Implementation Guide
ePA Medication Service
Version 1.2.0-ballot.1 - draft

Operation API: Entfernen einer eML-eMP-Verknüpfung

Seiteninhalt:

Die Operation Entfernen einer eML-eMP-Verknüpfung dient dazu, die Verknüpfung zwischen einem bestehenden eML-Eintrag (MedicationStatement) und einem dokumentierten eMP-Eintrag (MedicationRequest) gezielt aufzuheben.

Als Ergebnis wird eine neue Version des elektronischen Medikationsplans (eMP) erstellt. Die Rückgabe der Operation enthält die folgenden Elemente:

  • den aktualisierten MedicationStatement (nun ohne Verknüpfung),
  • den betroffenen MedicationRequest (eMP-Eintrag),
  • eine Provenance-Ressource zur Beschreibung der Aktivität (z. B. wer die Entknüpfung vorgenommen hat),
  • sowie eine Provenance-Ressource zur Beschreibung der neuen eMP-Version (Chronologieeintrag).

Diese Informationen ermöglichen die vollständige Nachvollziehbarkeit der Änderung und sichern die Konsistenz zwischen eML und eMP.

Nachricht

Die Nachricht zur Entfernung einer Verknüpfung zwischen einem eML-Eintrag und einem eMP-Eintrag wird als HTTP POST-Anfrage an den Medication Service auf die betreffende MedicationStatement-Instanz gesendet.

Auslösung

Diese Operation des Medication Service dient dazu, eine Verknüpfung zwischen einem bestehenden eML-Eintrag (MedicationStatement) und einem dokumentierten eMP-Eintrag (MedicationRequest) aufzuheben. Die Nachricht wird vom ePA-Client-System gesendet, wenn erkannt wird, dass die Verknüpfung nicht korrekt war und rückgängig gemacht werden muss.

Antwort

Die Operation gibt den aktualisierten eML-Eintrag (MedicationStatement) ohne Verknüpfung, den betroffenen eMP-Eintrag (MedicationRequest) sowie die zugehörigen Provenance-Ressourcen zur Beschreibung der Aktion und der neuen eMP-Version zurück.

FHIR Operation API

Das Primärsystem KANN die Operation API: Entfernen einer eML-eMP-Verknüpfung implementieren, um eine eML-eMP-Verknüpfung zu entfernen. Der Medication Service MUSS die Operation API: Entfernen einer eML-eMP-Verknüpfung gemäß der FHIR OperationDefinition eMP-Verknüpfung entfernen ausführen. 
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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":"unlink-emp-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 unlink-emp-op</p><a name=\"unlink-emp-op\"> </a><a name=\"hcunlink-emp-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]/MedicationStatement/[id]/$unlink-emp
Input parameters Profile:<a href=\"StructureDefinition-epa-op-link-emp-entry-parameters.html\">EPA Operation Link eMP Parameters</a>
Output parameters Profile:<a href=\"StructureDefinition-epa-op-link-emp-entry-output-parameters.html\">EPA Operation Link eMP Output Parameters</a>
Parameters
<table class=\"grid\">UseNameScopeCardinalityTypeBindingDocumentation</table></div>"},"extension":[{"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-method","valueCode":"POST"}],"url":"https://gematik.de/fhir/epa-medication/OperationDefinition/unlink-emp-op","version":"1.2.0-ballot.1","name":"unlinkEMP_MedicationSvc","title":"eMP-Verknüpfung entfernen","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 des Medication Service dient dazu, eine Verknüpfung zwischen einem bestehenden eML-Eintrag und einem dokumentierten eMP-Eintrag aufzuheben.","jurisdiction":[{"coding":[{"system":"urn:iso:std:iso:3166","code":"DE"}]}],"affectsState":true,"code":"unlink-emp","resource":["MedicationStatement"],"system":false,"type":false,"instance":true,"inputProfile":"https://gematik.de/fhir/epa-medication/StructureDefinition/epa-op-link-emp-entry-parameters","outputProfile":"https://gematik.de/fhir/epa-medication/StructureDefinition/epa-op-link-emp-entry-output-parameters"}

