# Operation API: Dispensierinformationen einstellen - 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: Dispensierinformationen einstellen**

## Operation API: Dispensierinformationen einstellen

Die Operation *[Dispensierinformationen einstellen](./OperationDefinition-provide-dispensation-erp-OP.md)* dient dazu, Informationen über die Arzneimittelabgabe, die auf Basis einer Verschreibung erfolgt, in den Medication Service einzutragen. Diese Operation wird vom E-Rezept-Fachdienst verwendet, wenn ein Versicherter sein Arzneimittel in einer Apotheke erhält. Sie dokumentiert, dass das Arzneimittel gemäß der Verschreibung abgegeben wurde, einschließlich der Details wie Menge, Abgabedatum und Informationen zur Apotheke. Dies ermöglicht einen vollständigen Überblick über die verschriebenen und dispensierten Arzneimittel des Versicherten.

Wird dabei eine eMP-Verknüpfung hergestellt, muss stets auch die dispensierte *Medication* aus dem entsprechenden eMP-Eintrag (d. h. dem *eMP MedicationRequest*) referenziert werden. Erfolgt die Abgabe jedoch in mehreren Packungen zu einem einzigen E-Rezept (z. B. durch Aufteilung auf verschiedene Packungen), dürfen diese Dispensierungen nicht zu einer Änderung oder Ersetzung der im eMP-Eintrag hinterlegten Referenz führen. In diesen Fällen bleibt die bestehende Referenz unverändert. Erfolgt die Dispensierung mit einer Substitution, so ist zusätzlich sicherzustellen, dass die zugehörige Dosierinformation ebenfalls auf den eMP-Eintrag übertragen wird. Eine Ausnahme bilden hierbei Kombipackungen (*kbvDarreichungsform = KPG*). Diese sollen im Rahmen einer Dispensierung nicht automatisch in den eMP-Eintrag umreferenziert werden.

### Nachricht

Die Nachricht zum Übertragen von Dispensierinformationen wird als HTTP POST-Anfrage an den Medication Service gesendet.

#### Auslösung

Der E-Rezept-Fachdienst sendet eine **Dispensierinformationen einstellen**-Nachricht an den Medication Service, um eine bereits erstellte elektronische Dispensierung zu übertragen. Der Medication Service verarbeitet die empfangenen Daten und speichert die Dispensierinformationen dauerhaft.

#### FHIR Operation API

Der Medication Service MUSS die Operation
*Dispensierinformationen einstellen*gemäß der FHIR OperationDefinition
[Provide Dispensation eRP](./OperationDefinition-provide-dispensation-erp-OP.md)ausführen. Die Verarbeitung der Dispensierinformationen MUSS entsprechend den in der
*OperationDefinition*festgelegten Regeln und Strukturen erfolgen.

Der E-Rezept-Fachdienst MUSS beim Einstellen einer Dispensierinformationen im E-Rezept-Fachdienst die Operation
*Dispensierinformationen einstellen*im ePA Medication Service aufrufen, um diese Änderung in der eML zu aktualisieren.

Der Medication Service MUSS die Operation
*Dispensierinformationen einstellen*mittels einer HTTP POST-Anfrage verarbeiten. Die empfangenen Dispensierinformationen MÜSSEN verarbeitet und die Dispensierinformationen dauerhaft gespeichert werden.

Der Medication Service MUSS für die Operation
*Dispensierinformationen einstellen*einen Partial Success ermöglichen.
* Falls einzelne Dispensierungen erfolgreich verarbeitet wurden, MUSS der Medication Service die zugehörigen *prescriptionId* und *authoredOn* Werte in der Antwort zurückgeben.
* Falls einzelne Dispensierungen nicht verarbeitet werden können, MUSS der Medication Service für diese ein *OperationOutcome* in der Antwort bereitstellen.
* Auch bei einer erfolgreichen Verarbeitung MUSS der Medication Service ein *OperationOutcome* mit einer entsprechenden Bestätigung bereitstellen.
* Der HTTP Response Code MUSS 200 OK sein, unabhängig davon, ob eine oder mehrere Dispensierungen fehlschlagen.

