Implementation Guide
ePA Medication Service
Version 1.2.0-ballot.2 - draft

## Resource Profile: eMP-Eintrag

Official URL: https://gematik.de/fhir/epa-medication/StructureDefinition/emp-medication-request | Version: 1.2.0-ballot.2
Draft as of 2025-09-02 | Computable Name: EMPMedicationRequest

Hält die Medikationsinformationen eines Eintrags für den elektronischen MedikationsPlan (eMP) vor und stellt das zentrale Element dar. Es stellt die Verbindung zwischen der Planung und einem oder mehrerer Verschreibungsprozesse oder Nachträge.

Usages:

- Use this Profile: EPA Operation addEMPEntry Input-Parameters, EPA Operation EMPEntry Output-Parameters, EPA Operation Link eMP Output Parameters and EPA Operation UpdateEMPEntry Input-Parameters
- Refer to this Profile: eMP-Chronologieeintrag and EPA MedicationRequest
- Examples for this Profile: MedicationRequest/266620a9-2c26-41c1-b0cb-a10947b867f5, MedicationRequest/71b66f1b-8032-4886-b7bf-e775daee22fb and MedicationRequest/Technical-Exp-NachtragEmpMedicationRequestEmp
- CapabilityStatements using this Profile: EPA Capability Statement für Clients des ePA Medication Service and EPA CapabilityStatement für den Medication Service

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequest | Ordering of medication for patient or group Constraints: dom-2, dom-3, dom-4, dom-5, dom-6
meta | S Σ | 0..1 | Meta | Metadata about the resource
versionId | S Σ | 0..1 | id | Version specific identifier
lastUpdated | S Σ | 0..1 | instant | When the resource version last changed
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:context | S | 1..1 | (Complex) | Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/context-extension
extension |  | 0..0 |  |
url |  | 1..1 | uri | "https://gematik.de/fhir/epa-medication/StructureDefinition/context-extension"
value[x] |  | 1..1 | code | Context of the resource Binding: Context Codes (required) Required Pattern: EMP
extension:activity | S | 0..* | Reference(EPA MedicationStatement) | Aktivität die zu diesem Planelement gehört URL: https://gematik.de/fhir/epa-medication/StructureDefinition/emp-medicationrequest-activity-extension
extension:reasonPatientInstruction | S | 0..1 | string | Patientenlesbarer Grund für den Planungseintrag URL: https://gematik.de/fhir/epa-medication/StructureDefinition/reason-patient-instruction-extension
extension:patientNote | S | 0..1 | Annotation | Hinweis für den Patienten URL: https://gematik.de/fhir/epa-medication/StructureDefinition/patient-note-extension
extension:effectiveDosePeriod | S | 0..1 | Period | Zeitraum, in dem die Medikation eingenommen werden soll. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.effectiveDosePeriod
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored Slice: Unordered, Open by value:url
Slices for identifier |  | 0..* | Identifier | External ids for this request Slice: Unordered, Open by value:$this
identifier:MedicationPlanIdentifier | S | 0..1 | MedicationPlanIdentifier | External ids for this request Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
use |  | 0..1 | code | usual | official | temp | secondary | old (If known)
type |  | 0..1 | CodeableConcept | Description of identifier
system |  | 1..1 | uri | The namespace for the identifier value Fixed Value: https://gematik.de/fhir/sid/emp-identifier
value |  | 0..1 | string | The value that is unique
period |  | 0..1 | Period | Time period when id is/was valid for use
assigner |  | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
status | ?!S Σ | 1..1 | code | active | on-hold | completed | entered-in-error | stopped Binding: eMP MedicationRequest Status Value Set (required)
intent | ?!Σ | 1..1 | code | plan Binding: medicationRequest Intent (required): The kind of medication order. Required Pattern: plan
doNotPerform | ?!Σ | 0..1 | boolean | True if request is prohibiting action
medication[x] | S Σ | 1..1 | Reference(EPA Medication) | Arzneimittel, welches geplant wird
subject | S Σ C | 1..1 | Reference(Patient) | Who or group medication request is for Constraints: ref-1
identifier | S Σ | 1..1 | IdentifierKvid10(1.5.4) | Logical reference, when literal reference is not known
authoredOn | S Σ C | 1..1 | dateTime | When request was initially authored Constraints: epa-datetime
reasonCode | S | 0..1 | CodeableConcept | Reason or indication for ordering or not ordering the medication Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
Slices for coding | S Σ | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Closed by pattern:$this
coding:icd-10-gm | S Σ | 0..1 | CodingICD10GM(1.5.4) | Code defined by a terminology system Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/bfarm/icd-10-gm
version |  | 0..1 | string | Version of the system - if relevant
code |  | 0..1 | code | Symbol in syntax defined by the system
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
Slices for extension |  |  |  | Content/Rules for all slices
extension:Mehrfachcodierungs-Kennzeichen | N | 0..1 | Coding | Optional Extensions Element URL: http://fhir.de/StructureDefinition/icd-10-gm-mehrfachcodierungs-kennzeichen Binding: Mehrfachkodierungs-Kennzeichen ICD10GM ValueSet (required)
extension:Seitenlokalisation | N | 0..1 | Coding | Optional Extensions Element URL: http://fhir.de/StructureDefinition/seitenlokalisation Binding: https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_ICD_SEITENLOKALISATION (required)
extension:Diagnosesicherheit | N | 0..1 | Coding | Optional Extensions Element URL: http://fhir.de/StructureDefinition/icd-10-gm-diagnosesicherheit Binding: https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_ICD_DIAGNOSESICHERHEIT (required)
system | S Σ | 1..1 | uri | Canonische CodeSystem URL für ICD-10-GM Fixed Value: http://fhir.de/CodeSystem/bfarm/icd-10-gm
version | S Σ | 1..1 | string | Die Jahresversion von ICD-10-GM. Angegeben wird immer die vierstellige Jahreszahl (z.B. "2017")
code | S Σ C | 1..1 | code | Der ICD-10-Code Constraints: icd-regex Example Einfacher ICD-Code: F17.4
display | S Σ | 1..1 | string | Representation defined by the system
note | S | 0..1 | Annotation | Zusätzliche Informationen durch einen Leistungserbringenden
time | S Σ | 0..1 | dateTime | When the annotation was made
text | S Σ | 1..1 | markdown | The annotation - text content (as markdown)
dosageInstruction | S | 1..* | DosageDgMP | Hier werden Informationen zur Dosierung angegeben.
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
MedicationRequest.extension:context.value[x] | required | Pattern Value: EMP `https://gematik.de/fhir/epa-medication/ValueSet/context-code` From this IG
MedicationRequest.status | required | EMPMedicationRequestStatusVS `https://gematik.de/fhir/epa-medication/ValueSet/emp-medicationrequest-status-vs` From this IG
MedicationRequest.intent | required | Pattern Value: plan `http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1` From the FHIR Standard
MedicationRequest.reasonCode | example | Condition/Problem/DiagnosisCodes `http://hl7.org/fhir/ValueSet/condition-code` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | MedicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | MedicationRequest | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
epa-datetime | error | MedicationRequest.authoredOn | dateTime muss mindestens aus Tag, Monat und Jahr bestehen : toString().matches('^([0-9]([0-9]([0-9][1-9]|[1-9]0)|[1-9]00)|[1-9]000)-(0[1-9]|1[0-2])-(0[1-9]|[1-2][0-9]|3[0-1])(T([01][0-9]|2[0-3]):[0-5][0-9]:([0-5][0-9]|60)(\\.[0-9]+)?(Z|(\\+|-)((0[0-9]|1[0-3]):[0-5][0-9]|14:00)))?$') |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
icd-regex | warning | MedicationRequest.reasonCode.coding:icd-10-gm.code | In code sind nur gültige ICD-10-Codes ohne Zusätze erlaubt : matches('^[A-Z][0-9][A-Z0-9](\\.?[A-Z0-9]{0,4})?$') |
ref-1 | error | MedicationRequest.subject | SHALL have a contained resource if a local reference is provided : reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) |

