Implementation Guide
ePA Medication Service
Version 1.3.3 - release

## Operation API: Medikationsliste abrufen (eML)

Die Operation Medikationsliste abrufen (eML) liefert die elektronische Medikationsliste (eML) in Form eines FHIR searchSet-Bundle. In der eML werden ausschließlich nicht-stornierte Instanzen von Verschreibungsdaten, Dispensierdaten, Nachträge von Medikationen sowie die zugehörige Versicherteninformation (Patient) aus dem Patient Service angezeigt.

Für eine vollständige historische Einsicht, einschließlich stornierter Einträge, können die entsprechenden Query APIs genutzt werden. Zusätzlich ermöglicht die optionale Eingabe eines Datumsbereichs eine verlaufsbasierte Ansicht auf relevante Medikationen.

### Nachricht

Die Nachricht zum Abruf der FHIR-Instanzen der elektronischen Medikationsliste (eML) wird als HTTP GET-Anfrage an den Medication Service gesendet.

#### Auslösung

Wenn das ePA-Client-System die elektronische Medikationsliste (eML) als strukturierte FHIR-Daten abrufen möchte, sendet es eine Operation API: Medikationsliste abrufen (eML)-Anfrage an den Medication Service. Der Medication Service verarbeitet die Anfrage und stellt die Medikationsliste zur Verfügung, damit sie im ePA-Client-System angezeigt werden kann.

#### FHIR Operation API

Das Primärsystem MUSS die Operation Medikationsliste abrufen (eML) implementieren, um einer Leistungserbringerinstitution die Anzeige der eML zu ermöglichen. Das ePA-FdV KANN die Operation Medikationsliste abrufen (eML) implementieren, um dem Nutzer die Anzeige der eML zu ermöglichen. Der Medication Service MUSS die Operation Medikationsliste abrufen (eML) gemäß der FHIR OperationDefinition Get Medication List ausführen.

