# Operation API: eMP-Eintrag hinzufügen - 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 hinzufügen**

## Operation API: eMP-Eintrag hinzufügen

Die Operation *[eMP-Eintrag hinzufügen](./OperationDefinition-add-emp-entry-op.md)* ermöglicht das gezielte Einfügen eines neuen Medikationseintrags in den elektronischen Medikationsplan (eMP). Dabei werden zwei Ressourcen kombiniert, die gemeinsam den vollständigen fachlichen Kontext der Medikation abbilden: eine **MedicationRequest**-Instanz mit dem intent **plan** sowie eine zugehörige **Medication**-Instanz. Die **MedicationRequest**-Ressource muss dabei stets dem fachlichen FHIR-Profil **EMPMedicationRequest** entsprechen.

Für die **Medication**-Ressource gilt:

* Wird eine neue **Medication**-Ressource im Rahmen der Operation in den Medication Service eingestellt, so muss diese dem Profil EMPMedication entsprechen.

Der Medication Service validiert die übermittelten Inhalte und übernimmt ausschließlich konforme Ressourcen, sofern eine neue **Medication** bereitgestellt wird.

Die **MedicationRequest** beschreibt dabei die konkrete beabsichtigte oder durchgeführte Medikation, während die **Medication** die fachlich abstrahierte Arzneimittelbeschreibung liefert. Für das ePA-Client-System bestehen somit zwei Möglichkeiten:

* eine neue **Medication**-Ressource für die reine Planung hinzufügen, oder
* auf eine bereits vorhandene **Medication**-Instanz aus dem Verschreibungs- oder Abgabeprozess referenzieren.

Damit können sowohl geplante Arzneimittel als auch verschriebene und abgegebene Arzneimittel konsistent im eMP dokumentiert werden. Im Gegensatz zur eML, in der konkrete Arzneimittelpackungen referenziert werden, dienen die im eMP verwendeten **Medication**-Instanzen der langfristigen fachlichen Beschreibung der Therapie.

Im Zuge dieser Operation wird ferner 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** dieses zuletzt erzeugten eMP-Chronologieeintrags angegeben werden. Zur Nachverfolgbarkeit werden im Rahmen der Operation zusätzlich zwei **Provenance**-Ressourcen erzeugt:

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

Die Ergebnisse der Operation werden in einer strukturierten **Output-Parameters**-Ressource zurückgegeben. Diese 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.

#### 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 Medikationseinträge zum 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
*eMP-Eintrag hinzufügen*implementieren, um einer Leistungserbringerinstitution das Hinzufügen eines Medikationseintrags zum eMP zu ermöglichen.

Das Primärsystem SOLL beim Erzeugen eines eMP-Eintrags mit anschließender Verordnung eines E-Rezepts dieselbe Arzneimittelkodierung und -bezeichnung sowie dieselbe Wirkstoffkodierung und -bezeichnung verwenden, wie sie im E-Rezept intendiert ist.

Das Primärsystem MUSS beim Erzeugen eines eMP-Eintrags mit anschließender Verordnung eines E-Rezepts den vom Medication Service erzeugten [gemIG_TI_Common#MedicationPlanIdentifier] an das E-Rezept(-Modul) übergeben, um diesen in das E-Rezept zu integrieren.

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

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

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
```

```

      {"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/1.2.0/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":"1.3.0","name":"addEMPEntry_MedicationSvc","title":"eMP-Eintrag hinzufügen","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 ermöglicht das Hinzufügen eines neuen Medikations-Eintrags zum elektronischen Medikationsplan (eMP). Der Eintrag wird als EMPMedicationRequest erzeugt, wobei die angegebene Medication sowohl in medicationReference als auch in extension[originMedication] referenziert wird.","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"}
    
```

### Geschäftslogik

Der Medication Service MUSS beim Erstellen einer
*MedicationRequest*-Instanz sicherstellen, dass das
*identifier*-Element mit dem Slice
*MedicationPlanIdentifier*gesetzt wird und denselben
*UUID*-Wert 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 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 hinzufügen* im Medication Service.

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

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