This structure is derived from MedicationRequest

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequest | Ordering of medication for patient or group
meta | S | 0..1 | Meta | Metadata about the resource
versionId | S | 0..1 | id | Version specific identifier
lastUpdated | S | 0..1 | instant | When the resource version last changed
extension |  | 1..* | Extension | Extension
Slices for extension |  |  |  | Content/Rules for all slices
extension:context | S | 1..1 | (Complex) | Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/context-extension
value[x] |  | 1..1 | code | Context of the resource Required Pattern: EMP
extension:activity | S | 0..* | Reference(EPA MedicationStatement) | Aktivität die zu diesem Planelement gehört URL: https://gematik.de/fhir/epa-medication/StructureDefinition/emp-medicationrequest-activity-extension
extension:reasonPatientInstruction | S | 0..1 | string | Patientenlesbarer Grund für den Planungseintrag URL: https://gematik.de/fhir/epa-medication/StructureDefinition/reason-patient-instruction-extension
extension:patientNote | S | 0..1 | Annotation | Hinweis für den Patienten URL: https://gematik.de/fhir/epa-medication/StructureDefinition/patient-note-extension
extension:effectiveDosePeriod | S | 0..1 | Period | Zeitraum, in dem die Medikation eingenommen werden soll. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.effectiveDosePeriod
Slices for identifier |  | 0..* | Identifier | External ids for this request Slice: Unordered, Open by value:$this
identifier:MedicationPlanIdentifier | S | 0..1 | MedicationPlanIdentifier | External ids for this request Required Pattern: At least the following
system |  | 1..1 | uri | The namespace for the identifier value Fixed Value: https://gematik.de/fhir/sid/emp-identifier
status | S | 1..1 | code | active | on-hold | completed | entered-in-error | stopped Binding: eMP MedicationRequest Status Value Set (required)
intent |  | 1..1 | code | plan Required Pattern: plan
medication[x] | S | 1..1 | Reference(EPA Medication) | Arzneimittel, welches geplant wird
subject | S | 1..1 | Reference(Patient) | Who or group medication request is for
identifier | S | 1..1 | IdentifierKvid10(1.5.4) | Logical reference, when literal reference is not known
authoredOn | S C | 1..1 | dateTime | When request was initially authored Constraints: epa-datetime
reasonCode | S | 0..1 | CodeableConcept | Reason or indication for ordering or not ordering the medication
Slices for coding | S | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Closed by pattern:$this
coding:icd-10-gm | S | 0..1 | CodingICD10GM(1.5.4) | Code defined by a terminology system Required Pattern: At least the following
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/bfarm/icd-10-gm
system | S | 1..1 | uri | Canonische CodeSystem URL für ICD-10-GM
version | S | 1..1 | string | Die Jahresversion von ICD-10-GM. Angegeben wird immer die vierstellige Jahreszahl (z.B. "2017")
code | S | 1..1 | code | Der ICD-10-Code
display | S | 1..1 | string | Representation defined by the system
note | S | 0..1 | Annotation | Zusätzliche Informationen durch einen Leistungserbringenden
time | S | 0..1 | dateTime | When the annotation was made
text | S | 1..1 | markdown | The annotation - text content (as markdown)
dosageInstruction | S | 1..* | DosageDgMP | Hier werden Informationen zur Dosierung angegeben.
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
MedicationRequest.status | required | EMPMedicationRequestStatusVS `https://gematik.de/fhir/epa-medication/ValueSet/emp-medicationrequest-status-vs` From this IG

#### Constraints

Id | Grade | Path(s) | Details | Requirements
epa-datetime | error | MedicationRequest.authoredOn | dateTime muss mindestens aus Tag, Monat und Jahr bestehen : toString().matches('^([0-9]([0-9]([0-9][1-9]|[1-9]0)|[1-9]00)|[1-9]000)-(0[1-9]|1[0-2])-(0[1-9]|[1-2][0-9]|3[0-1])(T([01][0-9]|2[0-3]):[0-5][0-9]:([0-5][0-9]|60)(\\.[0-9]+)?(Z|(\\+|-)((0[0-9]|1[0-3]):[0-5][0-9]|14:00)))?$') |

