Implementation Guide
ePA Medication Service
Version 1.3.0 - release

## Operation API: eML-Eintrag stornieren

Die Operation eML-Eintrag stornieren ermöglicht das gezielte Widerrufen bzw. Abbrechen eines bestehenden Medikationseintrags in der elektronischen Medikationsliste (eML). Sie kann ausschließlich für eML-Einträge aus einem Nachtrag verwendet werden. Einträge aus dem Verschreibungs- oder Abgabeprozess sind von dieser Operation ausgeschlossen.

### Nachricht

Die Nachricht zum Stornieren eines Medikationseintrags in der eML wird als HTTP POST-Anfrage an den Medication Service gesendet.

#### 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

Wenn das ePA-Client-System einen Medikationseintrag der elektronischen Medikationsliste stornieren möchte, verwendet es diese Operation des Medication Service.

#### Antwort

Die Operation gibt den stornierten Medikationseintrag als Instanz gemäß EPAMedicationStatement zurück, ergänzt um die zugehörige EPAMedication sowie die EPAActivityProvenance als Nachweis der durchgeführten Stornierungsaktivität.

#### FHIR Operation API

Das Primärsystem MUSS die Operation eML-Eintrag stornieren implementieren, um einer Leistungserbringerinstitution das Stornieren eines eML-Eintrags zu ermöglichen. Das Primärsystem MUSS für die Ausführung der Operation eML-Eintrag stornieren den HTTP Header X-Requesting-Organization übermitteln. Der Medication Service MUSS für die Operation eML-Eintrag stornieren 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 eML-Eintrag stornieren gemäß der FHIR OperationDefinition eML-Eintrag stornieren implementieren.

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exists"},{"url":"responseType","valueString":"EPAMSOperationOutcome"},{"url":"errorCode","valueString":"MEDSVC_EMP_ENTRY_ALREADY_EXISTS"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"}],"name":"add-emp-entry","definition":"https://gematik.de/fhir/epa-medication/OperationDefinition/add-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":"431"},{"url":"description","valueString":"Requesting Organization Header exceeds maximum size"},{"url":"responseType","valueString":"EPAMSOperationOutcome"},{"url":"errorCode","valueString":"SVC_ORG_HEADER_TOO_LARGE"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"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":"403"},{"url":"description","valueString":"ID-Token or Insurant-ID mismatch"},{"url":"responseType","valueString":"EPAMSOperationOutcome"},{"url":"errorCode","valueString":"SVC_IDENTITY_MISMATCH"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"extension":[{"url":"statusCode","valueString":"422"},{"url":"description","valueString":"Profile mismatch in header 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":"422"},{"url":"description","valueString":"Invalid Data Structure in Medication Service"},{"url":"responseType","valueString":"EPAMSOperationOutcome"},{"url":"errorCode","valueString":"MEDSVC_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":"431"},{"url":"description","valueString":"Requesting Organization Header exceeds maximum size"},{"url":"responseType","valueString":"EPAMSOperationOutcome"},{"url":"errorCode","valueString":"SVC_ORG_HEADER_TOO_LARGE"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"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 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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":"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":"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":"cancel-eml-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 cancel-eml-entry-op</p><a name=\"cancel-eml-entry-op\"> </a><a name=\"hccancel-eml-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]/MedicationStatement/[id]/$cancel-eml-entryOutput parameters Profile:<a href=\"StructureDefinition-epa-op-eml-entry-output-parameters.html\">EPA Operation EMLEntry 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/cancel-eml-entry-op","version":"1.3.0","name":"cancelEMLEntry_MedicationSvc","title":"Cancel Medication List Entry","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 dem gezielten Widerruf/Abbruch eines bestehenden Eintrags der elektronischen Medikationsliste (eML) auf Instanzebene.","jurisdiction":[{"coding":[{"system":"urn:iso:std:iso:3166","code":"DE"}]}],"affectsState":true,"code":"cancel-eml-entry","resource":["MedicationStatement"],"system":false,"type":false,"instance":true,"outputProfile":"https://gematik.de/fhir/epa-medication/StructureDefinition/epa-op-eml-entry-output-parameters"}