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###

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                  }
                ],
                "reference" : "MedicationRequest/266620a9-2c26-41c1-b0cb-a10947b867f5"
              }
            ],
            "status" : "unknown",
            "medicationReference" : {
              🔗 "reference" : "Medication/fc7b28e8-05ac-4ac8-86d7-7677d9c6134e"
            },
            "subject" : {
              "identifier" : {
                "system" : "http://fhir.de/sid/gkv/kvid-10",
                "value" : "X110411319"
              }
            },
            "effectivePeriod" : {
              "start" : "2025-11-01"
            },
            "dateAsserted" : "2026-11-01",
            "derivedFrom" : [
              {
                🔗 "reference" : "MedicationRequest/4dd6f19d-002c-44ac-ae2f-3c9d08ad35b8"
              },
              {
                🔗 "reference" : "MedicationDispense/fa0c29e1-c4e7-4f08-91ab-598a2233867c"
              }
            ],
            "dosage" : [
              {
                "timing" : {
                  "repeat" : {
                    "frequency" : 1,
                    "period" : 1,
                    "periodUnit" : "d",
                    "when" : [
                      "MORN"
                    ]
                  }
                },
                "doseAndRate" : [
                  {
                    "doseQuantity" : {
                      "value" : 1,
                      "unit" : "Stück",
                      "system" : "https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_BMP_DOSIEREINHEIT",
                      "code" : "1"
                    }
                  }
                ]
              }
            ]
          },
          "search" : {
            "mode" : "match"
          }
        },
        {
          "fullUrl" : "http://epa4all/epa/medication/api/v1/fhir/Provenance/176eec9c-8d5a-46a7-96e3-7af3f68c49ed",
          "resource" : {
            "resourceType" : "Provenance",
            "id" : "176eec9c-8d5a-46a7-96e3-7af3f68c49ed",
            "meta" : {
              "profile" : [
                🔗 "https://gematik.de/fhir/epa/StructureDefinition/epa-activity-provenance|1.3.0"
              ]
            },
            "target" : [
              {
                "reference" : "MedicationStatement/f29f1d0c-be05-4b0d-a335-3e508da39c0c/_history/2"
              }
            ],
            "recorded" : "2026-11-01T15:43:33.244Z",
            "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" : {
                  "identifier" : {
                    "system" : "https://gematik.de/fhir/sid/epa-fhir-data-service",
                    "value" : "MEDICATIONSVC"
                  },
                  "display" : "ePA Medication Service"
                }
              }
            ]
          },
          "search" : {
            "mode" : "include"
          }
        },
        {
          "fullUrl" : "http://epa4all/epa/medication/api/v1/fhir/Medication/fc7b28e8-05ac-4ac8-86d7-7677d9c6134e",
          "resource" : {
            "resourceType" : "Medication",
            "id" : "fc7b28e8-05ac-4ac8-86d7-7677d9c6134e",
            "meta" : {
              "versionId" : "2",
              "lastUpdated" : "2026-11-01T14:43:33.244Z",
              "profile" : [
                🔗 "https://gematik.de/fhir/epa-medication/StructureDefinition/epa-medication|1.3.0"
              ]
            },
            "extension" : [
              {
                "url" : "https://gematik.de/fhir/epa-medication/StructureDefinition/rx-prescription-process-identifier-extension",
                "valueIdentifier" : {
                  "system" : "https://gematik.de/fhir/epa-medication/sid/rx-prescription-process-identifier",
                  "value" : "160.100.000.000.007.24_20261101"
                }
              },
              {
                "url" : "https://gematik.de/fhir/epa-medication/StructureDefinition/epa-medication-type-extension",
                "valueCoding" : {
                  "system" : "http://snomed.info/sct",
                  "code" : "781405001"
                }
              },
              {
                "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" : "https://gematik.de/fhir/epa-medication/StructureDefinition/medication-id-vaccine-extension",
                "valueBoolean" : false
              },
              {
                "url" : "http://fhir.de/StructureDefinition/normgroesse",
                "valueCode" : "N1"
              }
            ],
            "identifier" : [
              {
                "system" : "https://gematik.de/fhir/epa-medication/sid/epa-medication-unique-identifier",
                "value" : "5CA9B89A31D81FFF6869E6A93B192C03C7F715FC4A568FB060630DD639F94EF1"
              },
              {
                "system" : "https://gematik.de/fhir/epa-medication/sid/rx-originator-process-identifier",
                "value" : "a3197c39-d03c-45fa-bcb7-b32578143c56_160.100.000.000.007.24"
              }
            ],
            "code" : {
              "coding" : [
                {
                  "system" : "http://fhir.de/CodeSystem/ifa/pzn",
                  "code" : "06313728"
                }
              ],
              "text" : "Sumatriptan-1a Pharma 100 mg Tabletten"
            },
            "status" : "active",
            "form" : {
              "coding" : [
                {
                  "system" : "https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_DARREICHUNGSFORM",
                  "code" : "TAB",
                  "display" : "Tabletten"
                }
              ]
            },
            "amount" : {
              "numerator" : {
                "extension" : [
                  {
                    "url" : "https://gematik.de/fhir/epa-medication/StructureDefinition/medication-total-quantity-formulation-extension",
                    "valueString" : "20 St."
                  }
                ],
                "value" : 20,
                "unit" : "St"
              },
              "denominator" : {
                "value" : 1
              }
            }
          },
          "search" : {
            "mode" : "include"
          }
        },
        {
          "fullUrl" : "http://epa4all/epa/medication/api/v1/fhir/MedicationRequest/4dd6f19d-002c-44ac-ae2f-3c9d08ad35b8",
          "resource" : {
            "resourceType" : "MedicationRequest",
            "id" : "4dd6f19d-002c-44ac-ae2f-3c9d08ad35b8",