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequest | Ordering of medication for patient or group Constraints: dom-2, dom-3, dom-4, dom-5, dom-6
id | Σ | 0..1 | id | Logical id of this artifact
meta | S Σ | 0..1 | Meta | Metadata about the resource
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
versionId | S Σ | 0..1 | id | Version specific identifier
lastUpdated | S Σ | 0..1 | instant | When the resource version last changed
source | Σ | 0..1 | uri | Identifies where the resource comes from
profile | Σ | 0..* | canonical(StructureDefinition) | Profiles this resource claims to conform to
security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag | Σ | 0..* | Coding | Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:context | S | 1..1 | (Complex) | Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/context-extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  |
url |  | 1..1 | uri | "https://gematik.de/fhir/epa-medication/StructureDefinition/context-extension"
value[x] |  | 1..1 | code | Context of the resource Binding: Context Codes (required) Required Pattern: EMP
extension:activity | S | 0..* | Reference(EPA MedicationStatement) | Aktivität die zu diesem Planelement gehört URL: https://gematik.de/fhir/epa-medication/StructureDefinition/emp-medicationrequest-activity-extension
extension:reasonPatientInstruction | S | 0..1 | string | Patientenlesbarer Grund für den Planungseintrag URL: https://gematik.de/fhir/epa-medication/StructureDefinition/reason-patient-instruction-extension
extension:patientNote | S | 0..1 | Annotation | Hinweis für den Patienten URL: https://gematik.de/fhir/epa-medication/StructureDefinition/patient-note-extension
extension:effectiveDosePeriod | S | 0..1 | Period | Zeitraum, in dem die Medikation eingenommen werden soll. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.effectiveDosePeriod
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored Slice: Unordered, Open by value:url
Slices for identifier |  | 0..* | Identifier | External ids for this request Slice: Unordered, Open by value:$this
identifier:MedicationPlanIdentifier | S | 0..1 | MedicationPlanIdentifier | External ids for this request Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
use |  | 0..1 | code | usual | official | temp | secondary | old (If known)
type |  | 0..1 | CodeableConcept | Description of identifier
system |  | 1..1 | uri | The namespace for the identifier value Fixed Value: https://gematik.de/fhir/sid/emp-identifier
value |  | 0..1 | string | The value that is unique
period |  | 0..1 | Period | Time period when id is/was valid for use
assigner |  | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
status | ?!S Σ | 1..1 | code | active | on-hold | completed | entered-in-error | stopped Binding: eMP MedicationRequest Status Value Set (required)
statusReason |  | 0..1 | CodeableConcept | Reason for current status Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
intent | ?!Σ | 1..1 | code | plan Binding: medicationRequest Intent (required): The kind of medication order. Required Pattern: plan
category |  | 0..* | CodeableConcept | Type of medication usage Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.
priority | Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform | ?!Σ | 0..1 | boolean | True if request is prohibiting action
reported[x] | Σ | 0..1 |  | Reported rather than primary record
reportedBoolean |  |  | boolean |
reportedReference |  |  | Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization) |
medication[x] | S Σ | 1..1 | Reference(EPA Medication) | Arzneimittel, welches geplant wird
subject | S Σ C | 1..1 | Reference(Patient) | Who or group medication request is for Constraints: ref-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | Σ C | 0..1 | string | Literal reference, Relative, internal or absolute URL
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | S Σ | 1..1 | IdentifierKvid10(1.5.4) | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
encounter | C | 0..1 | Reference(Encounter) | Encounter created as part of encounter/admission/stay Constraints: ref-1
supportingInformation | C | 0..* | Reference(Resource) | Information to support ordering of the medication Constraints: ref-1
authoredOn | S Σ C | 1..1 | dateTime | When request was initially authored Constraints: epa-datetime
requester | Σ C | 0..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) | Who/What requested the Request Constraints: ref-1
performer | C | 0..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) | Intended performer of administration Constraints: ref-1
performerType | Σ | 0..1 | CodeableConcept | Desired kind of performer of the medication administration Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.
recorder | C | 0..1 | Reference(Practitioner | PractitionerRole) | Person who entered the request Constraints: ref-1
reasonCode | S | 0..1 | CodeableConcept | Reason or indication for ordering or not ordering the medication Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding | S Σ | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Closed by pattern:$this
coding:icd-10-gm | S Σ | 0..1 | CodingICD10GM(1.5.4) | Code defined by a terminology system Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/bfarm/icd-10-gm
version |  | 0..1 | string | Version of the system - if relevant
code |  | 0..1 | code | Symbol in syntax defined by the system
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:Mehrfachcodierungs-Kennzeichen | N | 0..1 | Coding | Optional Extensions Element URL: http://fhir.de/StructureDefinition/icd-10-gm-mehrfachcodierungs-kennzeichen Binding: Mehrfachkodierungs-Kennzeichen ICD10GM ValueSet (required)
extension:Seitenlokalisation | N | 0..1 | Coding | Optional Extensions Element URL: http://fhir.de/StructureDefinition/seitenlokalisation Binding: https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_ICD_SEITENLOKALISATION (required)
extension:Diagnosesicherheit | N | 0..1 | Coding | Optional Extensions Element URL: http://fhir.de/StructureDefinition/icd-10-gm-diagnosesicherheit Binding: https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_ICD_DIAGNOSESICHERHEIT (required)
system | S Σ | 1..1 | uri | Canonische CodeSystem URL für ICD-10-GM Fixed Value: http://fhir.de/CodeSystem/bfarm/icd-10-gm
version | S Σ | 1..1 | string | Die Jahresversion von ICD-10-GM. Angegeben wird immer die vierstellige Jahreszahl (z.B. "2017")
code | S Σ C | 1..1 | code | Der ICD-10-Code Constraints: icd-regex Example Einfacher ICD-Code: F17.4
display | S Σ | 1..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
reasonReference | C | 0..* | Reference(Condition | Observation) | Condition or observation that supports why the prescription is being written Constraints: ref-1
instantiatesCanonical | Σ | 0..* | canonical() | Instantiates FHIR protocol or definition
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition
basedOn | Σ C | 0..* | Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) | What request fulfills Constraints: ref-1
groupIdentifier | Σ | 0..1 | Identifier | Composite request this is part of
courseOfTherapyType |  | 0..1 | CodeableConcept | Overall pattern of medication administration Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio.
insurance | C | 0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage Constraints: ref-1
note | S | 0..1 | Annotation | Zusätzliche Informationen durch einen Leistungserbringenden
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
author[x] | Σ | 0..1 |  | Individual responsible for the annotation
authorReference |  |  | Reference(Practitioner | Patient | RelatedPerson | Organization) |
authorString |  |  | string |
time | S Σ | 0..1 | dateTime | When the annotation was made
text | S Σ | 1..1 | markdown | The annotation - text content (as markdown)
dosageInstruction | S | 1..* | DosageDgMP | Hier werden Informationen zur Dosierung angegeben.
dispenseRequest |  | 0..1 | BackboneElement | Medication supply authorization
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
initialFill |  | 0..1 | BackboneElement | First fill details
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
quantity | C | 0..1 | SimpleQuantity | First fill quantity Constraints: qty-3, sqty-1
duration | C | 0..1 | Duration | First fill duration Constraints: drt-1, qty-3
dispenseInterval | C | 0..1 | Duration | Minimum period of time between dispenses Constraints: drt-1, qty-3
validityPeriod | C | 0..1 | Period | Time period supply is authorized for Constraints: per-1
numberOfRepeatsAllowed |  | 0..1 | unsignedInt | Number of refills authorized
quantity | C | 0..1 | SimpleQuantity | Amount of medication to supply per dispense Constraints: qty-3, sqty-1
expectedSupplyDuration | C | 0..1 | Duration | Number of days supply per dispense Constraints: drt-1, qty-3
performer | C | 0..1 | Reference(Organization) | Intended dispenser Constraints: ref-1
substitution |  | 0..1 | BackboneElement | Any restrictions on medication substitution
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
allowed[x] |  | 1..1 |  | Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.
allowedBoolean |  |  | boolean |
allowedCodeableConcept |  |  | CodeableConcept |
reason |  | 0..1 | CodeableConcept | Why should (not) substitution be made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
priorPrescription | C | 0..1 | Reference(MedicationRequest) | An order/prescription that is being replaced Constraints: ref-1
detectedIssue | C | 0..* | Reference(DetectedIssue) | Clinical Issue with action Constraints: ref-1
eventHistory | C | 0..* | Reference(Provenance) | A list of events of interest in the lifecycle Constraints: ref-1
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
MedicationRequest.meta.security | extensible | All Security Labels `http://hl7.org/fhir/ValueSet/security-labels` From the FHIR Standard
MedicationRequest.meta.tag | example | CommonTags `http://hl7.org/fhir/ValueSet/common-tags` From the FHIR Standard
MedicationRequest.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` From the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
MedicationRequest.extension:context.value[x] | required | Pattern Value: EMP `https://gematik.de/fhir/epa-medication/ValueSet/context-code` From this IG
MedicationRequest.status | required | EMPMedicationRequestStatusVS `https://gematik.de/fhir/epa-medication/ValueSet/emp-medicationrequest-status-vs` From this IG
MedicationRequest.statusReason | example | medicationRequest Status Reason Codes `http://hl7.org/fhir/ValueSet/medicationrequest-status-reason` From the FHIR Standard
MedicationRequest.intent | required | Pattern Value: plan `http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1` From the FHIR Standard
MedicationRequest.category | example | medicationRequest Category Codes `http://hl7.org/fhir/ValueSet/medicationrequest-category` From the FHIR Standard
MedicationRequest.priority | required | RequestPriority `http://hl7.org/fhir/ValueSet/request-priority|4.0.1` From the FHIR Standard
MedicationRequest.subject.type | extensible | ResourceType `http://hl7.org/fhir/ValueSet/resource-types` From the FHIR Standard
MedicationRequest.performerType | example | ProcedurePerformerRoleCodes `http://hl7.org/fhir/ValueSet/performer-role` From the FHIR Standard
MedicationRequest.reasonCode | example | Condition/Problem/DiagnosisCodes `http://hl7.org/fhir/ValueSet/condition-code` From the FHIR Standard
MedicationRequest.courseOfTherapyType | example | medicationRequest Course of Therapy Codes `http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy` From the FHIR Standard
MedicationRequest.substitution.allowed[x] | example | ActSubstanceAdminSubstitutionCode `http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode`
MedicationRequest.substitution.reason | example | SubstanceAdminSubstitutionReason `http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason`