    {
      "resourceType" : "Parameters",
      "id" : "example-epa-op-eml-entry-cancelled-output-parameters-1",
      "meta" : {
        "profile" : [
          🔗 "https://gematik.de/fhir/epa-medication/StructureDefinition/epa-op-eml-entry-output-parameters|1.3.0"
        ]
      },
      "parameter" : [
        {
          "name" : "relatedActivity",
          "resource" : {
            "resourceType" : "Provenance",
            "id" : "39475183-3444-4b63-bfed-ae0741f4496b",
            "meta" : {
              "profile" : [
                "https://gematik.de/fhir/epa/StructureDefinition/epa-activity-provenance|1.3.0"
              ]
            },
            "target" : [
              {
                "reference" : "MedicationStatement/6e340b90-35cd-4070-bad8-c26704d85d55/_history/1"
              }
            ],
            "recorded" : "2026-02-23T15:00:00.550Z",
            "activity" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/v3-DataOperation",
                  "code" : "DELETE"
                }
              ]
            },
            "agent" : [
              {
                "type" : {
                  "coding" : [
                    {
                      "system" : "http://terminology.hl7.org/CodeSystem/provenance-participant-type",
                      "code" : "author"
                    }
                  ]
                },
                "who" : {
                  🔗 "reference" : "Organization/8B421590-9F7F-46BE-BD1E-C987063AC4F5",
                  "identifier" : {
                    "type" : {
                      "coding" : [
                        {
                          "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                          "code" : "PRN"
                        }
                      ]
                    },
                    "system" : "https://gematik.de/fhir/sid/telematik-id",
                    "value" : "9-2.58.00000060"
                  },
                  "display" : "Die Apotheke"
                }
              }
            ]
          }
        }
      ]
    }

    <Parameters xmlns="http://hl7.org/fhir">
      <id value="example-epa-op-eml-entry-cancelled-output-parameters-1"/>
      <meta>
        <profile
                 value="https://gematik.de/fhir/epa-medication/StructureDefinition/epa-op-eml-entry-output-parameters|1.3.0"/>
      </meta>
      <parameter>
        <name value="relatedActivity"/>
        <resource>
          <Provenance>
            <id value="39475183-3444-4b63-bfed-ae0741f4496b"/>
            <meta>
              <profile
                       value="https://gematik.de/fhir/epa/StructureDefinition/epa-activity-provenance|1.3.0"/>
            </meta>
            <target>
              <reference
                         value="MedicationStatement/6e340b90-35cd-4070-bad8-c26704d85d55/_history/1"/>
            </target>
            <recorded value="2026-02-23T15:00:00.550Z"/>
            <activity>
              <coding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/v3-DataOperation"/>
                <code value="DELETE"/>
              </coding>
            </activity>
            <agent>
              <type>
                <coding>
                  <system
                          value="http://terminology.hl7.org/CodeSystem/provenance-participant-type"/>
                  <code value="author"/>
                </coding>
              </type>
              <who>🔗
                <reference
                           value="Organization/8B421590-9F7F-46BE-BD1E-C987063AC4F5"/>
                <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="9-2.58.00000060"/>
                </identifier>
                <display value="Die Apotheke"/>
              </who>
            </agent>
          </Provenance>
        </resource>
      </parameter>
    </Parameters>

### Geschäftslogik

Anhand der Eingangsdaten werden bei Ausführung dieser Operation die folgenden FHIR-Artefakte erzeugt bzw. aktualisiert:

- Die adressierte Medikationsinformation als Instanz gemäß Profil EPAMedicationStatement wird aktualisiert. Dabei wird der Status der Instanz auf entered-in-error gesetzt, um den Eintrag in der elektronischen Medikationsliste (eML) als storniert zu kennzeichnen.

- Die zur Medikationsinformation gehörende Instanz gemäß Profil EPAMedication wird ebenfalls auf entered-in-error gesetzt und im Operationsergebnis zurückgegeben, um die referenzierte Medikation konsistent als storniert nachzuweisen.

- Ein zur Medikationsinformation zugehöriger Änderungseintrag wird als Instanz gemäß Profil EPAActivityProvenance erzeugt, der die Stornierungsaktivität dokumentiert.

- Eine zum Änderungseintrag zugehörige verordnende LEI wird als Instanz gemäß Profil TIOrganization erzeugt bzw. aktualisiert.

Einschränkung: Diese Operation kann ausschließlich für eML-Nachträge verwendet werden. Wird versucht, einen Eintrag aus dem Verschreibungs- oder Abgabeprozess zu stornieren, gibt der Medication Service einen Fehler zurück.

Der Medication Service MUSS die Geschäftlogik der Operation eML-Eintrag stornieren gemäß dem Aktivitätsdiagramm mit der ID IG-MED-BL-CANCEL-EML-ENTRY-V3 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 eML-Eintrag stornieren im Medication Service.

Abbildung: Geschäftslogik für die Operation eML-Eintrag stornieren

### Sicherheitsanforderungen

Generelle Sicherheitsanforderungen werden hier festgehalten.