            "meta" : {
              "versionId" : "2",
              "lastUpdated" : "2026-11-01T14:43:33.244Z",
              "profile" : [
                🔗 "https://gematik.de/fhir/epa-medication/StructureDefinition/epa-medication-request|1.3.0"
              ]
            },
            "extension" : [
              {
                "extension" : [
                  {
                    "url" : "indicator",
                    "valueBoolean" : false
                  }
                ],
                "url" : "https://gematik.de/fhir/epa-medication/StructureDefinition/multiple-prescription-extension"
              },
              {
                "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction",
                "valueMarkdown" : "1-0-0-0 Stück"
              },
              {
                "extension" : [
                  {
                    "url" : "algorithmVersion",
                    "valueString" : "1.0.1"
                  },
                  {
                    "url" : "language",
                    "valueCode" : "de-DE"
                  }
                ],
                "url" : "http://ig.fhir.de/igs/medication/StructureDefinition/GeneratedDosageInstructionsMeta"
              }
            ],
            "identifier" : [
              {
                "system" : "https://gematik.de/fhir/epa-medication/sid/rx-prescription-process-identifier",
                "value" : "160.100.000.000.007.24_20250425"
              },
              {
                "system" : "https://gematik.de/fhir/epa-medication/sid/rx-originator-process-identifier",
                "value" : "5f4bc41c-480e-4ee4-b58e-a99268c1a1d0_160.100.000.000.007.24"
              }
            ],
            "status" : "active",
            "intent" : "filler-order",
            "medicationReference" : {
              🔗 "reference" : "Medication/fc7b28e8-05ac-4ac8-86d7-7677d9c6134e"
            },
            "subject" : {
              "identifier" : {
                "system" : "http://fhir.de/sid/gkv/kvid-10",
                "value" : "X110411319"
              }
            },
            "authoredOn" : "2026-11-01",
            "requester" : {
              🔗 "reference" : "PractitionerRole/73a551f8-d8cd-4b44-823d-ab5f8aeab1aa",
              "display" : "Dr. Max Manfred Mustermann / Praxis Dr. med. Max Mustermann"
            },
            "basedOn" : [
              {
                "identifier" : {
                  "system" : "https://gematik.de/fhir/sid/emp-identifier",
                  "value" : "4dd6f19d-002c-44ac-ae2f-3c9d08ad35b8"
                }
              }
            ],
            "dosageInstruction" : [
              {
                "timing" : {
                  "repeat" : {
                    "frequency" : 1,
                    "period" : 1,
                    "periodUnit" : "d",
                    "when" : [
                      "MORN"
                    ]
                  }
                },
                "doseAndRate" : [
                  {
                    "doseQuantity" : {
                      "value" : 1,
                      "unit" : "Stück",
                      "system" : "https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_BMP_DOSIEREINHEIT",
                      "code" : "1"
                    }
                  }
                ]
              }
            ],
            "dispenseRequest" : {
              "quantity" : {
                "value" : 1,
                "system" : "http://unitsofmeasure.org",
                "code" : "{Package}"
              }
            },
            "substitution" : {
              "allowedBoolean" : true
            }
          },
          "search" : {
            "mode" : "include"
          }
        },
        {
          "fullUrl" : "http://epa4all/epa/medication/api/v1/fhir/MedicationDispense/fa0c29e1-c4e7-4f08-91ab-598a2233867c",
          "resource" : {
            "resourceType" : "MedicationDispense",
            "id" : "fa0c29e1-c4e7-4f08-91ab-598a2233867c",
            "meta" : {
              "versionId" : "1",
              "lastUpdated" : "2026-11-01T15:43:33.244Z",
              "profile" : [
                🔗 "https://gematik.de/fhir/epa-medication/StructureDefinition/epa-medication-dispense|1.3.0"
              ]
            },
            "extension" : [
              {
                "url" : "https://gematik.de/fhir/epa-medication/StructureDefinition/rx-prescription-process-identifier-extension",
                "valueIdentifier" : {
                  "system" : "https://gematik.de/fhir/epa-medication/sid/rx-prescription-process-identifier",
                  "value" : "160.100.000.000.007.24_20261101"
                }
              }
            ],
            "identifier" : [
              {
                "system" : "https://gematik.de/fhir/epa-medication/sid/rx-originator-process-identifier",
                "value" : "1da91bd3-d5cb-459b-a270-32fad7d5d5d5_160.100.000.000.007.24"
              }
            ],
            "status" : "completed",
            "medicationReference" : {
              🔗 "reference" : "Medication/fc7b28e8-05ac-4ac8-86d7-7677d9c6134e"
            },
            "subject" : {
              "identifier" : {
                "system" : "http://fhir.de/sid/gkv/kvid-10",
                "value" : "X110411319"
              }
            },
            "performer" : [
              {
                "actor" : {
                  🔗 "reference" : "Organization/151f1697-7512-4e21-9466-1b75207475d8",
                  "identifier" : {
                    "type" : {
                      "coding" : [
                        {
                          "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                          "code" : "PRN",
                          "display" : "Provider number"
                        }
                      ]
                    },
                    "system" : "https://gematik.de/fhir/sid/telematik-id",
                    "value" : "9-2.58.00000023"
                  },
                  "display" : "gematik Apotheke"
                }
              }
            ],
            "authorizingPrescription" : [
              {
                🔗 "reference" : "MedicationRequest/4dd6f19d-002c-44ac-ae2f-3c9d08ad35b8"
              }
            ],
            "whenHandedOver" : "2026-11-01",
            "substitution" : {
              "wasSubstituted" : false
            }
          },
          "search" : {
            "mode" : "include"
          }
        }
      ]
    }