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | MedicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | MedicationRequest | A resource should have narrative for robust management : text.`div`.exists() |
drt-1 | error | MedicationRequest.dispenseRequest.initialFill.duration, MedicationRequest.dispenseRequest.dispenseInterval, MedicationRequest.dispenseRequest.expectedSupplyDuration | There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM. : code.exists() implies ((system = %ucum) and value.exists()) |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
epa-datetime | error | MedicationRequest.authoredOn | dateTime muss mindestens aus Tag, Monat und Jahr bestehen : toString().matches('^([0-9]([0-9]([0-9][1-9]|[1-9]0)|[1-9]00)|[1-9]000)-(0[1-9]|1[0-2])-(0[1-9]|[1-2][0-9]|3[0-1])(T([01][0-9]|2[0-3]):[0-5][0-9]:([0-5][0-9]|60)(\\.[0-9]+)?(Z|(\\+|-)((0[0-9]|1[0-3]):[0-5][0-9]|14:00)))?$') |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
icd-regex | warning | MedicationRequest.reasonCode.coding:icd-10-gm.code | In code sind nur gültige ICD-10-Codes ohne Zusätze erlaubt : matches('^[A-Z][0-9][A-Z0-9](\\.?[A-Z0-9]{0,4})?$') |
per-1 | error | MedicationRequest.dispenseRequest.validityPeriod | If present, start SHALL have a lower value than end : start.hasValue().not() or end.hasValue().not() or (start <= end) |
qty-3 | error | MedicationRequest.dispenseRequest.initialFill.quantity, MedicationRequest.dispenseRequest.initialFill.duration, MedicationRequest.dispenseRequest.dispenseInterval, MedicationRequest.dispenseRequest.quantity, MedicationRequest.dispenseRequest.expectedSupplyDuration | If a code for the unit is present, the system SHALL also be present : code.empty() or system.exists() |
ref-1 | error | MedicationRequest.subject, MedicationRequest.encounter, MedicationRequest.supportingInformation, MedicationRequest.requester, MedicationRequest.performer, MedicationRequest.recorder, MedicationRequest.reasonReference, MedicationRequest.basedOn, MedicationRequest.insurance, MedicationRequest.dispenseRequest.performer, MedicationRequest.priorPrescription, MedicationRequest.detectedIssue, MedicationRequest.eventHistory | SHALL have a contained resource if a local reference is provided : reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) |
sqty-1 | error | MedicationRequest.dispenseRequest.initialFill.quantity, MedicationRequest.dispenseRequest.quantity | The comparator is not used on a SimpleQuantity : comparator.empty() |

This structure is derived from MedicationRequest

Summary

Mandatory: 5 elements(1 nested mandatory element)
Must-Support: 25 elements

Structures

This structure refers to these other structures:

- Profil für den Identifikator eines eMP-Eintrags (https://gematik.de/fhir/ti/StructureDefinition/medication-plan-identifier)
- EPA Medication (https://gematik.de/fhir/epa-medication/StructureDefinition/epa-medication)
- Identifier-Profil für die 10-stellige Krankenversichertennummer (http://fhir.de/StructureDefinition/identifier-kvid-10)
- Coding-Profil für ICD-10-GM (http://fhir.de/StructureDefinition/CodingICD10GM)
- Dosage dgMP (http://ig.fhir.de/igs/medication/StructureDefinition/DosageDgMP)

Extensions

This structure refers to these extensions:

