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

## Operation API: eMP-Eintrag hinzufügen

Die auf dieser Seite dargestellten Inhalte geben den Stand der Version 1.2.0-ballot.1 wieder. Rückmeldungen aus dem laufenden Kommentierungsverfahren sowie daraus resultierende fachliche oder technische Anpassungen sind in dieser Fassung noch nicht oder nur teilweise berücksichtigt.

Die Operation eMP-Eintrag hinzufügen ermöglicht das gezielte Einfügen eines neuen Medikationseintrags in den elektronischen Medikationsplan (eMP). Dabei werden zwei Ressourcen übergeben, die gemeinsam den vollständigen fachlichen Kontext der Medikation abbilden: eine MedicationRequest-Instanz mit dem Intent plan sowie eine zugehörige Medication-Instanz. Beide Ressourcen müssen den fachlichen FHIR-Profilen EMPMedicationRequest und EMPMedication entsprechen, wie sie im Rahmen des eMP spezifiziert sind. Der Medication Service validiert die übermittelten Ressourcen und übernimmt ausschließlich konforme Inhalte.

Die MedicationRequest beschreibt dabei die beabsichtigte Medikation, während die zugehörige Medication eine fachlich abstrahierte Arzneimittelbeschreibung darstellt. Im Gegensatz zur Medikationsliste (eML), in der konkrete Arzneimittelpackungen referenziert werden, dienen die im eMP verwendeten Medication-Instanzen der langfristigen fachlichen Beschreibung der Therapie und sind nicht an bestimmte Handelsformen gebunden.

Im Zuge dieser Operation wird automatisch eine neue Version des eMP erzeugt. Dazu wird eine Provenance-Ressource gemäß dem Profil EMPChronologyProvenance erstellt, die alle gültigen eMP-Einträge zum Zeitpunkt der Operation referenziert. Die Auswahl dieser Einträge basiert auf dem Status der MedicationRequest-Instanzen:

- Berücksichtigt werden alle Einträge mit Status aktiv (active) oder pausiert (on-hold).
- Nicht berücksichtigt werden Einträge mit Status beendet (completed), abgebrochen (stopped) oder fehlerhaft (entered-in-error).

Als Lesenachweis für die aktuell gültige eMP-Version muss bei Abrufoperationen immer die Resource.id dieser zuletzt erzeugten Chronologie-Provenance angegeben werden.

Zur Nachverfolgbarkeit werden im Rahmen der Operation zusätzlich zwei Provenance-Ressourcen erzeugt:

- Eine Activity Provenance dokumentiert die Änderung an der MedicationRequest-Instanz und enthält Informationen zur ausführenden Organisation (aus dem HTTP-Header X-Requesting-Organization).
- Eine Chronology Provenance dokumentiert die vollständige eMP-Version zum aktuellen Zeitpunkt und referenziert alle relevanten Einträge gemäß oben genannter Statuslogik.

Die Ergebnisse der Operation werden in einem strukturierten Output-Parameters zurückgegeben. Dieser enthält die neu erstellten oder aktualisierten Ressourcen, einschließlich der Provenance-Instanzen.

### Nachricht

Die Nachricht zum Hinzufügen eines Medikationseintrags zum eMP wird als HTTP POST-Anfrage an den Medication Service gesendet.

#### Auslösung

Wenn das ePA-Client-System Medikationseinträge zur eMP ergänzen möchte, verwendet es diese Operation des Medication Service.

#### Antwort

Die Operation gibt den erzeugten Medikationseintrag mit den Instanzen gemäß EMPMedicationRequest und EMPMedication als Ergebnis zurück.

#### FHIR Operation API

Das Primärsystem MUSS die Operation API: eMP-Eintrag hinzufügen implementieren, um einer Leistungserbringerinstitution das Hinzufügen eines Medikationseintrags zum eMP zu ermöglichen. Der Medication Service MUSS die Operation API: eMP-Eintrag hinzufügen gemäß der FHIR OperationDefinition eMP-Eintrag hinzufügen implementieren.