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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 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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"},{"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":"410"},{"url":"description","valueString":"Resource was deleted"},{"url":"responseType","valueString":"EPAMSOperationOutcome"},{"url":"errorCode","valueString":"MSG_DELETED"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"extension":[{"url":"statusCode","valueString":"409"},{"url":"description","valueString":"eMP entry already 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 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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 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":"422"},{"url":"description","valueString":"Profile mismatch in header 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
```

```

      {"resourceType":"OperationDefinition","id":"provide-dispensation-erp-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 provide-dispensation-erp-OP</p><a name=\"provide-dispensation-erp-OP\"> </a><a name=\"hcprovide-dispensation-erp-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]/$provide-dispensation-erpInput parameters Profile:<a href=\"StructureDefinition-epa-op-provide-dispensation-erp-input-parameters.html\">EPA Operation ProvideDispensation ERP Input-Parameters</a>Output parameters Profile:<a href=\"StructureDefinition-epa-op-rx-dispensation-erp-output-parameters.html\">EPA Operation RxDispensation ERP 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/provide-dispensation-erp-OP","version":"1.3.0","name":"provideDispensation_MedicationSvc","title":"Provide Dispensation eRP","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":"The Provide Dispensation eRP operation in the ePA Medication Service is used to record information about the dispensing of medications based on an electronic prescription in the patient's record. This operation comes into play when a patient receives their medication from a pharmacy. It documents that the medication has been dispensed as per the prescription, including details like the quantity, date of dispensing, and pharmacy information. This helps maintain a comprehensive overview of the patient's medication history.","jurisdiction":[{"coding":[{"system":"urn:iso:std:iso:3166","code":"DE"}]}],"affectsState":true,"code":"provide-dispensation-erp","system":true,"type":false,"instance":false,"inputProfile":"https://gematik.de/fhir/epa-medication/StructureDefinition/epa-op-provide-dispensation-erp-input-parameters","outputProfile":"https://gematik.de/fhir/epa-medication/StructureDefinition/epa-op-rx-dispensation-erp-output-parameters"}
    
```

### Geschäftslogik

Diese Operation verarbeitet eine oder mehrere Dispensierinformationen, die im FHIR **Parameters**-Objekt übergeben werden. Für jede übergebene Abgabe erfolgt zunächst eine Validierung der enthaltenen Ressourcen **Medication**, **Organization** und **MedicationDispense**. Anhand des Abgabedatums und der **E-Prescription-ID** wird ein eindeutiger **RxPrescriptionProcessIdentifier** gebildet, der als Schlüssel für die weiteren Verarbeitungsschritte dient. Es wird geprüft, ob eine passende **MedicationRequest**-Instanz existiert, die noch nicht abgeschlossen ist. Falls nicht, wird die Verarbeitung abgebrochen. Ist die **MedicationRequest**-Instanz gültig, wird im Kontext einer Transaktion wie folgt weiterverarbeitet:

* Die angegebene **Organization**-Ressource wird anhand der Telematik-ID aktualisiert oder neu angelegt.
* Vorherige **MedicationDispense**-Instanzen zum selben **RxPrescriptionProcessIdentifier**, werden auf den Status **entered-in-error** gesetzt.
* Ebenso werden **Medication**-Instanzen auf den Status **entered-in-error** gesetzt, die noch aktiv sind, aber nicht mehr von der zugehörigen **MedicationRequest** referenziert werden.

Für jede übergebene **MedicationDispense** wird die referenzierte **Medication**-Ressource aus den Input-Parametern ermittelt. Je nach Substitutionsstatus (**MedicationDispense.substitution.wasSubstituted**) wird entweder eine neue **Medication**-Instanz angelegt oder diejenige aktualisiert, die von der verschreibenden **MedicationRequest** referenziert wird.

Anschließend wird eine neue **MedicationDispense**-Instanz erstellt, deren Status aus dem Parameter **RxDispensation.part.status** übernommen wird. Wird der Status nicht gesetzt oder ist er gleich **completed**, so wird zusätzlich die zugehörige **MedicationRequest** auf **completed** gesetzt.

Alle Änderungen erfolgen transaktional. Am Ende der erfolgreichen Verarbeitung wird eine entsprechende **OperationOutcome**-Meldung zurückgegeben. Fehlerhafte Eingaben führen zu einer abgeleiteten Fehlermeldung in der Antwortnachricht.

Der Medication Service MUSS bei der Ausführung der Operation
*Dispensierinformationen einstellen*erkennen, ob es sich um eine Substitution handelt. Dies geschieht durch die Prüfung, ob der boolesche Wert
*MedicationDispense.substitution.wasSubstituted*auf
*true*gesetzt ist.

* Falls *wasSubstituted* den Wert *true* hat, MUSS eine neue *Medication*-Instanz für diesen Abgabeprozess erstellt werden.
* Falls *wasSubstituted* nicht gesetzt oder *false* ist, muss die im Verschreibungsprozess vorhandene *Medication*-Instanz aktualisiert werden

Der Medication Service MUSS die Geschäftlogik der Operation
*Dispensierinformationen einstellen*gemäß dem Aktivitätsdiagramm mit der ID
**IG-MED-BL-PROVIDE-DISPENSATION-ERP-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 *Dispensierinformationen einstellen* im Medication Service.

**Abbildung:**Geschäftslogik für die Operation
*Dispensierinformationen einstellen*
### Sicherheitsanforderungen

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