- https://gematik.de/fhir/epa-medication/StructureDefinition/context-extension
- https://gematik.de/fhir/epa-medication/StructureDefinition/emp-medicationrequest-activity-extension
- https://gematik.de/fhir/epa-medication/StructureDefinition/reason-patient-instruction-extension
- https://gematik.de/fhir/epa-medication/StructureDefinition/patient-note-extension
- http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.effectiveDosePeriod

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of MedicationRequest.identifier
- The element 1 is sliced based on the value of MedicationRequest.reasonCode.coding (Closed)

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequest | Ordering of medication for patient or group Constraints: dom-2, dom-3, dom-4, dom-5, dom-6
meta | S Σ | 0..1 | Meta | Metadata about the resource
versionId | S Σ | 0..1 | id | Version specific identifier
lastUpdated | S Σ | 0..1 | instant | When the resource version last changed
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:context | S | 1..1 | (Complex) | Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/context-extension
extension |  | 0..0 |  |
url |  | 1..1 | uri | "https://gematik.de/fhir/epa-medication/StructureDefinition/context-extension"
value[x] |  | 1..1 | code | Context of the resource Binding: Context Codes (required) Required Pattern: EMP
extension:activity | S | 0..* | Reference(EPA MedicationStatement) | Aktivität die zu diesem Planelement gehört URL: https://gematik.de/fhir/epa-medication/StructureDefinition/emp-medicationrequest-activity-extension
extension:reasonPatientInstruction | S | 0..1 | string | Patientenlesbarer Grund für den Planungseintrag URL: https://gematik.de/fhir/epa-medication/StructureDefinition/reason-patient-instruction-extension
extension:patientNote | S | 0..1 | Annotation | Hinweis für den Patienten URL: https://gematik.de/fhir/epa-medication/StructureDefinition/patient-note-extension
extension:effectiveDosePeriod | S | 0..1 | Period | Zeitraum, in dem die Medikation eingenommen werden soll. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.effectiveDosePeriod
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored Slice: Unordered, Open by value:url
Slices for identifier |  | 0..* | Identifier | External ids for this request Slice: Unordered, Open by value:$this
identifier:MedicationPlanIdentifier | S | 0..1 | MedicationPlanIdentifier | External ids for this request Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
use |  | 0..1 | code | usual | official | temp | secondary | old (If known)
type |  | 0..1 | CodeableConcept | Description of identifier
system |  | 1..1 | uri | The namespace for the identifier value Fixed Value: https://gematik.de/fhir/sid/emp-identifier
value |  | 0..1 | string | The value that is unique
period |  | 0..1 | Period | Time period when id is/was valid for use
assigner |  | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
status | ?!S Σ | 1..1 | code | active | on-hold | completed | entered-in-error | stopped Binding: eMP MedicationRequest Status Value Set (required)
intent | ?!Σ | 1..1 | code | plan Binding: medicationRequest Intent (required): The kind of medication order. Required Pattern: plan
doNotPerform | ?!Σ | 0..1 | boolean | True if request is prohibiting action
medication[x] | S Σ | 1..1 | Reference(EPA Medication) | Arzneimittel, welches geplant wird
subject | S Σ C | 1..1 | Reference(Patient) | Who or group medication request is for Constraints: ref-1
identifier | S Σ | 1..1 | IdentifierKvid10(1.5.4) | Logical reference, when literal reference is not known
authoredOn | S Σ C | 1..1 | dateTime | When request was initially authored Constraints: epa-datetime
reasonCode | S | 0..1 | CodeableConcept | Reason or indication for ordering or not ordering the medication Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
Slices for coding | S Σ | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Closed by pattern:$this
coding:icd-10-gm | S Σ | 0..1 | CodingICD10GM(1.5.4) | Code defined by a terminology system Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/bfarm/icd-10-gm
version |  | 0..1 | string | Version of the system - if relevant
code |  | 0..1 | code | Symbol in syntax defined by the system
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
Slices for extension |  |  |  | Content/Rules for all slices
extension:Mehrfachcodierungs-Kennzeichen | N | 0..1 | Coding | Optional Extensions Element URL: http://fhir.de/StructureDefinition/icd-10-gm-mehrfachcodierungs-kennzeichen Binding: Mehrfachkodierungs-Kennzeichen ICD10GM ValueSet (required)
extension:Seitenlokalisation | N | 0..1 | Coding | Optional Extensions Element URL: http://fhir.de/StructureDefinition/seitenlokalisation Binding: https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_ICD_SEITENLOKALISATION (required)
extension:Diagnosesicherheit | N | 0..1 | Coding | Optional Extensions Element URL: http://fhir.de/StructureDefinition/icd-10-gm-diagnosesicherheit Binding: https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_ICD_DIAGNOSESICHERHEIT (required)
system | S Σ | 1..1 | uri | Canonische CodeSystem URL für ICD-10-GM Fixed Value: http://fhir.de/CodeSystem/bfarm/icd-10-gm
version | S Σ | 1..1 | string | Die Jahresversion von ICD-10-GM. Angegeben wird immer die vierstellige Jahreszahl (z.B. "2017")
code | S Σ C | 1..1 | code | Der ICD-10-Code Constraints: icd-regex Example Einfacher ICD-Code: F17.4
display | S Σ | 1..1 | string | Representation defined by the system
note | S | 0..1 | Annotation | Zusätzliche Informationen durch einen Leistungserbringenden
time | S Σ | 0..1 | dateTime | When the annotation was made
text | S Σ | 1..1 | markdown | The annotation - text content (as markdown)
dosageInstruction | S | 1..* | DosageDgMP | Hier werden Informationen zur Dosierung angegeben.
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
MedicationRequest.extension:context.value[x] | required | Pattern Value: EMP `https://gematik.de/fhir/epa-medication/ValueSet/context-code` From this IG
MedicationRequest.status | required | EMPMedicationRequestStatusVS `https://gematik.de/fhir/epa-medication/ValueSet/emp-medicationrequest-status-vs` From this IG
MedicationRequest.intent | required | Pattern Value: plan `http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1` From the FHIR Standard
MedicationRequest.reasonCode | example | Condition/Problem/DiagnosisCodes `http://hl7.org/fhir/ValueSet/condition-code` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | MedicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | MedicationRequest | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
epa-datetime | error | MedicationRequest.authoredOn | dateTime muss mindestens aus Tag, Monat und Jahr bestehen : toString().matches('^([0-9]([0-9]([0-9][1-9]|[1-9]0)|[1-9]00)|[1-9]000)-(0[1-9]|1[0-2])-(0[1-9]|[1-2][0-9]|3[0-1])(T([01][0-9]|2[0-3]):[0-5][0-9]:([0-5][0-9]|60)(\\.[0-9]+)?(Z|(\\+|-)((0[0-9]|1[0-3]):[0-5][0-9]|14:00)))?$') |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
icd-regex | warning | MedicationRequest.reasonCode.coding:icd-10-gm.code | In code sind nur gültige ICD-10-Codes ohne Zusätze erlaubt : matches('^[A-Z][0-9][A-Z0-9](\\.?[A-Z0-9]{0,4})?$') |
ref-1 | error | MedicationRequest.subject | SHALL have a contained resource if a local reference is provided : reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) |