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Organization"},{"url":"responseType","valueString":"EPAMSOperationOutcome"},{"url":"errorCode","valueString":"SVC_ORG_HEADER_PROFILE_MISMATCH"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"extension":[{"url":"statusCode","valueString":"409"},{"url":"description","valueString":"Update Conflict (server current version = %s, client version referenced = %s)"},{"url":"responseType","valueString":"EPAMSOperationOutcome"},{"url":"errorCode","valueString":"MSG_VERSION_AWARE_CONFLICT"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"extension":[{"url":"statusCode","valueString":"404"},{"url":"description","valueString":"Resource is not known"},{"url":"responseType","valueString":"EPAMSOperationOutcome"},{"url":"errorCode","valueString":"MSG_RESOURCE_ID_FAIL"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"extension":[{"url":"statusCode","valueString":"400"},{"url":"description","valueString":"Invalid dosage structure or content"},{"url":"responseType","valueString":"EPAMSOperationOutcome"},{"url":"errorCode","valueString":"MEDSVC_DOSAGE_INVALID"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"extension":[{"url":"statusCode","valueString":"400"},{"url":"description","valueString":"Invalid Data Structure in Medication Service"},{"url":"responseType","valueString":"EPAMSOperationOutcome"},{"url":"errorCode","valueString":"MEDICATIONSVC_NO_VALID_STRUCTURE"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"extension":[{"url":"statusCode","valueString":"400"},{"url":"description","valueString":"Parameter 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"},{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation","valueCode":"SHALL"},{"extension":[{"url":"name","valueString":"X-Requesting-Organization"},{"url":"type","valueString":"string"},{"url":"description","valueString":"Base64 encoded FHIR Organization resource in JSON format used to identify the originator of the request"},{"url":"format","valueString":"base64(fhir+json:Organization)"},{"url":"required","valueBoolean":true}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-header"},{"extension":[{"url":"statusCode","valueString":"200"},{"url":"description","valueString":"Successful operation"},{"url":"responseType","valueString":"Bundle"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"extension":[{"url":"statusCode","valueString":"400"},{"url":"description","valueString":"Invalid request"},{"url":"responseType","valueString":"EPAMSOperationOutcome"},{"url":"errorCode","valueString":"MSG_BAD_FORMAT"}],"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"},{"extension":[{"url":"statusCode","valueString":"400"},{"url":"description","valueString":"Invalid dosage structure or content"},{"url":"responseType","valueString":"EPAMSOperationOutcome"},{"url":"errorCode","valueString":"MEDSVC_DOSAGE_INVALID"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"extension":[{"url":"statusCode","valueString":"400"},{"url":"description","valueString":"Invalid Data Structure in Medication Service"},{"url":"responseType","valueString":"EPAMSOperationOutcome"},{"url":"errorCode","valueString":"MEDICATIONSVC_NO_VALID_STRUCTURE"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"extension":[{"url":"statusCode","valueString":"400"},{"url":"description","valueString":"Parameter 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":"Update Conflict (server current version = %s, client version referenced = %s)"},{"url":"responseType","valueString":"EPAMSOperationOutcome"},{"url":"errorCode","valueString":"MSG_VERSION_AWARE_CONFLICT"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"extension":[{"url":"statusCode","valueString":"404"},{"url":"description","valueString":"Resource is not known"},{"url":"responseType","valueString":"EPAMSOperationOutcome"},{"url":"errorCode","valueString":"MSG_RESOURCE_ID_FAIL"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"}],"name":"batch-emp","definition":"https://gematik.de/fhir/epa-medication/OperationDefinition/batch-emp-entries-op"},{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation","valueCode":"SHALL"},{"extension":[{"url":"name","valueString":"X-Requesting-Organization"},{"url":"type","valueString":"string"},{"url":"description","valueString":"Base64 encoded FHIR Organization resource in JSON format used to identify the originator of the request"},{"url":"format","valueString":"base64(fhir+json:Organization)"},{"url":"required","valueBoolean":true}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-header"},{"extension":[{"url":"statusCode","valueString":"200"},{"url":"description","valueString":"Successful operation"},{"url":"responseType","valueString":"Parameters"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"extension":[{"url":"statusCode","valueString":"405"},{"url":"description","valueString":"The operation can only be executed within a batch context"},{"url":"responseType","valueString":"EPAMSOperationOutcome"},{"url":"errorCode","valueString":"MEDSVC_OPERATION_OUTSIDE_BATCH"}],"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":"emp-commit","definition":"https://gematik.de/fhir/epa-medication/OperationDefinition/emp-commit-op"}]}]}

###

          {"resourceType":"OperationDefinition","id":"add-emp-entry-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 add-emp-entry-op</p><a name=\"add-emp-entry-op\"> </a><a name=\"hcadd-emp-entry-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]/$$add-emp-entryInput parameters Profile:<a href=\"StructureDefinition-epa-op-add-emp-entry-input-parameters.html\">EPA Operation addEMPEntry Input-Parameters</a>Output parameters Profile:<a href=\"StructureDefinition-epa-op-emp-entry-output-parameters.html\">EPA Operation EMPEntry 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/add-emp-entry-op","version":"1.2.0-ballot.2","name":"addEMPEntry_MedicationSvc","title":"eMP-Eintrag hinzufügen","status":"draft","kind":"operation","date":"2025-09-02","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 das gezielte Hinzufügen eines neuen Medikations-Eintrags zum elektronischen Medikationsplan (eMP).","jurisdiction":[{"coding":[{"system":"urn:iso:std:iso:3166","code":"DE"}]}],"affectsState":true,"code":"add-emp-entry","system":true,"type":false,"instance":false,"inputProfile":"https://gematik.de/fhir/epa-medication/StructureDefinition/epa-op-add-emp-entry-input-parameters","outputProfile":"https://gematik.de/fhir/epa-medication/StructureDefinition/epa-op-emp-entry-output-parameters"}