    <Bundle xmlns="http://hl7.org/fhir">
      <id value="example-get-medication-list-bundle1"/>
      <identifier>
        <system value="urn:ietf:rfc:3986"/>
        <value value="urn:uuid:9e1f5895-ab0b-4237-856d-fa1065631400"/>
      </identifier>
      <type value="searchset"/>
      <timestamp value="2025-01-01T00:00:00Z"/>
      <total value="16"/>
      <link>
        <relation value="self"/>
        <url
             value="http://epa4all/epa/medication/api/v1/fhir/$medication-list&amp;date=le2025-12-24&amp;date=ge2025-01-01&amp;_count=10&amp;_offset=0"/>
      </link>
      <link>
        <relation value="first"/>
        <url
             value="http://epa4all/epa/medication/api/v1/fhir/$medication-list&amp;date=le2025-12-24&amp;date=ge2025-01-01&amp;_count=10&amp;_offset=0"/>
      </link>
      <link>
        <relation value="next"/>
        <url
             value="http://epa4all/epa/medication/api/v1/fhir/$medication-list&amp;date=le2025-12-24&amp;date=ge2025-01-01&amp;_count=10&amp;_offset=10"/>
      </link>
      <link>
        <relation value="last"/>
        <url
             value="http://epa4all/epa/medication/api/v1/fhir/$medication-list&amp;date=le2025-12-24&amp;date=ge2025-01-01&amp;_count=10&amp;_offset=10"/>
      </link>
      <entry>
        <fullUrl
                 value="http://epa4all/epa/medication/api/v1/fhir/Patient/641f4cf5-e54b-406c-b8a8-1d3292fd5087"/>
        <resource>
          <Patient>
            <id value="641f4cf5-e54b-406c-b8a8-1d3292fd5087"/>
            <meta>
              <profile
                       value="https://gematik.de/fhir/epa/StructureDefinition/epa-patient|1.3.0"/>
            </meta>
            <identifier>
              <system value="http://fhir.de/sid/gkv/kvid-10"/>
              <value value="X110411319"/>
            </identifier>
            <name>
              <use value="official"/>
              <family value="Mustermann"/>
              <given value="Max"/>
            </name>
            <gender value="male"/>
            <birthDate value="1976-02-01"/>
          </Patient>
        </resource>
        <search>
          <mode value="include"/>
        </search>
      </entry>
      <entry>
        <fullUrl
                 value="http://epa4all/epa/medication/api/v1/fhir/MedicationStatement/f3988023-2313-4645-bd6b-f9e37cfb6fc7"/>
        <resource>
          <MedicationStatement>
            <id value="f3988023-2313-4645-bd6b-f9e37cfb6fc7"/>
            <meta>
              <versionId value="2"/>
              <lastUpdated value="2025-05-22T14:43:34.244Z"/>
              <profile
                       value="https://gematik.de/fhir/epa-medication/StructureDefinition/epa-medication-statement|1.3.0"/>
            </meta>
            <extension
                       url="https://gematik.de/fhir/epa-medication/StructureDefinition/rx-prescription-process-identifier-extension">
              <valueIdentifier>
                <system
                        value="https://gematik.de/fhir/epa-medication/sid/rx-prescription-process-identifier"/>
                <value value="160.100.000.000.006.24_20250520"/>
              </valueIdentifier>
            </extension>
            <extension
                       url="https://gematik.de/fhir/epa-medication/StructureDefinition/context-extension">
              <valueCode value="PRESCRIPTION"/>
            </extension>
            <extension
                       url="http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationStatement.renderedDosageInstruction">
              <valueMarkdown value="1-0-1-0 Stück"/>
            </extension>
            <extension
                       url="http://ig.fhir.de/igs/medication/StructureDefinition/GeneratedDosageInstructionsMeta">
              <extension url="algorithmVersion">
                <valueString value="1.0.1"/>
              </extension>
              <extension url="language">
                <valueCode value="de-DE"/>
              </extension>
            </extension>
            <status value="unknown"/>
            <medicationReference>🔗
              <reference value="Medication/bb91cde8-0426-4f4b-a766-5d818d0605bd"/>
            </medicationReference>
            <subject>
              <identifier>
                <system value="http://fhir.de/sid/gkv/kvid-10"/>
                <value value="X110411319"/>
              </identifier>
            </subject>
            <effectivePeriod>
              <start value="2025-05-22"/>
            </effectivePeriod>
            <dateAsserted value="2025-05-22"/>
            <derivedFrom>🔗
              <reference
                         value="MedicationRequest/3191d752-3adf-4c7f-848d-8d43766fed72"/>
            </derivedFrom>
            <derivedFrom>🔗
              <reference
                         value="MedicationDispense/4e6e1623-778e-44a3-b208-8479f5339e43"/>
            </derivedFrom>
            <dosage>
              <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>
            </dosage>
          </MedicationStatement>
        </resource>
        <search>
          <mode value="match"/>
        </search>
      </entry>
      <entry>
        <fullUrl
                 value="http://epa4all/epa/medication/api/v1/fhir/Provenance/de42aa65-f84e-4e96-acfb-b9fd5e104b2d"/>
        <resource>
          <Provenance>
            <id value="de42aa65-f84e-4e96-acfb-b9fd5e104b2d"/>
            <meta>
              <profile
                       value="https://gematik.de/fhir/epa/StructureDefinition/epa-activity-provenance|1.3.0"/>
            </meta>
            <target>
              <reference
                         value="MedicationStatement/f3988023-2313-4645-bd6b-f9e37cfb6fc7/_history/2"/>
            </target>
            <recorded value="2025-05-22T14:43:34.244Z"/>
            <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>
                <identifier>
                  <system
                          value="https://gematik.de/fhir/sid/epa-fhir-data-service"/>
                  <value value="MEDICATIONSVC"/>
                </identifier>
                <display value="ePA Medication Service"/>
              </who>
            </agent>
          </Provenance>
        </resource>
        <search>
          <mode value="include"/>
        </search>
      </entry>
      <entry>
        <fullUrl