Differential View

This structure is derived from MedicationRequest

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequest | Ordering of medication for patient or group
meta | S | 0..1 | Meta | Metadata about the resource
versionId | S | 0..1 | id | Version specific identifier
lastUpdated | S | 0..1 | instant | When the resource version last changed
extension |  | 1..* | Extension | Extension
Slices for extension |  |  |  | Content/Rules for all slices
extension:context | S | 1..1 | (Complex) | Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/context-extension
value[x] |  | 1..1 | code | Context of the resource Required Pattern: EMP
extension:activity | S | 0..* | Reference(EPA MedicationStatement) | Aktivität die zu diesem Planelement gehört URL: https://gematik.de/fhir/epa-medication/StructureDefinition/emp-medicationrequest-activity-extension
extension:reasonPatientInstruction | S | 0..1 | string | Patientenlesbarer Grund für den Planungseintrag URL: https://gematik.de/fhir/epa-medication/StructureDefinition/reason-patient-instruction-extension
extension:patientNote | S | 0..1 | Annotation | Hinweis für den Patienten URL: https://gematik.de/fhir/epa-medication/StructureDefinition/patient-note-extension
extension:effectiveDosePeriod | S | 0..1 | Period | Zeitraum, in dem die Medikation eingenommen werden soll. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.effectiveDosePeriod
Slices for identifier |  | 0..* | Identifier | External ids for this request Slice: Unordered, Open by value:$this
identifier:MedicationPlanIdentifier | S | 0..1 | MedicationPlanIdentifier | External ids for this request Required Pattern: At least the following
system |  | 1..1 | uri | The namespace for the identifier value Fixed Value: https://gematik.de/fhir/sid/emp-identifier
status | S | 1..1 | code | active | on-hold | completed | entered-in-error | stopped Binding: eMP MedicationRequest Status Value Set (required)
intent |  | 1..1 | code | plan Required Pattern: plan
medication[x] | S | 1..1 | Reference(EPA Medication) | Arzneimittel, welches geplant wird
subject | S | 1..1 | Reference(Patient) | Who or group medication request is for
identifier | S | 1..1 | IdentifierKvid10(1.5.4) | Logical reference, when literal reference is not known
authoredOn | S C | 1..1 | dateTime | When request was initially authored Constraints: epa-datetime
reasonCode | S | 0..1 | CodeableConcept | Reason or indication for ordering or not ordering the medication
Slices for coding | S | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Closed by pattern:$this
coding:icd-10-gm | S | 0..1 | CodingICD10GM(1.5.4) | Code defined by a terminology system Required Pattern: At least the following
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/bfarm/icd-10-gm
system | S | 1..1 | uri | Canonische CodeSystem URL für ICD-10-GM
version | S | 1..1 | string | Die Jahresversion von ICD-10-GM. Angegeben wird immer die vierstellige Jahreszahl (z.B. "2017")
code | S | 1..1 | code | Der ICD-10-Code
display | S | 1..1 | string | Representation defined by the system
note | S | 0..1 | Annotation | Zusätzliche Informationen durch einen Leistungserbringenden
time | S | 0..1 | dateTime | When the annotation was made
text | S | 1..1 | markdown | The annotation - text content (as markdown)
dosageInstruction | S | 1..* | DosageDgMP | Hier werden Informationen zur Dosierung angegeben.
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
MedicationRequest.status | required | EMPMedicationRequestStatusVS `https://gematik.de/fhir/epa-medication/ValueSet/emp-medicationrequest-status-vs` From this IG

#### Constraints

Id | Grade | Path(s) | Details | Requirements
epa-datetime | error | MedicationRequest.authoredOn | dateTime muss mindestens aus Tag, Monat und Jahr bestehen : toString().matches('^([0-9]([0-9]([0-9][1-9]|[1-9]0)|[1-9]00)|[1-9]000)-(0[1-9]|1[0-2])-(0[1-9]|[1-2][0-9]|3[0-1])(T([01][0-9]|2[0-3]):[0-5][0-9]:([0-5][0-9]|60)(\\.[0-9]+)?(Z|(\\+|-)((0[0-9]|1[0-3]):[0-5][0-9]|14:00)))?$') |