    {
      "resourceType" : "Parameters",
      "id" : "example-epa-op-add-emp-entry-input-parameters-1",
      "meta" : {
        "profile" : [
          🔗 "https://gematik.de/fhir/epa-medication/StructureDefinition/epa-op-add-emp-entry-input-parameters"
        ]
      },
      "parameter" : [
        {
          "name" : "acknowledgedChronologyId",
          "valueId" : "0b383501-f078-464b-b984-9fdb6751601b"
        },
        {
          "name" : "empEntry",
          "resource" : {
            "resourceType" : "MedicationRequest",
            "id" : "881f3c6d-20e6-443e-b7dc-580a40fa3d14",
            "meta" : {
              "profile" : [
                🔗 "https://gematik.de/fhir/epa-medication/StructureDefinition/emp-medication-request"
              ]
            },
            "extension" : [
              {
                "url" : "https://gematik.de/fhir/epa-medication/StructureDefinition/context-extension",
                "valueCode" : "EMP"
              },
              {
                "url" : "https://gematik.de/fhir/epa-medication/StructureDefinition/reason-patient-instruction-extension",
                "valueString" : "Bluthochdruck"
              },
              {
                "url" : "https://gematik.de/fhir/epa-medication/StructureDefinition/patient-note-extension",
                "valueAnnotation" : {
                  "text" : "Benazepril kann anfangs Schwindel verursachen - daher zuerst in Ruhe einnehmen und Autofahren vermeiden."
                }
              },
              {
                "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.effectiveDosePeriod",
                "valuePeriod" : {
                  "start" : "2026-12-01"
                }
              }
            ],
            "status" : "active",
            "intent" : "plan",
            "medicationReference" : {
              "reference" : "Medication/1193c409-3df4-4b55-b672-811665aaa1b7"
            },
            "subject" : {
              "identifier" : {
                "system" : "http://fhir.de/sid/gkv/kvid-10",
                "value" : "X110411319"
              }
            },
            "authoredOn" : "2026-12-01",
            "note" : [
              {
                "text" : "Hinweis für den LE"
              }
            ],
            "dosageInstruction" : [
              {
                "extension" : [
                  {
                    "extension" : [
                      {
                        "url" : "algorithm",
                        "valueCoding" : {
                          "system" : "http://ig.fhir.de/igs/medication/CodeSystem/DosageTextAlgorithm",
                          "version" : "1.0.0",
                          "code" : "GematikDosageTextGenerator"
                        }
                      },
                      {
                        "url" : "algorithmVersion",
                        "valueString" : "1.0.0"
                      },
                      {
                        "url" : "language",
                        "valueCode" : "de-DE"
                      },
                      {
                        "url" : "text",
                        "valueString" : "2 x täglich: morgens und abends — je 1 Stück"
                      }
                    ],
                    "url" : "http://ig.fhir.de/igs/medication/StructureDefinition/GeneratedDosageInstructions"
                  }
                ],
                "timing" : {
                  "repeat" : {
                    "frequency" : 2,
                    "period" : 1,
                    "periodUnit" : "d",
                    "when" : [
                      "MORN",
                      "EVE"
                    ]
                  }
                },
                "doseAndRate" : [
                  {
                    "doseQuantity" : {
                      "value" : 1,
                      "unit" : "Stück",
                      "system" : "https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_BMP_DOSIEREINHEIT",
                      "code" : "1"
                    }
                  }
                ]
              }
            ]
          }
        },
        {
          "name" : "medication",
          "resource" : {
            "resourceType" : "Medication",
            "id" : "1193c409-3df4-4b55-b672-811665aaa1b7",
            "meta" : {
              "profile" : [
                🔗 "https://gematik.de/fhir/epa-medication/StructureDefinition/emp-medication"
              ]
            },
            "extension" : [
              {
                "url" : "https://gematik.de/fhir/epa-medication/StructureDefinition/context-extension",
                "valueCode" : "EMP"
              },
              {
                "url" : "https://gematik.de/fhir/epa-medication/StructureDefinition/epa-medication-type-extension",
                "valueCoding" : {
                  "system" : "http://snomed.info/sct",
                  "code" : "763158003",
                  "display" : "Medicinal product (product)"
                }
              },
              {
                "url" : "https://gematik.de/fhir/epa-medication/StructureDefinition/drug-category-extension",
                "valueCoding" : {
                  "system" : "https://gematik.de/fhir/epa-medication/CodeSystem/epa-drug-category-cs",
                  "code" : "00"
                }
              },
              {
                "url" : "http://fhir.de/StructureDefinition/normgroesse",
                "valueCode" : "N3"
              },
              {
                "url" : "https://gematik.de/fhir/epa-medication/StructureDefinition/medication-id-vaccine-extension",
                "valueBoolean" : false
              }
            ],
            "code" : {
              "coding" : [
                {
                  "system" : "http://fhir.de/CodeSystem/ifa/pzn",
                  "code" : "04351736",
                  "display" : "Benazepril AL 20mg 98 Filmtabletten N3"
                }
              ],
              "text" : "Benazepril AL 20mg 98 Filmtabletten N3"
            },
            "status" : "active",
            "form" : {
              "coding" : [
                {
                  "system" : "https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_DARREICHUNGSFORM",
                  "code" : "FTA"
                }
              ]
            },
            "amount" : {
              "numerator" : {
                "extension" : [
                  {
                    "url" : "https://gematik.de/fhir/epa-medication/StructureDefinition/medication-total-quantity-formulation-extension",
                    "valueString" : "98"
                  }
                ],
                "unit" : "Stück"
              },
              "denominator" : {
                "value" : 1
              }
            },
            "ingredient" : [
              {
                "itemCodeableConcept" : {
                  "coding" : [
                    {
                      "system" : "http://fhir.de/CodeSystem/ask",
                      "code" : "23413"
                    }
                  ],
                  "text" : "Benazepril hydrochlorid"
                },
                "strength" : {
                  "numerator" : {
                    "value" : 20,
                    "unit" : "mg"
                  },
                  "denominator" : {
                    "value" : 1,
                    "unit" : "Filmtbl."
                  }
                }
              }
            ]
          }
        }
      ]
    }