                 value="http://epa4all/epa/medication/api/v1/fhir/Medication/bb91cde8-0426-4f4b-a766-5d818d0605bd"/>
        <resource>
          <Medication>
            <id value="bb91cde8-0426-4f4b-a766-5d818d0605bd"/>
            <meta>
              <versionId value="2"/>
              <lastUpdated value="2025-05-22T14:43:33.244Z"/>
              <profile
                       value="https://gematik.de/fhir/epa-medication/StructureDefinition/epa-medication|1.3.0"/>
            </meta>
            <extension
                       url="https://gematik.de/fhir/epa-medication/StructureDefinition/rx-prescription-process-identifier-extension">
              <valueIdentifier>
                <system
                        value="https://gematik.de/fhir/epa-medication/sid/rx-prescription-process-identifier"/>
                <value value="160.100.000.000.006.24_20250520"/>
              </valueIdentifier>
            </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="N1"/>
            </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="936396A4B0EAD8DE8ACD0F32BBC410523150A2F943908D3C9600AF253BE4B93A"/>
            </identifier>
            <identifier>
              <system
                      value="https://gematik.de/fhir/epa-medication/sid/rx-originator-process-identifier"/>
              <value
                     value="ec4d55a0-dec1-46b7-96cc-096845b74c4b_160.100.000.000.006.24"/>
            </identifier>
            <code>
              <coding>
                <system value="http://fhir.de/CodeSystem/ifa/pzn"/>
                <code value="00814665"/>
              </coding>
              <text value="Januvia® 50 mg 28 Filmtabletten N1"/>
            </code>
            <status value="active"/>
            <form>
              <coding>
                <system
                        value="https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_DARREICHUNGSFORM"/>
                <code value="FTA"/>
                <display value="Tabletten"/>
              </coding>
            </form>
          </Medication>
        </resource>
        <search>
          <mode value="include"/>
        </search>
      </entry>
      <entry>
        <fullUrl
                 value="http://epa4all/epa/medication/api/v1/fhir/MedicationRequest/3191d752-3adf-4c7f-848d-8d43766fed72"/>
        <resource>
          <MedicationRequest>
            <id value="3191d752-3adf-4c7f-848d-8d43766fed72"/>
            <meta>
              <versionId value="2"/>
              <lastUpdated value="2025-05-22T14:43:33.244Z"/>
              <profile
                       value="https://gematik.de/fhir/epa-medication/StructureDefinition/epa-medication-request|1.3.0"/>
            </meta>
            <extension
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          <Medication>
            <id value="fc7b28e8-05ac-4ac8-86d7-7677d9c6134e"/>
            <meta>
              <versionId value="2"/>
              <lastUpdated value="2026-11-01T14:43:33.244Z"/>
              <profile
                       value="https://gematik.de/fhir/epa-medication/StructureDefinition/epa-medication|1.3.0"/>
            </meta>
            <extension
                       url="https://gematik.de/fhir/epa-medication/StructureDefinition/rx-prescription-process-identifier-extension">
              <valueIdentifier>
                <system
                        value="https://gematik.de/fhir/epa-medication/sid/rx-prescription-process-identifier"/>
                <value value="160.100.000.000.007.24_20261101"/>
              </valueIdentifier>
            </extension>
            <extension
                       url="https://gematik.de/fhir/epa-medication/StructureDefinition/epa-medication-type-extension">
              <valueCoding>
                <system value="http://snomed.info/sct"/>
                <code value="781405001"/>
              </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="https://gematik.de/fhir/epa-medication/StructureDefinition/medication-id-vaccine-extension">
              <valueBoolean value="false"/>
            </extension>
            <extension url="http://fhir.de/StructureDefinition/normgroesse">
              <valueCode value="N1"/>
            </extension>
            <identifier>
              <system
                      value="https://gematik.de/fhir/epa-medication/sid/epa-medication-unique-identifier"/>
              <value
                     value="5CA9B89A31D81FFF6869E6A93B192C03C7F715FC4A568FB060630DD639F94EF1"/>
            </identifier>
            <identifier>
              <system
                      value="https://gematik.de/fhir/epa-medication/sid/rx-originator-process-identifier"/>
              <value
                     value="a3197c39-d03c-45fa-bcb7-b32578143c56_160.100.000.000.007.24"/>
            </identifier>
            <code>
              <coding>
                <system value="http://fhir.de/CodeSystem/ifa/pzn"/>
                <code value="06313728"/>
              </coding>
              <text value="Sumatriptan-1a Pharma 100 mg Tabletten"/>
            </code>
            <status value="active"/>
            <form>
              <coding>
                <system
                        value="https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_DARREICHUNGSFORM"/>
                <code value="TAB"/>
                <display value="Tabletten"/>
              </coding>
            </form>
            <amount>
              <numerator>
                <extension
                           url="https://gematik.de/fhir/epa-medication/StructureDefinition/medication-total-quantity-formulation-extension">
                  <valueString value="20 St."/>
                </extension>
                <value value="20"/>
                <unit value="St"/>
              </numerator>
              <denominator>
                <value value="1"/>
              </denominator>
            </amount>
          </Medication>
        </resource>
        <search>
          <mode value="include"/>
        </search>
      </entry>
      <entry>
        <fullUrl
                 value="http://epa4all/epa/medication/api/v1/fhir/MedicationRequest/4dd6f19d-002c-44ac-ae2f-3c9d08ad35b8"/>
        <resource>
          <MedicationRequest>
            <id value="4dd6f19d-002c-44ac-ae2f-3c9d08ad35b8"/>
            <meta>
              <versionId value="2"/>
              <lastUpdated value="2026-11-01T14:43:33.244Z"/>