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequest | Ordering of medication for patient or group Constraints: dom-2, dom-3, dom-4, dom-5, dom-6
id | Σ | 0..1 | id | Logical id of this artifact
meta | S Σ | 0..1 | Meta | Metadata about the resource
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
versionId | S Σ | 0..1 | id | Version specific identifier
lastUpdated | S Σ | 0..1 | instant | When the resource version last changed
source | Σ | 0..1 | uri | Identifies where the resource comes from
profile | Σ | 0..* | canonical(StructureDefinition) | Profiles this resource claims to conform to
security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag | Σ | 0..* | Coding | Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:context | S | 1..1 | (Complex) | Extension URL: https://gematik.de/fhir/epa-medication/StructureDefinition/context-extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  |
url |  | 1..1 | uri | "https://gematik.de/fhir/epa-medication/StructureDefinition/context-extension"
value[x] |  | 1..1 | code | Context of the resource Binding: Context Codes (required) Required Pattern: EMP
extension:activity | S | 0..* | Reference(EPA MedicationStatement) | Aktivität die zu diesem Planelement gehört URL: https://gematik.de/fhir/epa-medication/StructureDefinition/emp-medicationrequest-activity-extension
extension:reasonPatientInstruction | S | 0..1 | string | Patientenlesbarer Grund für den Planungseintrag URL: https://gematik.de/fhir/epa-medication/StructureDefinition/reason-patient-instruction-extension
extension:patientNote | S | 0..1 | Annotation | Hinweis für den Patienten URL: https://gematik.de/fhir/epa-medication/StructureDefinition/patient-note-extension
extension:effectiveDosePeriod | S | 0..1 | Period | Zeitraum, in dem die Medikation eingenommen werden soll. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.effectiveDosePeriod
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored Slice: Unordered, Open by value:url
Slices for identifier |  | 0..* | Identifier | External ids for this request Slice: Unordered, Open by value:$this
identifier:MedicationPlanIdentifier | S | 0..1 | MedicationPlanIdentifier | External ids for this request Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
use |  | 0..1 | code | usual | official | temp | secondary | old (If known)
type |  | 0..1 | CodeableConcept | Description of identifier
system |  | 1..1 | uri | The namespace for the identifier value Fixed Value: https://gematik.de/fhir/sid/emp-identifier
value |  | 0..1 | string | The value that is unique
period |  | 0..1 | Period | Time period when id is/was valid for use
assigner |  | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
status | ?!S Σ | 1..1 | code | active | on-hold | completed | entered-in-error | stopped Binding: eMP MedicationRequest Status Value Set (required)
statusReason |  | 0..1 | CodeableConcept | Reason for current status Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
intent | ?!Σ | 1..1 | code | plan Binding: medicationRequest Intent (required): The kind of medication order. Required Pattern: plan
category |  | 0..* | CodeableConcept | Type of medication usage Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.
priority | Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform | ?!Σ | 0..1 | boolean | True if request is prohibiting action
reported[x] | Σ | 0..1 |  | Reported rather than primary record
reportedBoolean |  |  | boolean |
reportedReference |  |  | Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization) |
medication[x] | S Σ | 1..1 | Reference(EPA Medication) | Arzneimittel, welches geplant wird
subject | S Σ C | 1..1 | Reference(Patient) | Who or group medication request is for Constraints: ref-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | Σ C | 0..1 | string | Literal reference, Relative, internal or absolute URL
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | S Σ | 1..1 | IdentifierKvid10(1.5.4) | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
encounter | C | 0..1 | Reference(Encounter) | Encounter created as part of encounter/admission/stay Constraints: ref-1
supportingInformation | C | 0..* | Reference(Resource) | Information to support ordering of the medication Constraints: ref-1
authoredOn | S Σ C | 1..1 | dateTime | When request was initially authored Constraints: epa-datetime
requester | Σ C | 0..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) | Who/What requested the Request Constraints: ref-1
performer | C | 0..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) | Intended performer of administration Constraints: ref-1
performerType | Σ | 0..1 | CodeableConcept | Desired kind of performer of the medication administration Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.
recorder | C | 0..1 | Reference(Practitioner | PractitionerRole) | Person who entered the request Constraints: ref-1
reasonCode | S | 0..1 | CodeableConcept | Reason or indication for ordering or not ordering the medication Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding | S Σ | 0..* | Coding | Code defined by a terminology system Slice: Unordered, Closed by pattern:$this
coding:icd-10-gm | S Σ | 0..1 | CodingICD10GM(1.5.4) | Code defined by a terminology system Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/bfarm/icd-10-gm
version |  | 0..1 | string | Version of the system - if relevant
code |  | 0..1 | code | Symbol in syntax defined by the system
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:Mehrfachcodierungs-Kennzeichen | N | 0..1 | Coding | Optional Extensions Element URL: http://fhir.de/StructureDefinition/icd-10-gm-mehrfachcodierungs-kennzeichen Binding: Mehrfachkodierungs-Kennzeichen ICD10GM ValueSet (required)
extension:Seitenlokalisation | N | 0..1 | Coding | Optional Extensions Element URL: http://fhir.de/StructureDefinition/seitenlokalisation Binding: https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_ICD_SEITENLOKALISATION (required)
extension:Diagnosesicherheit | N | 0..1 | Coding | Optional Extensions Element URL: http://fhir.de/StructureDefinition/icd-10-gm-diagnosesicherheit Binding: https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_ICD_DIAGNOSESICHERHEIT (required)
system | S Σ | 1..1 | uri | Canonische CodeSystem URL für ICD-10-GM Fixed Value: http://fhir.de/CodeSystem/bfarm/icd-10-gm
version | S Σ | 1..1 | string | Die Jahresversion von ICD-10-GM. Angegeben wird immer die vierstellige Jahreszahl (z.B. "2017")
code | S Σ C | 1..1 | code | Der ICD-10-Code Constraints: icd-regex Example Einfacher ICD-Code: F17.4
display | S Σ | 1..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
reasonReference | C | 0..* | Reference(Condition | Observation) | Condition or observation that supports why the prescription is being written Constraints: ref-1
instantiatesCanonical | Σ | 0..* | canonical() | Instantiates FHIR protocol or definition
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition
basedOn | Σ C | 0..* | Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) | What request fulfills Constraints: ref-1
groupIdentifier | Σ | 0..1 | Identifier | Composite request this is part of
courseOfTherapyType |  | 0..1 | CodeableConcept | Overall pattern of medication administration Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio.
insurance | C | 0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage Constraints: ref-1
note | S | 0..1 | Annotation | Zusätzliche Informationen durch einen Leistungserbringenden
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
author[x] | Σ | 0..1 |  | Individual responsible for the annotation
authorReference |  |  | Reference(Practitioner | Patient | RelatedPerson | Organization) |
authorString |  |  | string |
time | S Σ | 0..1 | dateTime | When the annotation was made
text | S Σ | 1..1 | markdown | The annotation - text content (as markdown)
dosageInstruction | S | 1..* | DosageDgMP | Hier werden Informationen zur Dosierung angegeben.
dispenseRequest |  | 0..1 | BackboneElement | Medication supply authorization
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
initialFill |  | 0..1 | BackboneElement | First fill details
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
quantity | C | 0..1 | SimpleQuantity | First fill quantity Constraints: qty-3, sqty-1
duration | C | 0..1 | Duration | First fill duration Constraints: drt-1, qty-3
dispenseInterval | C | 0..1 | Duration | Minimum period of time between dispenses Constraints: drt-1, qty-3
validityPeriod | C | 0..1 | Period | Time period supply is authorized for Constraints: per-1
numberOfRepeatsAllowed |  | 0..1 | unsignedInt | Number of refills authorized
quantity | C | 0..1 | SimpleQuantity | Amount of medication to supply per dispense Constraints: qty-3, sqty-1
expectedSupplyDuration | C | 0..1 | Duration | Number of days supply per dispense Constraints: drt-1, qty-3
performer | C | 0..1 | Reference(Organization) | Intended dispenser Constraints: ref-1
substitution |  | 0..1 | BackboneElement | Any restrictions on medication substitution
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
allowed[x] |  | 1..1 |  | Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.
allowedBoolean |  |  | boolean |
allowedCodeableConcept |  |  | CodeableConcept |
reason |  | 0..1 | CodeableConcept | Why should (not) substitution be made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
priorPrescription | C | 0..1 | Reference(MedicationRequest) | An order/prescription that is being replaced Constraints: ref-1
detectedIssue | C | 0..* | Reference(DetectedIssue) | Clinical Issue with action Constraints: ref-1
eventHistory | C | 0..* | Reference(Provenance) | A list of events of interest in the lifecycle Constraints: ref-1
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
MedicationRequest.meta.security | extensible | All Security Labels `http://hl7.org/fhir/ValueSet/security-labels` From the FHIR Standard
MedicationRequest.meta.tag | example | CommonTags `http://hl7.org/fhir/ValueSet/common-tags` From the FHIR Standard
MedicationRequest.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` From the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
MedicationRequest.extension:context.value[x] | required | Pattern Value: EMP `https://gematik.de/fhir/epa-medication/ValueSet/context-code` From this IG
MedicationRequest.status | required | EMPMedicationRequestStatusVS `https://gematik.de/fhir/epa-medication/ValueSet/emp-medicationrequest-status-vs` From this IG
MedicationRequest.statusReason | example | medicationRequest Status Reason Codes `http://hl7.org/fhir/ValueSet/medicationrequest-status-reason` From the FHIR Standard
MedicationRequest.intent | required | Pattern Value: plan `http://hl7.org/fhir/ValueSet/medicationrequest-intent|4.0.1` From the FHIR Standard
MedicationRequest.category | example | medicationRequest Category Codes `http://hl7.org/fhir/ValueSet/medicationrequest-category` From the FHIR Standard
MedicationRequest.priority | required | RequestPriority `http://hl7.org/fhir/ValueSet/request-priority|4.0.1` From the FHIR Standard
MedicationRequest.subject.type | extensible | ResourceType `http://hl7.org/fhir/ValueSet/resource-types` From the FHIR Standard
MedicationRequest.performerType | example | ProcedurePerformerRoleCodes `http://hl7.org/fhir/ValueSet/performer-role` From the FHIR Standard
MedicationRequest.reasonCode | example | Condition/Problem/DiagnosisCodes `http://hl7.org/fhir/ValueSet/condition-code` From the FHIR Standard
MedicationRequest.courseOfTherapyType | example | medicationRequest Course of Therapy Codes `http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy` From the FHIR Standard
MedicationRequest.substitution.allowed[x] | example | ActSubstanceAdminSubstitutionCode `http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode`
MedicationRequest.substitution.reason | example | SubstanceAdminSubstitutionReason `http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason`