    <Parameters xmlns="http://hl7.org/fhir">
      <id value="example-epa-op-add-emp-entry-input-parameters-1"/>
      <meta>
        <profile
                 value="https://gematik.de/fhir/epa-medication/StructureDefinition/epa-op-add-emp-entry-input-parameters"/>
      </meta>
      <parameter>
        <name value="acknowledgedChronologyId"/>
        <valueId value="0b383501-f078-464b-b984-9fdb6751601b"/>
      </parameter>
      <parameter>
        <name value="empEntry"/>
        <resource>
          <MedicationRequest>
            <id value="881f3c6d-20e6-443e-b7dc-580a40fa3d14"/>
            <meta>
              <profile
                       value="https://gematik.de/fhir/epa-medication/StructureDefinition/emp-medication-request"/>
            </meta>
            <extension
                       url="https://gematik.de/fhir/epa-medication/StructureDefinition/context-extension">
              <valueCode value="EMP"/>
            </extension>
            <extension
                       url="https://gematik.de/fhir/epa-medication/StructureDefinition/reason-patient-instruction-extension">
              <valueString value="Bluthochdruck"/>
            </extension>
            <extension
                       url="https://gematik.de/fhir/epa-medication/StructureDefinition/patient-note-extension">
              <valueAnnotation>
                <text
                      value="Benazepril kann anfangs Schwindel verursachen - daher zuerst in Ruhe einnehmen und Autofahren vermeiden."/>
              </valueAnnotation>
            </extension>
            <extension
                       url="http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.effectiveDosePeriod">
              <valuePeriod>
                <start value="2026-12-01"/>
              </valuePeriod>
            </extension>
            <status value="active"/>
            <intent value="plan"/>
            <medicationReference>
              <reference value="Medication/1193c409-3df4-4b55-b672-811665aaa1b7"/>
            </medicationReference>
            <subject>
              <identifier>
                <system value="http://fhir.de/sid/gkv/kvid-10"/>
                <value value="X110411319"/>
              </identifier>
            </subject>
            <authoredOn value="2026-12-01"/>
            <note>
              <text value="Hinweis für den LE"/>
            </note>
            <dosageInstruction>
              <extension
                         url="http://ig.fhir.de/igs/medication/StructureDefinition/GeneratedDosageInstructions">
                <extension url="algorithm">
                  <valueCoding>
                    <system
                            value="http://ig.fhir.de/igs/medication/CodeSystem/DosageTextAlgorithm"/>
                    <version value="1.0.0"/>
                    <code value="GematikDosageTextGenerator"/>
                  </valueCoding>
                </extension>
                <extension url="algorithmVersion">
                  <valueString value="1.0.0"/>
                </extension>
                <extension url="language">
                  <valueCode value="de-DE"/>
                </extension>
                <extension url="text">
                  <valueString
                               value="2 x täglich: morgens und abends — je 1 Stück"/>
                </extension>
              </extension>
              <timing>
                <repeat>
                  <frequency value="2"/>
                  <period value="1"/>
                  <periodUnit value="d"/>
                  <when value="MORN"/>
                  <when value="EVE"/>
                </repeat>
              </timing>
              <doseAndRate>
                <doseQuantity>
                  <value value="1"/>
                  <unit value="Stück"/>
                  <system
                          value="https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_BMP_DOSIEREINHEIT"/>
                  <code value="1"/>
                </doseQuantity>
              </doseAndRate>
            </dosageInstruction>
          </MedicationRequest>
        </resource>
      </parameter>
      <parameter>
        <name value="medication"/>
        <resource>
          <Medication>
            <id value="1193c409-3df4-4b55-b672-811665aaa1b7"/>
            <meta>
              <profile
                       value="https://gematik.de/fhir/epa-medication/StructureDefinition/emp-medication"/>
            </meta>
            <extension
                       url="https://gematik.de/fhir/epa-medication/StructureDefinition/context-extension">
              <valueCode value="EMP"/>
            </extension>
            <extension
                       url="https://gematik.de/fhir/epa-medication/StructureDefinition/epa-medication-type-extension">
              <valueCoding>
                <system value="http://snomed.info/sct"/>
                <code value="763158003"/>
                <display value="Medicinal product (product)"/>
              </valueCoding>
            </extension>
            <extension
                       url="https://gematik.de/fhir/epa-medication/StructureDefinition/drug-category-extension">
              <valueCoding>
                <system
                        value="https://gematik.de/fhir/epa-medication/CodeSystem/epa-drug-category-cs"/>
                <code value="00"/>
              </valueCoding>
            </extension>
            <extension url="http://fhir.de/StructureDefinition/normgroesse">
              <valueCode value="N3"/>
            </extension>
            <extension
                       url="https://gematik.de/fhir/epa-medication/StructureDefinition/medication-id-vaccine-extension">
              <valueBoolean value="false"/>
            </extension>
            <code>
              <coding>
                <system value="http://fhir.de/CodeSystem/ifa/pzn"/>
                <code value="04351736"/>
                <display value="Benazepril AL 20mg 98 Filmtabletten N3"/>
              </coding>
              <text value="Benazepril AL 20mg 98 Filmtabletten N3"/>
            </code>
            <status value="active"/>
            <form>
              <coding>
                <system
                        value="https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_DARREICHUNGSFORM"/>
                <code value="FTA"/>
              </coding>
            </form>
            <amount>
              <numerator>
                <extension
                           url="https://gematik.de/fhir/epa-medication/StructureDefinition/medication-total-quantity-formulation-extension">
                  <valueString value="98"/>
                </extension>
                <unit value="Stück"/>
              </numerator>
              <denominator>
                <value value="1"/>
              </denominator>
            </amount>
            <ingredient>
              <itemCodeableConcept>
                <coding>
                  <system value="http://fhir.de/CodeSystem/ask"/>
                  <code value="23413"/>
                </coding>
                <text value="Benazepril hydrochlorid"/>
              </itemCodeableConcept>
              <strength>
                <numerator>
                  <value value="20"/>
                  <unit value="mg"/>
                </numerator>
                <denominator>
                  <value value="1"/>
                  <unit value="Filmtbl."/>
                </denominator>
              </strength>
            </ingredient>
          </Medication>
        </resource>
      </parameter>
    </Parameters>

