out","min":1,"max":"1","documentation":"Ein Bundle vom Typ collection, das alle relevanten Ressourceninstanzen enthält, die zum angegebenen eMP-Zustand gehören. Diese Ressourcen stammen aus dem Datenraum des Medication Service und bilden gemeinsam den logischen Medikationsplan zum gewünschten Stand ab.","type":"Bundle"}]}

Beispiel für den Abruf der aktuellen Version des eMP:

GET [base] /epa/medication/api/v1/fhir/$medication-plan

Beispiel für den Abruf einer äteren Version des eMP:

GET [base] /epa/medication/api/v1/fhir/$medication-plan?provenance=F530632C-7CE9-4369-B99B-2DE68B0C9F25

Beispiel für den Abruf eines Medikationsplans in XML:

GET [base] /epa/medication/api/v1/fhir/$medication-plan?_format=xml

Der Medication Service MUSS in der Operation Medikationsplan abrufen (eMP) das Ergebnis als FHIR Bundle mit dem type collection zurückgeben. Der Medication Service MUSS sicherstellen, dass das Ergebnis der Operation Medikationsplan abrufen (eMP) ausschließlich relevante Instanzen des adressierten eMP-Chronologieeintrags enthält.
Das zurückgegebene FHIR Collection Bundle MUSS folgende Instanzen enthalten:

Instanz des Profils EPAPatient aus dem Patient Service,
die adressierte Provenance Instanz des Profils EMPChronologyProvenance,
alle Versionen von Instanzen des Profils EMPMedicationRequest, die in Provenance.target (EMPChronologyProvenance) referenziert sind,
alle Instanzen des Profils EMPMedication, die in MedicationRequest.medicationReference (EMPMedicationRequest) referenziert sind (eMP-Medikation),
alle Instanzen des Profils EPAActivityProvenance, die in Provenance.target (EPAActivityProvenance) auf die relevanten Versionen von MedicationRequest (EMPMedicationRequest) verweisen,
alle Instanzen des Profils TIOrganization, die in Provenance.agent.who (EPAActivityProvenance) referenziert werden,
falls vorhanden:
- jeweils die in MedicationRequest.activity (EMPMedicationRequest) referenzierte Instanz des Profils EPAMedicationStatement (erlaubter Status: unknown). Werden mehrere Instanzen des Profils EPAMedicationStatement referenziert, wird die gemäß MedicationStatement.effectiveDateTime (EPAMedicationStatement) jeweils jüngste Instanz verwendet.
- alle durch die relevanten Instanzen des Profils EPAMedicationStatement in MedicationStatement.derivedFrom referenzierten Instanzen des Profils EPAMedicationDispense,
- alle durch die relevanten Instanzen des Profils EPAMedicationStatement in MedicationStatement.derivedFrom referenzierten Instanzen des Profils EPAMedicationRequest,
- alle durch die relevanten Instanzen des Profils EPAMedicationRequest und EPAMedicationDispense in medicationReference referenzierten Instanzen des Profils EPAMedication,
- alle in MedicationDispense.performer.actor (EPAMedicationDispense) referenzierten Instanzen des Profils PractitionerDirectory,
- alle in MedicationRequest.requester (EPAMedicationRequest) referenzierten Instanzen des Profils PractitionerRole, sowie deren in PractitionerRole.practitioner referenzierten Instanzen des Profils PractitionerDirectory und in PractitionerRole.organization referenzierten Instanzen des Profils OrganizationDirectory.

Der Medication Service MUSS die eMP-Einträge im Suchergebnis der Operation Medikationsplan abrufen (eMP) entsprechend des Elements MedicationRequest.authoredOn der Instanzen des Profils EMPMedicationRequest auflisten (neueste zuerst) und bei gleichem MedicationRequest.authoredOn alphabetisch aufsteigend entsprechend Medication.ingredient.item[x]:itemCodeableConcept.text (Wirkstoff) sortieren. Der Medication Service MUSS die Operation Medikationsplan abrufen (eMP) abbrechen und mit einer OperationOutcome-Ressource und Wert MSG_NO_MATCH antworten, wenn die relevante EMPChronologyProvenance auf keinen eMP-Eintrag (EMPMedicationRequest) verweist.

Das folgende Beispiel zeigt die erwartete Antwort bei einem eMP ohne Einträge:

{
  "resourceType" : "OperationOutcome",
  "id" : "a4da96e5-84d6-4883-8789-5df2e1363c40",
  "meta" : {
    "profile" : [
      🔗 "https://gematik.de/fhir/epa-medication/StructureDefinition/epa-ms-operation-outcome"
    ]
  },
  "issue" : [
    {
      "severity" : "error",
      "code" : "processing",
      "details" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/operation-outcome",
            "code" : "MSG_NO_MATCH",
            "display" : "No Resource found matching the query \"%s\""
          }
        ]
      },
      "diagnostics" : "No Resource found matching the query $medication-list"
    }
  ]
}


<OperationOutcome xmlns="http://hl7.org/fhir">
  <id value="a4da96e5-84d6-4883-8789-5df2e1363c40"/>
  <meta>
    <profile
             value="https://gematik.de/fhir/epa-medication/StructureDefinition/epa-ms-operation-outcome"/>
  </meta>
  <issue>
    <severity value="error"/>
    <code value="processing"/>
    <details>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/operation-outcome"/>
        <code value="MSG_NO_MATCH"/>
        <display value="No Resource found matching the query &quot;%s&quot;"/>
      </coding>
    </details>
    <diagnostics
                 value="No Resource found matching the query $medication-list"/>
  </issue>
</OperationOutcome>

Der Medication Service MUSS die Operation Medikationsplan abrufen (eMP) abbrechen und mit einer OperationOutcome-Ressource und Wert MSG_RESOURCE_ID_FAIL antworten, wenn:

die durch den Parameter Provenance-ID adressierte EMPChronologyProvenance nicht vorhanden ist
oder wenn bei Abruf des aktuellen eMP keine EMPChronologyProvenance existiert.

Das folgende Beispiel zeigt die erwartete Antwort bei einem nicht existierenden eMP:

{
  "resourceType" : "OperationOutcome",
  "id" : "98ca7dff-aa8d-47d0-a074-4055f55cb4db",
  "meta" : {
    "profile" : [
      🔗 "https://gematik.de/fhir/epa-medication/StructureDefinition/epa-ms-operation-outcome"
    ]
  },
  "issue" : [
    {
      "severity" : "error",
      "code" : "not-found",
      "details" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/operation-outcome",
            "code" : "MSG_RESOURCE_ID_FAIL",
            "display" : "unable to allocate resource id"
          }
        ]
      },
      "diagnostics" : "unable to allocate resource id"
    }
  ]
}


<OperationOutcome xmlns="http://hl7.org/fhir">
  <id value="98ca7dff-aa8d-47d0-a074-4055f55cb4db"/>
  <meta>
    <profile
             value="https://gematik.de/fhir/epa-medication/StructureDefinition/epa-ms-operation-outcome"/>
  </meta>
  <issue>
    <severity value="error"/>
    <code value="not-found"/>
    <details>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/operation-outcome"/>
        <code value="MSG_RESOURCE_ID_FAIL"/>
        <display value="unable to allocate resource id"/>
      </coding>
    </details>
    <diagnostics value="unable to allocate resource id"/>
  </issue>
</OperationOutcome>

Sicherheitsanforderungen

Generelle Sicherheitsanforderungen werden hier festgehalten.