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | MedicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | MedicationRequest | A resource should have narrative for robust management : text.`div`.exists() |
drt-1 | error | MedicationRequest.dispenseRequest.initialFill.duration, MedicationRequest.dispenseRequest.dispenseInterval, MedicationRequest.dispenseRequest.expectedSupplyDuration | There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM. : code.exists() implies ((system = %ucum) and value.exists()) |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
epa-datetime | error | MedicationRequest.authoredOn | dateTime muss mindestens aus Tag, Monat und Jahr bestehen : toString().matches('^([0-9]([0-9]([0-9][1-9]|[1-9]0)|[1-9]00)|[1-9]000)-(0[1-9]|1[0-2])-(0[1-9]|[1-2][0-9]|3[0-1])(T([01][0-9]|2[0-3]):[0-5][0-9]:([0-5][0-9]|60)(\\.[0-9]+)?(Z|(\\+|-)((0[0-9]|1[0-3]):[0-5][0-9]|14:00)))?$') |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
icd-regex | warning | MedicationRequest.reasonCode.coding:icd-10-gm.code | In code sind nur gültige ICD-10-Codes ohne Zusätze erlaubt : matches('^[A-Z][0-9][A-Z0-9](\\.?[A-Z0-9]{0,4})?$') |
per-1 | error | MedicationRequest.dispenseRequest.validityPeriod | If present, start SHALL have a lower value than end : start.hasValue().not() or end.hasValue().not() or (start <= end) |
qty-3 | error | MedicationRequest.dispenseRequest.initialFill.quantity, MedicationRequest.dispenseRequest.initialFill.duration, MedicationRequest.dispenseRequest.dispenseInterval, MedicationRequest.dispenseRequest.quantity, MedicationRequest.dispenseRequest.expectedSupplyDuration | If a code for the unit is present, the system SHALL also be present : code.empty() or system.exists() |
ref-1 | error | MedicationRequest.subject, MedicationRequest.encounter, MedicationRequest.supportingInformation, MedicationRequest.requester, MedicationRequest.performer, MedicationRequest.recorder, MedicationRequest.reasonReference, MedicationRequest.basedOn, MedicationRequest.insurance, MedicationRequest.dispenseRequest.performer, MedicationRequest.priorPrescription, MedicationRequest.detectedIssue, MedicationRequest.eventHistory | SHALL have a contained resource if a local reference is provided : reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) |
sqty-1 | error | MedicationRequest.dispenseRequest.initialFill.quantity, MedicationRequest.dispenseRequest.quantity | The comparator is not used on a SimpleQuantity : comparator.empty() |

This structure is derived from MedicationRequest

Summary

Mandatory: 5 elements(1 nested mandatory element)
Must-Support: 25 elements

Structures

This structure refers to these other structures:

- Profil für den Identifikator eines eMP-Eintrags (https://gematik.de/fhir/ti/StructureDefinition/medication-plan-identifier)
- EPA Medication (https://gematik.de/fhir/epa-medication/StructureDefinition/epa-medication)
- Identifier-Profil für die 10-stellige Krankenversichertennummer (http://fhir.de/StructureDefinition/identifier-kvid-10)
- Coding-Profil für ICD-10-GM (http://fhir.de/StructureDefinition/CodingICD10GM)
- Dosage dgMP (http://ig.fhir.de/igs/medication/StructureDefinition/DosageDgMP)

Extensions

This structure refers to these extensions:

- https://gematik.de/fhir/epa-medication/StructureDefinition/context-extension
- https://gematik.de/fhir/epa-medication/StructureDefinition/emp-medicationrequest-activity-extension
- https://gematik.de/fhir/epa-medication/StructureDefinition/reason-patient-instruction-extension
- https://gematik.de/fhir/epa-medication/StructureDefinition/patient-note-extension
- http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.effectiveDosePeriod

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of MedicationRequest.identifier
- The element 1 is sliced based on the value of MedicationRequest.reasonCode.coding (Closed)

Other representations of profile: CSV, Excel, Schematron