    {
      "resourceType" : "Parameters",
      "id" : "example-epa-op-emp-entry-output-parameters-1",
      "meta" : {
        "profile" : [
          🔗 "https://gematik.de/fhir/epa-medication/StructureDefinition/epa-op-emp-entry-output-parameters"
        ]
      },
      "parameter" : [
        {
          "name" : "empEntry",
          "resource" : {
            "resourceType" : "MedicationRequest",
            "id" : "71b66f1b-8032-4886-b7bf-e775daee22fb",
            "meta" : {
              "versionId" : "1",
              "lastUpdated" : "2026-12-01T14:00:00.400Z",
              "profile" : [
                🔗 "https://gematik.de/fhir/epa-medication/StructureDefinition/emp-medication-request"
              ]
            },
            "extension" : [
              {
                "url" : "https://gematik.de/fhir/epa-medication/StructureDefinition/context-extension",
                "valueCode" : "EMP"
              },
              {
                "url" : "https://gematik.de/fhir/epa-medication/StructureDefinition/reason-patient-instruction-extension",
                "valueString" : "Bluthochdruck"
              },
              {
                "url" : "https://gematik.de/fhir/epa-medication/StructureDefinition/patient-note-extension",
                "valueAnnotation" : {
                  "text" : "Benazepril kann anfangs Schwindel verursachen - daher zuerst in Ruhe einnehmen und Autofahren vermeiden."
                }
              },
              {
                "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.effectiveDosePeriod",
                "valuePeriod" : {
                  "start" : "2026-12-01"
                }
              }
            ],
            "identifier" : [
              {
                "system" : "https://gematik.de/fhir/sid/emp-identifier",
                "value" : "71b66f1b-8032-4886-b7bf-e775daee22fb"
              }
            ],
            "status" : "active",
            "intent" : "plan",
            "medicationReference" : {
              🔗 "reference" : "Medication/13c66845-d0ce-43e1-9b0b-884cbbe8df7f"
            },
            "subject" : {
              "identifier" : {
                "system" : "http://fhir.de/sid/gkv/kvid-10",
                "value" : "X110411319"
              }
            },
            "authoredOn" : "2026-12-01",
            "note" : [
              {
                "text" : "Hinweis für den LE"
              }
            ],
            "dosageInstruction" : [
              {
                "extension" : [
                  {
                    "extension" : [
                      {
                        "url" : "algorithm",
                        "valueCoding" : {
                          "system" : "http://ig.fhir.de/igs/medication/CodeSystem/DosageTextAlgorithm",
                          "version" : "1.0.0",
                          "code" : "GematikDosageTextGenerator"
                        }
                      },
                      {
                        "url" : "algorithmVersion",
                        "valueString" : "1.0.0"
                      },
                      {
                        "url" : "language",
                        "valueCode" : "de-DE"
                      },
                      {
                        "url" : "text",
                        "valueString" : "2 x täglich: morgens und abends — je 1 Stück"
                      }
                    ],
                    "url" : "http://ig.fhir.de/igs/medication/StructureDefinition/GeneratedDosageInstructions"
                  }
                ],
                "timing" : {
                  "repeat" : {
                    "frequency" : 2,
                    "period" : 1,
                    "periodUnit" : "d",
                    "when" : [
                      "MORN",
                      "EVE"
                    ]
                  }
                },
                "doseAndRate" : [
                  {
                    "doseQuantity" : {
                      "value" : 1,
                      "unit" : "Stück",
                      "system" : "https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_BMP_DOSIEREINHEIT",
                      "code" : "1"
                    }
                  }
                ]
              }
            ]
          }
        },
        {
          "name" : "medication",
          "resource" : {
            "resourceType" : "Medication",
            "id" : "13c66845-d0ce-43e1-9b0b-884cbbe8df7f",
            "meta" : {
              "versionId" : "1",
              "lastUpdated" : "2026-12-01T14:00:00.200Z",
              "profile" : [
                🔗 "https://gematik.de/fhir/epa-medication/StructureDefinition/emp-medication"
              ]
            },
            "extension" : [
              {
                "url" : "https://gematik.de/fhir/epa-medication/StructureDefinition/context-extension",
                "valueCode" : "EMP"
              },
              {
                "url" : "https://gematik.de/fhir/epa-medication/StructureDefinition/epa-medication-type-extension",
                "valueCoding" : {
                  "system" : "http://snomed.info/sct",
                  "code" : "763158003",
                  "display" : "Medicinal product (product)"
                }
              },
              {
                "url" : "https://gematik.de/fhir/epa-medication/StructureDefinition/drug-category-extension",
                "valueCoding" : {
                  "system" : "https://gematik.de/fhir/epa-medication/CodeSystem/epa-drug-category-cs",
                  "code" : "00"
                }
              },
              {
                "url" : "http://fhir.de/StructureDefinition/normgroesse",
                "valueCode" : "N3"
              },
              {
                "url" : "https://gematik.de/fhir/epa-medication/StructureDefinition/medication-id-vaccine-extension",
                "valueBoolean" : false
              }
            ],
            "identifier" : [
              {