              <profile
                       value="https://gematik.de/fhir/epa-medication/StructureDefinition/epa-medication-request|1.3.0"/>
            </meta>
            <extension
                       url="https://gematik.de/fhir/epa-medication/StructureDefinition/multiple-prescription-extension">
              <extension url="indicator">
                <valueBoolean value="false"/>
              </extension>
            </extension>
            <extension
                       url="http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.renderedDosageInstruction">
              <valueMarkdown value="1-0-0-0 Stück"/>
            </extension>
            <extension
                       url="http://ig.fhir.de/igs/medication/StructureDefinition/GeneratedDosageInstructionsMeta">
              <extension url="algorithmVersion">
                <valueString value="1.0.1"/>
              </extension>
              <extension url="language">
                <valueCode value="de-DE"/>
              </extension>
            </extension>
            <identifier>
              <system
                      value="https://gematik.de/fhir/epa-medication/sid/rx-prescription-process-identifier"/>
              <value value="160.100.000.000.007.24_20250425"/>
            </identifier>
            <identifier>
              <system
                      value="https://gematik.de/fhir/epa-medication/sid/rx-originator-process-identifier"/>
              <value
                     value="5f4bc41c-480e-4ee4-b58e-a99268c1a1d0_160.100.000.000.007.24"/>
            </identifier>
            <status value="active"/>
            <intent value="filler-order"/>
            <medicationReference>🔗
              <reference value="Medication/fc7b28e8-05ac-4ac8-86d7-7677d9c6134e"/>
            </medicationReference>
            <subject>
              <identifier>
                <system value="http://fhir.de/sid/gkv/kvid-10"/>
                <value value="X110411319"/>
              </identifier>
            </subject>
            <authoredOn value="2026-11-01"/>
            <requester>🔗
              <reference
                         value="PractitionerRole/73a551f8-d8cd-4b44-823d-ab5f8aeab1aa"/>
              <display
                       value="Dr. Max Manfred Mustermann / Praxis Dr. med. Max Mustermann"/>
            </requester>
            <basedOn>
              <identifier>
                <system value="https://gematik.de/fhir/sid/emp-identifier"/>
                <value value="4dd6f19d-002c-44ac-ae2f-3c9d08ad35b8"/>
              </identifier>
            </basedOn>
            <dosageInstruction>
              <timing>
                <repeat>
                  <frequency value="1"/>
                  <period value="1"/>
                  <periodUnit value="d"/>
                  <when value="MORN"/>
                </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>
            <dispenseRequest>
              <quantity>
                <value value="1"/>
                <system value="http://unitsofmeasure.org"/>
                <code value="{Package}"/>
              </quantity>
            </dispenseRequest>
            <substitution>
              <allowedBoolean value="true"/>
            </substitution>
          </MedicationRequest>
        </resource>
        <search>
          <mode value="include"/>
        </search>
      </entry>
      <entry>
        <fullUrl
                 value="http://epa4all/epa/medication/api/v1/fhir/MedicationDispense/fa0c29e1-c4e7-4f08-91ab-598a2233867c"/>
        <resource>
          <MedicationDispense>
            <id value="fa0c29e1-c4e7-4f08-91ab-598a2233867c"/>
            <meta>
              <versionId value="1"/>
              <lastUpdated value="2026-11-01T15:43:33.244Z"/>
              <profile
                       value="https://gematik.de/fhir/epa-medication/StructureDefinition/epa-medication-dispense|1.3.0"/>
            </meta>
            <extension
                       url="https://gematik.de/fhir/epa-medication/StructureDefinition/rx-prescription-process-identifier-extension">
              <valueIdentifier>
                <system
                        value="https://gematik.de/fhir/epa-medication/sid/rx-prescription-process-identifier"/>
                <value value="160.100.000.000.007.24_20261101"/>
              </valueIdentifier>
            </extension>
            <identifier>
              <system
                      value="https://gematik.de/fhir/epa-medication/sid/rx-originator-process-identifier"/>
              <value
                     value="1da91bd3-d5cb-459b-a270-32fad7d5d5d5_160.100.000.000.007.24"/>
            </identifier>
            <status value="completed"/>
            <medicationReference>🔗
              <reference value="Medication/fc7b28e8-05ac-4ac8-86d7-7677d9c6134e"/>
            </medicationReference>
            <subject>
              <identifier>
                <system value="http://fhir.de/sid/gkv/kvid-10"/>
                <value value="X110411319"/>
              </identifier>
            </subject>
            <performer>
              <actor>🔗
                <reference
                           value="Organization/151f1697-7512-4e21-9466-1b75207475d8"/>
                <identifier>
                  <type>
                    <coding>
                      <system
                              value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
                      <code value="PRN"/>
                      <display value="Provider number"/>
                    </coding>
                  </type>
                  <system value="https://gematik.de/fhir/sid/telematik-id"/>
                  <value value="9-2.58.00000023"/>
                </identifier>
                <display value="gematik Apotheke"/>
              </actor>
            </performer>
            <authorizingPrescription>🔗
              <reference
                         value="MedicationRequest/4dd6f19d-002c-44ac-ae2f-3c9d08ad35b8"/>
            </authorizingPrescription>
            <whenHandedOver value="2026-11-01"/>
            <substitution>
              <wasSubstituted value="false"/>
            </substitution>
          </MedicationDispense>
        </resource>
        <search>
          <mode value="include"/>
        </search>
      </entry>
    </Bundle>

