# Operation API: eMP-Eintrag aktualisieren - Implementation Guide ePA Medication Service v1.3.0

Implementation Guide

ePA Medication Service

Version 1.3.0 - release

* [**Table of Contents**](toc.md)
* [**Operation API**](operation-api.md)
* **Operation API: eMP-Eintrag aktualisieren**

## Operation API: eMP-Eintrag aktualisieren

Die Operation *[eMP-Eintrag aktualisieren](./OperationDefinition-update-emp-entry-op.md)* dient der gezielten Aktualisierung eines bestehenden Medikationseintrags im elektronischen Medikationsplan (eMP). Sie ermöglicht es, inhaltliche Änderungen an einer bereits dokumentierten Medikation vorzunehmen – beispielsweise um eine Notiz zu ergänzen, eine Dosierung zu verändern oder den Status des Eintrags zu aktualisieren.

### Nachricht

Die Nachricht zum Aktualisieren eines Medikationseintrags zum eMP wird als HTTP POST-Anfrage an den Medication Service gesendet. Als Eingabe werden eine **MedicationRequest**-Instanz mit dem Profil **EMPMedicationRequest** sowie ein eindeutiger Bezeichner (**identifier[MedicationPlanIdentifier]**) erwartet, über den der bestehende eMP-Eintrag im Medication Service identifiziert werden kann.

Die **Medication**-Instanz selbst wird ebenfalls geladen und ggf. aktualisiert – etwa wenn sich aus dem geänderten Status der **MedicationRequest**-Instanz ergibt, dass die zugehörige Medikation nun ebenfalls als fehlerhaft (**entered-in-error**) oder inaktiv markiert werden muss.

Die Aktualisierung eines Eintrags kann auch dazu verwendet werden, den Eintrag aus dem aktuellen eMP zu entfernen. Dies geschieht nicht durch Löschen, sondern durch Setzen eines geeigneten Statuswertes wie “beendet” (**completed**), abgebrochen (**stopped**) oder fehlerhaft (**entered-in-error**). Nur Einträge mit den Statuswerten aktiv (**active**) oder pausiert (**on-hold**) werden bei der Erzeugung einer neuen eMP-Version berücksichtigt – Einträge mit anderen Statuswerten gelten als fachlich nicht mehr relevant für den aktuellen Plan.

#### Verwendung des HTTP Header X-Requesting-Organization

Bei der Ausführung dieser Operation ist der HTTP Header *X-Requesting-Organization* mitzugeben. Er enthält eine FHIR *Organization*-Ressource im Format FHIR+JSON, die Base64-kodiert übermittelt wird.

Die übermittelte Organisation dient zur Identifikation der anfragenden Leistungserbringerinstitution (LEI). Sie wird vom Service validiert, in jedem Änderungseintrag (*Provenance* nach dem Profil *EPA Activity Provenance*) der betroffenen Instanz referenziert und zusätzlich im Medication Service als *Organization*-Ressource dedupliziert gespeichert. Dadurch ist sichergestellt, dass alle Änderungen eindeutig einer LEI zugeordnet und auch über die Query API nachvollzogen werden können

#### Auslösung

Diese Operation des Medication Service dient dazu, bestehende eMP-Einträge gezielt zu aktualisieren oder aus dem elektronischen Medikationsplan (eMP) zu entfernen. Sie wird vom ePA-Client-System aufgerufen, wenn bereits dokumentierte Medikationseinträge angepasst oder aus dem eMP ausgeschlossen werden sollen – etwa durch Statusänderung auf **stopped**, **completed** oder **entered-in-error**.

#### 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
*eMP-Eintrag aktualisieren*implementieren, um einer Leistungserbringerinstitution das Aktualisieren eines Medikationseintrags zum eMP zu ermöglichen.

Das Primärsystem MUSS für die Ausführung der Operation
*eMP-Eintrag aktualisieren*den HTTP Header
*X-Requesting-Organization*übermitteln.