                "system" : "https://gematik.de/fhir/epa-medication/sid/epa-medication-unique-identifier",
                "value" : "D15E4956F59A13CD3BB365799857D6FA9757C62D36DBDB9578D018CA4B6D969F"
              }
            ],
            "code" : {
              "coding" : [
                {
                  "system" : "http://fhir.de/CodeSystem/ifa/pzn",
                  "code" : "04351736",
                  "display" : "Benazepril AL 20mg 98 Filmtabletten N3"
                }
              ],
              "text" : "Benazepril AL 20mg 98 Filmtabletten N3"
            },
            "status" : "active",
            "form" : {
              "coding" : [
                {
                  "system" : "https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_DARREICHUNGSFORM",
                  "code" : "FTA"
                }
              ]
            },
            "amount" : {
              "numerator" : {
                "extension" : [
                  {
                    "url" : "https://gematik.de/fhir/epa-medication/StructureDefinition/medication-total-quantity-formulation-extension",
                    "valueString" : "98"
                  }
                ],
                "unit" : "Stück"
              },
              "denominator" : {
                "value" : 1
              }
            },
            "ingredient" : [
              {
                "itemCodeableConcept" : {
                  "coding" : [
                    {
                      "system" : "http://fhir.de/CodeSystem/ask",
                      "code" : "23413"
                    }
                  ],
                  "text" : "Benazepril hydrochlorid"
                },
                "strength" : {
                  "numerator" : {
                    "value" : 20,
                    "unit" : "mg"
                  },
                  "denominator" : {
                    "value" : 1,
                    "unit" : "Filmtbl."
                  }
                }
              }
            ]
          }
        },
        {
          "name" : "relatedActivity",
          "resource" : {
            "resourceType" : "Provenance",
            "id" : "8faa45dd-b2dc-4a80-8956-94aeab1db04b",
            "meta" : {
              "profile" : [
                🔗 "https://gematik.de/fhir/epa/StructureDefinition/epa-activity-provenance"
              ]
            },
            "target" : [
              {
                "reference" : "MedicationRequest/71b66f1b-8032-4886-b7bf-e775daee22fb/_history/1"
              }
            ],
            "recorded" : "2026-12-01T14:00:00.600Z",
            "activity" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/v3-DataOperation",
                  "code" : "CREATE"
                }
              ]
            },
            "agent" : [
              {
                "type" : {
                  "coding" : [
                    {
                      "system" : "http://terminology.hl7.org/CodeSystem/provenance-participant-type",
                      "code" : "author"
                    }
                  ]
                },
                "who" : {
                  🔗 "reference" : "Organization/450a9511-53e5-4af7-be36-a18444bb8dd2",
                  "identifier" : {
                    "type" : {
                      "coding" : [
                        {
                          "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                          "code" : "PRN"
                        }
                      ]
                    },
                    "system" : "https://gematik.de/fhir/sid/telematik-id",
                    "value" : "9-2.58.00000089"
                  },
                  "display" : "Die Hausarztpraxis"
                }
              }
            ]
          }
        },
        {
          "name" : "relatedChronology",
          "resource" : {
            "resourceType" : "Provenance",
            "id" : "b467ce05-e0e5-4d71-9a0b-d824dbb492ef",
            "meta" : {
              "profile" : [
                🔗 "https://gematik.de/fhir/epa-medication/StructureDefinition/emp-chronology-provenance"
              ]
            },
            "extension" : [
              {
                "url" : "https://gematik.de/fhir/epa-medication/StructureDefinition/is-emp-chronology-extension",
                "valueBoolean" : true
              }
            ],
            "target" : [
              {
                "reference" : "MedicationRequest/173439a1-40ee-4b61-bb8c-aab3f5a1af10/_history/2"
              },
              {
                "reference" : "MedicationRequest/e2da4372-accc-4a76-81da-83e43ef9b15a/_history/1"
              },
              {
                "reference" : "MedicationRequest/71b66f1b-8032-4886-b7bf-e775daee22fb/_history/1"
              }
            ],
            "occurredDateTime" : "2026-12-01T14:00:00.700Z",
            "recorded" : "2026-12-01T14:00:00.700Z",
            "activity" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/v3-DataOperation",
                  "code" : "UPDATE"
                }
              ]
            },
            "agent" : [
              {
                "type" : {
                  "coding" : [
                    {
                      "system" : "http://terminology.hl7.org/CodeSystem/provenance-participant-type",
                      "code" : "author"
                    }
                  ]
                },
                "who" : {
                  🔗 "reference" : "Organization/450a9511-53e5-4af7-be36-a18444bb8dd2",
                  "identifier" : {
                    "type" : {
                      "coding" : [
                        {
                          "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                          "code" : "PRN"
                        }
                      ]
                    },
                    "system" : "https://gematik.de/fhir/sid/telematik-id",
                    "value" : "9-2.58.00000089"
                  },
                  "display" : "Die Hausarztpraxis"
                }
              }
            ]
          }
        }
      ]
    }