Zusätzlich ermöglicht der Parameter date die Eingrenzung eines Datumsbereichs, indem obere und untere Grenzen definiert werden. So können gezielt Medikations-, Verschreibungs- und Dispensierdaten innerhalb eines bestimmten Zeitraums abgerufen werden.

Beispiel für eine Datumsfilterung

    GET [base]/epa/medication/api/v1/fhir/$medication-list?date=le2025-12-24&date=ge2025-01-01

Beispiel für eine Medikationsliste (eML) in XML

    GET [base]/epa/medication/api/v1/fhir/$medication-list?_format=application/fhir+xml

Der Medication Service MUSS in der Operation Medikationsliste abrufen (eML) das Ergebnis als FHIR Bundle mit dem type searchset zurückgeben. Der Medication Service MUSS sicherstellen, dass das Suchergebnis der Operation Medikationsliste abrufen (eML) auf MedicationStatement-Instanzen basiert und ausschließlich relevante Instanzen enthält.
Das zurückgegebene FHIR Search Set Bundle enthält:

- Alle relevanten MedicationStatement-Instanzen des Profils EPAMedicationStatement. Diese sind die zentrale Grundlage der Medikationsliste.
- Alle Medication-Instanzen, die in der medicationReference des MedicationStatement oder in den über derivedFrom referenzierten MedicationRequest- und MedicationDispense-Instanzen verwendet werden.
- Alle MedicationRequest-Instanzen, die über MedicationStatement.derivedFrom referenziert sind.
- Alle MedicationDispense-Instanzen, die über MedicationStatement.derivedFrom referenziert sind.
- Alle PractitionerRole- und Organization-Instanzen, die in MedicationRequest oder MedicationDispense referenziert werden.
- Alle Practitioner- und Organization-Instanzen, die von den jeweiligen PractitionerRole-Instanzen referenziert werden.
- Alle relevanten Provenance-Instanzen des Profils EPAActivityProvenance, die als target auf die jeweilige Version der MedicationStatement-Instanz zeigen.
- Alle Organization-Instanzen, die in den Provenance.agent.who-Referenzen enthalten sind.

Der Medication Service MUSS sicherstellen, dass alle in den Provenance.agent.who-Angaben referenzierten Organization-Instanzen korrekt im Ergebnis der Operation Medikationsliste abrufen (eML) enthalten sind.
Dabei sind sowohl

- literal Referenzen (d.h. Provenance.agent.who.reference mit relativen oder absoluten Referenz-URLs auf eine Organization-Ressource) und
- logische Referenzen (d.h. Provenance.agent.who.identifier mit einer eindeutigen Identifier-Angabe der Organization)

zu berücksichtigen und korrekt aufzulösen. Der Medication Service MUSS in der Operation Medikationsliste abrufen (eML) sicherstellen, dass MedicationStatement-Instanzen mit dem Status entered-in-error sowie die davon abhängigen Instanzen nicht in das Suchergebnis aufgenommen werden.
Dabei gelten folgende Ausschlusskriterien:

- MedicationStatement-Instanzen mit dem Status entered-in-error werden ausgeschlossen.
- MedicationRequest- und MedicationDispense-Instanzen werden ausgeschlossen, wenn sie ausschließlich von ausgeschlossenen MedicationStatement-Instanzen über derivedFrom referenziert werden.
- Medication-Instanzen werden ausgeschlossen, wenn sie ausschließlich von ausgeschlossenen MedicationStatement-Instanzen referenziert werden.
- MedicationDispense-Instanzen werden ausgeschlossen, wenn ihr Status entweder auf cancelled oder declined gesetzt ist.
- Medication-Instanzen werden ausgeschlossen, wenn sie ausschließlich von stornierten MedicationRequest- oder MedicationDispense-Instanzen referenziert wird. Falls eine Medication-Instanz sowohl von einer stornierten als auch von einer nicht-stornierten Instanz referenziert wird, muss sie im Suchergebnis enthalten bleiben.