Der Medication Service MUSS für die Operation
*eMP-Eintrag aktualisieren*die im HTTP Header
*X-Requesting-Organization*enthaltene
*Organization*-Ressource validieren, im Änderungseintrag (
*Provenance*nach dem Profil
*EPAActivityProvenance*) referenzieren und als
*Organization*-Instanz dedupliziert speichern.

Der Medication Service MUSS die Operation
*eMP-Eintrag aktualisieren*gemäß der FHIR OperationDefinition
[eMP-Eintrag aktualisieren](./OperationDefinition-update-emp-entry-op.md)implementieren.

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
```

```

      {"resourceType":"OperationDefinition","id":"update-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 update-emp-entry-op</p><a name=\"update-emp-entry-op\"> </a><a name=\"hcupdate-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/1.2.0/StructureDefinition-ti-operationdefinition.html\">OperationDefinition Profil für TI FHIR Data Service</a></p></div>URL: [base]/$update-emp-entryInput parameters Profile:<a href=\"StructureDefinition-epa-op-update-emp-entry-input-parameters.html\">EPA Operation UpdateEMPEntry 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/update-emp-entry-op","version":"1.3.0","name":"updateEMPEntry_MedicationSvc","title":"eMP-Eintrag aktualisieren","status":"active","kind":"operation","date":"2025-12-15","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 dient der gezielten Aktualisierung eines bestehenden Medikations-Eintrags im elektronischen Medikationsplan (eMP).","jurisdiction":[{"coding":[{"system":"urn:iso:std:iso:3166","code":"DE"}]}],"affectsState":true,"code":"update-emp-entry","system":true,"type":false,"instance":false,"inputProfile":"https://gematik.de/fhir/epa-medication/StructureDefinition/epa-op-update-emp-entry-input-parameters","outputProfile":"https://gematik.de/fhir/epa-medication/StructureDefinition/epa-op-emp-entry-output-parameters"}
    
```

### Geschäftslogik

Wurde ein Eintrag erfolgreich geändert, wird automatisch eine neue Version des eMP erzeugt. Dabei wird eine Provenance-Instanz vom Profil **EMPChronologyProvenance** erstellt, die alle derzeit relevanten **MedicationRequest**-Instanzen im Kontext des eMP referenziert. Diese Version bildet den neuen Stand des Medikationsplans ab. Als Lesenachweis für diesen Stand dient die **Resource.id** der soeben erzeugten Provenance-Instanz mit **isEMPChronology = true**.

Zusätzlich wird auch eine **Provenance**-Instanz vom Profil **EPAActivityProvenance** erzeugt, um die durchgeführte Aktivität (UPDATE) zu dokumentieren. Diese verweist auf die aktualisierte **MedicationRequest-Instanz** und gibt die Organisation an, die die Änderung vorgenommen hat – abgeleitet aus dem HTTP Header **X-Requesting-Organization**.

Das Ergebnis dieser Operation wird im Format eines **Output-Parameters** zurückgegeben, welcher die aktualisierten bzw. geladenen Ressourcen enthält (einschließlich beider **Provenance**-Instanzen).

Der Medication Service MUSS die Geschäftlogik der Operation
*eMP-Eintrag aktualisieren*gemäß dem Aktivitätsdiagramm mit der ID
**IG-MED-BL-UPDATE-EMP-ENTRY-V2**ausführen. Dabei sind alle mit
**transaction**gekennzeichneten Abschnitte entsprechend den Transaktionssicherheitsregeln des ePA-Aktensystems umzusetzen, sodass diese Abschnitte mit ihren Verarbeitungsschritten atomar, konsistent und isoliert durchgeführt werden.
Das folgende Aktivitätsdiagramm illustriert die Geschäftslogik der Operation *eMP-Eintrag aktualisieren* im Medication Service.

**Abbildung:**Geschäftslogik für die Operation
*eMP-Eintrag aktualisieren*
### Sicherheitsanforderungen

Generelle Sicherheitsanforderungen werden [hier](./privacy-security.md) festgehalten.