    <Parameters xmlns="http://hl7.org/fhir">
      <id value="example-epa-op-emp-entry-output-parameters-1"/>
      <meta>
        <profile
                 value="https://gematik.de/fhir/epa-medication/StructureDefinition/epa-op-emp-entry-output-parameters"/>
      </meta>
      <parameter>
        <name value="empEntry"/>
        <resource>
          <MedicationRequest>
            <id value="71b66f1b-8032-4886-b7bf-e775daee22fb"/>
            <meta>
              <versionId value="1"/>
              <lastUpdated value="2026-12-01T14:00:00.400Z"/>
              <profile
                       value="https://gematik.de/fhir/epa-medication/StructureDefinition/emp-medication-request"/>
            </meta>
            <extension
                       url="https://gematik.de/fhir/epa-medication/StructureDefinition/context-extension">
              <valueCode value="EMP"/>
            </extension>
            <extension
                       url="https://gematik.de/fhir/epa-medication/StructureDefinition/reason-patient-instruction-extension">
              <valueString value="Bluthochdruck"/>
            </extension>
            <extension
                       url="https://gematik.de/fhir/epa-medication/StructureDefinition/patient-note-extension">
              <valueAnnotation>
                <text
                      value="Benazepril kann anfangs Schwindel verursachen - daher zuerst in Ruhe einnehmen und Autofahren vermeiden."/>
              </valueAnnotation>
            </extension>
            <extension
                       url="http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.effectiveDosePeriod">
              <valuePeriod>
                <start value="2026-12-01"/>
              </valuePeriod>
            </extension>
            <identifier>
              <system value="https://gematik.de/fhir/sid/emp-identifier"/>
              <value value="71b66f1b-8032-4886-b7bf-e775daee22fb"/>
            </identifier>
            <status value="active"/>
            <intent value="plan"/>
            <medicationReference>🔗
              <reference value="Medication/13c66845-d0ce-43e1-9b0b-884cbbe8df7f"/>
            </medicationReference>
            <subject>
              <identifier>
                <system value="http://fhir.de/sid/gkv/kvid-10"/>
                <value value="X110411319"/>
              </identifier>
            </subject>
            <authoredOn value="2026-12-01"/>
            <note>
              <text value="Hinweis für den LE"/>
            </note>
            <dosageInstruction>
              <extension
                         url="http://ig.fhir.de/igs/medication/StructureDefinition/GeneratedDosageInstructions">
                <extension url="algorithm">
                  <valueCoding>
                    <system
                            value="http://ig.fhir.de/igs/medication/CodeSystem/DosageTextAlgorithm"/>
                    <version value="1.0.0"/>
                    <code value="GematikDosageTextGenerator"/>
                  </valueCoding>
                </extension>
                <extension url="algorithmVersion">
                  <valueString value="1.0.0"/>
                </extension>
                <extension url="language">
                  <valueCode value="de-DE"/>
                </extension>
                <extension url="text">
                  <valueString
                               value="2 x täglich: morgens und abends — je 1 Stück"/>
                </extension>
              </extension>
              <timing>
                <repeat>
                  <frequency value="2"/>
                  <period value="1"/>
                  <periodUnit value="d"/>
                  <when value="MORN"/>
                  <when value="EVE"/>
                </repeat>
              </timing>
              <doseAndRate>
                <doseQuantity>
                  <value value="1"/>
                  <unit value="Stück"/>
                  <system
                          value="https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_BMP_DOSIEREINHEIT"/>
                  <code value="1"/>
                </doseQuantity>
              </doseAndRate>
            </dosageInstruction>
          </MedicationRequest>
        </resource>
      </parameter>
      <parameter>
        <name value="medication"/>
        <resource>
          <Medication>
            <id value="13c66845-d0ce-43e1-9b0b-884cbbe8df7f"/>
            <meta>
              <versionId value="1"/>
              <lastUpdated value="2026-12-01T14:00:00.200Z"/>
              <profile
                       value="https://gematik.de/fhir/epa-medication/StructureDefinition/emp-medication"/>
            </meta>
            <extension
                       url="https://gematik.de/fhir/epa-medication/StructureDefinition/context-extension">
              <valueCode value="EMP"/>
            </extension>
            <extension
                       url="https://gematik.de/fhir/epa-medication/StructureDefinition/epa-medication-type-extension">
              <valueCoding>
                <system value="http://snomed.info/sct"/>
                <code value="763158003"/>
                <display value="Medicinal product (product)"/>
              </valueCoding>
            </extension>
            <extension
                       url="https://gematik.de/fhir/epa-medication/StructureDefinition/drug-category-extension">
              <valueCoding>
                <system
                        value="https://gematik.de/fhir/epa-medication/CodeSystem/epa-drug-category-cs"/>
                <code value="00"/>
              </valueCoding>
            </extension>
            <extension url="http://fhir.de/StructureDefinition/normgroesse">
              <valueCode value="N3"/>
            </extension>
            <extension
                       url="https://gematik.de/fhir/epa-medication/StructureDefinition/medication-id-vaccine-extension">
              <valueBoolean value="false"/>
            </extension>
            <identifier>
              <system
                      value="https://gematik.de/fhir/epa-medication/sid/epa-medication-unique-identifier"/>
              <value
                     value="D15E4956F59A13CD3BB365799857D6FA9757C62D36DBDB9578D018CA4B6D969F"/>
            </identifier>
            <code>
              <coding>
                <system value="http://fhir.de/CodeSystem/ifa/pzn"/>
                <code value="04351736"/>