Der Medication Service MUSS das Suchergebnis der Operation Medikationsliste abrufen (eML) absteigend (desc) nach dem Datum der Medikationsinformation sortieren. Grundlage der Sortierung ist das Element MedicationStatement.effective, das sowohl das ursprüngliche Verordnungsdatum als auch ein Nachtragsdatum abbilden kann. Bei mehreren MedicationStatement-Instanzen mit demselben effective-Wert ist zusätzlich das Element MedicationStatement.meta.lastUpdated in absteigender Reihenfolge zu berücksichtigen. Bei Nicht-Angabe von MedicationStatement.effective wird nach dem Element MedicationStatement.meta.lastUpdated sortiert. Der Medication Service MUSS in der Operation Medikationsliste abrufen (eML) die Paginierung unterstützen, um eine Verarbeitung und Navigation großer Datenmengen zu ermöglichen. Die Implementierung der Paginierung erfolgt gemäß den allgemeinen Paginierungsanforderungen des FHIR Data Service.

In der Operation Medikationsliste abrufen (eML) können neben den Standardpaginierungsparametern wie _count und _offset weitere Parameter enthalten sein, die die Paginierung erleichtern. Ein Beispiel hierfür ist der Parameter stateid, der den aktuellen Zustand der Ergebnisliste repräsentiert. Dies ermöglicht es dem Medication Service, die Navigation durch die Ergebnisse effizient zu verwalten, indem der Kontext oder Zustand der Suche erhalten bleibt.

Der Medication Service MUSS sicherstellen, dass alle referenzierten Instanzen innerhalb einer einzelnen Ergebnisseite der Paginierung enthalten sind. Eine referenzierte Instanz MUSS in derselben Seite wie die Instanz enthalten sein, die auf sie verweist. Dies gilt für die folgenden Ressourcen: MedicationStatement, Medication, MedicationRequest, MedicationDispense, PractitionerRole, Practitioner, Organization und Provenance. Der Medication Service MUSS sicherstellen, dass die zugehörige Patient-Instanz aus dem Patient Service in das Suchergebnis der Operation Medikationsliste abrufen (eML) eingebunden wird, sofern sie vorhanden ist. Der Medication Service MUSS sicherstellen, dass die Patient-Instanz innerhalb des Suchergebnisses der Operation Medikationsliste abrufen (eML) immer als erstes Element der ersten Ergebnisseite zurückgegeben wird. Liegt die Patient-Instanz aus dem Patient Service nicht vor, ist sie kein Bestandteil der zurückzuliefernden Suchergebnismenge. Der Medication Service MUSS bei Angabe eines Datumparameters (date) alle MedicationStatement-Instanzen mit effective im angegebenen Datumsbereich für die Ergebnismenge der Operation berücksichtigen. Der Medication Service MUSS, wenn kein Datumparameter (date) angegeben ist, alle MedicationStatement-Instanzen für die Ergebnismenge der Operation berücksichtigen. Der Medication Service MUSS bei Berechnung der Anzahl von Elementen auf einer Suchergebnisseite per _count ausschließlich die MedicationStatement-Instanzen berücksichtigen (d.h. sich nicht auf die Gesamtanzahl der Einträge im FHIR Bundle beziehen). Die MedicationStatement-Instanzen sollen im FHIR Bundle mit entry.search.mode = "match" gekennzeichnet werden. Zugehörig referenzierte Ressourcen (d.h. Medication, MedicationRequest, MedicationDispense, Practitioner, PractitionerRole, Organization, Provenance und - sofern im Patient Service vorliegend - Patient) müssen zusätzlich in das FHIR Bundle aufgenommen und mit entry.search.mode = "include" markiert werden. Der Medication Service MUSS mit dem HTTP Status Code 404 und einer OperationOutcome-Ressource antworten, wenn die Ergebnismenge der Operation Medikationsliste abrufen (eML) leer ist. Die OperationOutcome-Ressource enthält im Element issue.details.coding.code den Wert MSG_NO_MATCH.

Das folgende Beispiel zeigt die erwartete Antwort bei einer leeren eML.

    {
      "resourceType": "OperationOutcome",
      "issue": [
        {
          "severity": "error",
          "code": "processing",
          "details": {
            "coding": [
              {
                "code": "MSG_NO_MATCH",
                "system": "http://terminology.hl7.org/CodeSystem/operation-outcome"
              }
            ]
            "diagnostics": "No Resource found matching the query"
          }
        }
      ]
    }

### Sicherheitsanforderungen

Generelle Sicherheitsanforderungen werden hier festgehalten.