Geschäftslogik

Der Medication Service MUSS die Geschäftlogik der Operation Entfernen einer eML-eMP-Verknüpfung gemäß dem Aktivitätsdiagramm mit der ID IG-MED-BL-UNLINK-EMP-ENTRY-V1 ausführen. Dabei sind alle mit transaction gekennzeichneten Abschnitte entsprechend den Transaktionssicherheitsregeln der ePA umzusetzen, sodass diese Abschnitte mit ihren Verarbeitungsschritten atomar, konsistent und isoliert durchgeführt werden.
IG-MED-BL-UNLINK-EMP-ENTRY-V1Check whether theOrganizationresource from theX-Requesting-OrganizationHTTP headerconforms to theTIOrganizationprofileReturn errorOperationOutcomewith codestructureand detailsSVC_ORG_HEADER_PROFILE_MISMATCH(HTTP 400)noOrganization is valid?yesCheck whether the KVNR-based logical reference(s) in thesubjectelement match thex-insurantvalue from the HTTP header,and whether the Telematics ID from theX-Requesting-Organizationheader matches the Telematics ID from the ID tokenReturn errorOperationOutcomewith codeforbiddenand detailsSVC_IDENTITY_MISMATCH(HTTP 403)noidentity information is valid?yesValidateInput-Parametersaccording toEPAOpLinkEMPEntryParametersprofileReturn errorOperationOutcomewith codestructureand detailsMEDICATIONSVC_NO_VALID_STRUCTURE(HTTP 400)noValidation successfullyestransactionRetrieveMedicationStatementinstance using the ID provided in the instance-level operation URL (i.e.[Base URL of FHIR API]/MedicationStatement/[id]/$unlink-emp)Return errorOperationOutcomewith codenot-foundand detailsMSG_RESOURCE_ID_FAIL(HTTP 404)noMedicationStatement exists?yesRetrieveMedicationRequestinstance using the identifier provided inInput-Parameters.parameter[medicationPlanIdentifier]and where extension[context].valueCode isEMPReturn errorOperationOutcomewith codeprocessingand detailsUNLINKING_NOT_SUCCESSFUL(HTTP 400)noMedicationRequest exists?yesCheck whether the loadedMedicationStatementcontains abasedOn.referencethat references the loadedMedicationRequestinstanceand that this reference has anextension[isEmp]withvalue = trueReturn errorOperationOutcomewith codeforbiddenand detailsMSG_OP_NOT_ALLOWED(HTTP 405)noMedicationStatement.basedOn references the loaded MedicationRequest instance and extension[isEmp].value = trueyesCheck for existingOrganizationwith TelematikID from the X-Requesting-Organization HTTP headerOrganization exists?yesno«Update»Organizationderived from X-Requesting-Organization header,conforming to theTIOrganizationprofileidentifier[TelematikID] = value from headerReplace all other elements with the provided instance«Create»Organizationderived from X-Requesting-Organization header,conforming to theTIOrganizationprofileidentifier[TelematikID] = value from headerSet all other elements with the provided instance«UPDATE»EPAMedicationStatement  removebasedOnreference to the loadedEMPMedicationRequest  including the associatedextension[isEMP] = true Note:agent.who = Reference(Organization)incl. display and TelematikID identifier alslogical reference «Create»EPAActivityProvenanceactivity =UPDATEagent.type =authoragent.who = Organization instance derived from X-Requesting-Organization headertarget = VersionedReference(EPAMedicationStatement)«Update»EMPMedicationRequest  removeReference(EPAMedicationStatement)  fromextension[activity]«Create»EPAActivityProvenanceactivity =UPDATEagent.type =authoragent.who = Organization instance derived from X-Requesting-Organization headertarget = VersionedReference(EMPMedicationRequest)Create eMP Chronology ProvenanceLoad allMedicationRequestresources from the Medication Service with extension[context] =EMPand status in (active,draft,on-hold)Check whether the updatedMedicationRequest(EMPMedicationRequest) instance has extension[context] =EMPandstatusin (active,draft,on-hold) Note:  The elementagent.whomust be a Reference(Organization)and include bothdisplayand a logical identifier (TelematikID). The list ofMedicationRequestinstances, referenced viatarget,may be empty. «CREATE»Provenanceconforming to theEMPChronologyProvenanceprofileactivity =UPDATE  extension[isEMPChronology].valueBoolean =true  agent.type =author  agent.who = Organization instance derived fromX-Requesting-Organizationheadertarget = versioned references to all collectedMedicationRequestinstancesReturnOutput-Parameterscontaining theMedicationStatementinstance,MedicationRequestinstance,Provenancefor the activity provenance and and if exists theProvenancefor the chronology provenance as resourcesinparameter[medicationStatement],parameter[empEntry],parameter[relatedActivity]and if existsparameter[relatedChronology]  conforming to the profileEPAOpLinkEMPEntryOutputParameters(HTTP 200)
Abbildung: Geschäftslogik für die Operation Entfernen einer eML-eMP-Verknüpfung

Sicherheitsanforderungen

Generelle Sicherheitsanforderungen werden hier festgehalten.