                <display value="Benazepril AL 20mg 98 Filmtabletten N3"/>
              </coding>
              <text value="Benazepril AL 20mg 98 Filmtabletten N3"/>
            </code>
            <status value="active"/>
            <form>
              <coding>
                <system
                        value="https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_DARREICHUNGSFORM"/>
                <code value="FTA"/>
              </coding>
            </form>
            <amount>
              <numerator>
                <extension
                           url="https://gematik.de/fhir/epa-medication/StructureDefinition/medication-total-quantity-formulation-extension">
                  <valueString value="98"/>
                </extension>
                <unit value="Stück"/>
              </numerator>
              <denominator>
                <value value="1"/>
              </denominator>
            </amount>
            <ingredient>
              <itemCodeableConcept>
                <coding>
                  <system value="http://fhir.de/CodeSystem/ask"/>
                  <code value="23413"/>
                </coding>
                <text value="Benazepril hydrochlorid"/>
              </itemCodeableConcept>
              <strength>
                <numerator>
                  <value value="20"/>
                  <unit value="mg"/>
                </numerator>
                <denominator>
                  <value value="1"/>
                  <unit value="Filmtbl."/>
                </denominator>
              </strength>
            </ingredient>
          </Medication>
        </resource>
      </parameter>
      <parameter>
        <name value="relatedActivity"/>
        <resource>
          <Provenance>
            <id value="8faa45dd-b2dc-4a80-8956-94aeab1db04b"/>
            <meta>
              <profile
                       value="https://gematik.de/fhir/epa/StructureDefinition/epa-activity-provenance"/>
            </meta>
            <target>
              <reference
                         value="MedicationRequest/71b66f1b-8032-4886-b7bf-e775daee22fb/_history/1"/>
            </target>
            <recorded value="2026-12-01T14:00:00.600Z"/>
            <activity>
              <coding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/v3-DataOperation"/>
                <code value="CREATE"/>
              </coding>
            </activity>
            <agent>
              <type>
                <coding>
                  <system
                          value="http://terminology.hl7.org/CodeSystem/provenance-participant-type"/>
                  <code value="author"/>
                </coding>
              </type>
              <who>🔗
                <reference
                           value="Organization/450a9511-53e5-4af7-be36-a18444bb8dd2"/>
                <identifier>
                  <type>
                    <coding>
                      <system
                              value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
                      <code value="PRN"/>
                    </coding>
                  </type>
                  <system value="https://gematik.de/fhir/sid/telematik-id"/>
                  <value value="9-2.58.00000089"/>
                </identifier>
                <display value="Die Hausarztpraxis"/>
              </who>
            </agent>
          </Provenance>
        </resource>
      </parameter>
      <parameter>
        <name value="relatedChronology"/>
        <resource>
          <Provenance>
            <id value="b467ce05-e0e5-4d71-9a0b-d824dbb492ef"/>
            <meta>
              <profile
                       value="https://gematik.de/fhir/epa-medication/StructureDefinition/emp-chronology-provenance"/>
            </meta>
            <extension
                       url="https://gematik.de/fhir/epa-medication/StructureDefinition/is-emp-chronology-extension">
              <valueBoolean value="true"/>
            </extension>
            <target>
              <reference
                         value="MedicationRequest/173439a1-40ee-4b61-bb8c-aab3f5a1af10/_history/2"/>
            </target>
            <target>
              <reference
                         value="MedicationRequest/e2da4372-accc-4a76-81da-83e43ef9b15a/_history/1"/>
            </target>
            <target>
              <reference
                         value="MedicationRequest/71b66f1b-8032-4886-b7bf-e775daee22fb/_history/1"/>
            </target>
            <occurredDateTime value="2026-12-01T14:00:00.700Z"/>
            <recorded value="2026-12-01T14:00:00.700Z"/>
            <activity>
              <coding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/v3-DataOperation"/>
                <code value="UPDATE"/>
              </coding>
            </activity>
            <agent>
              <type>
                <coding>
                  <system
                          value="http://terminology.hl7.org/CodeSystem/provenance-participant-type"/>
                  <code value="author"/>
                </coding>
              </type>
              <who>🔗
                <reference
                           value="Organization/450a9511-53e5-4af7-be36-a18444bb8dd2"/>
                <identifier>
                  <type>
                    <coding>
                      <system
                              value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
                      <code value="PRN"/>
                    </coding>
                  </type>
                  <system value="https://gematik.de/fhir/sid/telematik-id"/>
                  <value value="9-2.58.00000089"/>
                </identifier>
                <display value="Die Hausarztpraxis"/>
              </who>
            </agent>
          </Provenance>
        </resource>
      </parameter>
    </Parameters>

### Geschäftslogik

Der Medication Service MUSS beim Erstellen einer MedicationRequest Instanz sicherstellen, dass der identifier mit dem Slice MedicationPlanIdentifier gesetzt wird und denselben UUIDWert wie die resource.id der erzeugten MedicationRequest Instanz erhält. Der Medication Service MUSS die Geschäftlogik der Operation eMP-Eintrag hinzufügen gemäß dem Aktivitätsdiagramm mit der ID IG-MED-BL-ADD-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.
Abbildung: Geschäftslogik für die Operation eMP-Eintrag hinzufügen

### Sicherheitsanforderungen

Generelle Sicherheitsanforderungen werden hier festgehalten.