Seiteninhalt:
Das Hinzufügen und Aktualisieren einer Patient-Ressource wird vom zugehörigen Kostenträger über die FHIR RESTful API mittels HTTP PUT-Anfrage für den Versicherten durchgeführt. Der Patient Service setzt die Semantik des [FHIR Conditional update] um.
Die Primärsysteme der Kostenträger nutzen diese Operation, um die Versicherteninformationen hinzuzufügen oder zu aktualisieren.
Die Nachricht zum Hinzufügen oder Aktualisieren der Versicherteninformationen durch den zuständigen Kostenträger.
Ein Kostenträger übermittelt die Versicherteninformationen, wenn ein Aktenkonto in einem ePA-Aktensystem angelegt wird oder sich demografische Daten ändern, wie beispielsweise Name, Anrede sowie amtliches Geschlecht.
Die bedingte Aktualisierung ([FHIR Conditional update]) ermöglicht das Aktualisieren einer vorhandenen FHIR-Ressourceninstanz anhand eines Identifikationskriteriums anstelle einer direkten Referenz über die logische ID. Falls keine passende Ressourceninstanz existiert, wird eine neue erstellt.
Bedingtes Update über Suchparameter
Die Aktualisierung einer FHIR-Ressourceninstanz erfolgt über eine HTTP PUT-Anfrage mit Suchparametern:
PUT [base]/[type]?[search parameters]
{"resourceType":"CapabilityStatement","id":"epa-patient-server","meta":{"profile":["https://gematik.de/fhir/ti/StructureDefinition/ti-capability-statement"]},"extension":[{"extension":[{"url":"name","valueString":"X-Request-ID"},{"url":"type","valueString":"string"},{"url":"description","valueString":"UUID of the request message"},{"url":"format","valueString":"uuid"},{"url":"required","valueBoolean":true}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-header"},{"extension":[{"url":"name","valueString":"x-insurantid"},{"url":"type","valueString":"string"},{"url":"description","valueString":"Health Record Identifier"},{"url":"pattern","valueString":"^[A-Z]{1}\\d{9}$"},{"url":"required","valueBoolean":true}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-header"},{"extension":[{"url":"name","valueString":"x-useragent"},{"url":"type","valueString":"string"},{"url":"description","valueString":"user agent information"},{"url":"pattern","valueString":"^[a-zA-Z0-9]{20}\\/[a-zA-Z0-9\\-\\.]{1,15}$"},{"url":"required","valueBoolean":true}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-header"},{"extension":[{"url":"statusCode","valueString":"403"},{"url":"description","valueString":"Requestor not authorized (no user session with valid ID-Token available)"},{"url":"responseType","valueString":"application/json"},{"url":"errorCode","valueString":"invalAuth"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"extension":[{"url":"statusCode","valueString":"403"},{"url":"description","valueString":"Requestor has no valid entitlement"},{"url":"responseType","valueString":"application/json"},{"url":"errorCode","valueString":"notEntitled"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"extension":[{"url":"statusCode","valueString":"403"},{"url":"description","valueString":"Requestor role is not in the list of allowed user groups"},{"url":"responseType","valueString":"application/json"},{"url":"errorCode","valueString":"invalidOid"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"extension":[{"url":"statusCode","valueString":"403"},{"url":"description","valueString":"Device registration does not exist (if requestor role is oid_versicherter only)"},{"url":"responseType","valueString":"application/json"},{"url":"errorCode","valueString":"unregisteredDevice"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"extension":[{"url":"statusCode","valueString":"404"},{"url":"description","valueString":"Health record is in state UNKNOWN or INITIALIZED"},{"url":"responseType","valueString":"application/json"},{"url":"errorCode","valueString":"noHealthRecord"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"extension":[{"url":"statusCode","valueString":"409"},{"url":"description","valueString":"Health record is in state SUSPENDED or MAINTENANCE"},{"url":"responseType","valueString":"application/json"},{"url":"errorCode","valueString":"statusMismatch"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"extension":[{"url":"statusCode","valueString":"500"},{"url":"description","valueString":"Any other error"},{"url":"responseType","valueString":"application/json"},{"url":"errorCode","valueString":"internalError"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-base-url","valueString":"http://epa4all/epa/patient/api/v1/fhir"}],"url":"https://gematik.de/fhir/epa/CapabilityStatement/epa-patient-server","version":"1.2.0-ballot.1","name":"EPAPatientServer","title":"EPA CapabilityStatement für den Patient Service","status":"draft","date":"2025-08-01","publisher":"gematik GmbH","contact":[{"telecom":[{"system":"url","value":"https://www.gematik.de"}]}],"description":"EPA Capability Statement für den Patient Service","jurisdiction":[{"coding":[{"system":"urn:iso:std:iso:3166","code":"DE"}]}],"kind":"requirements","imports":["https://gematik.de/fhir/epa/CapabilityStatement/epa-basic-server"],"_imports":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation","valueCode":"SHALL"}]}],"fhirVersion":"4.0.1","format":["application/fhir+json","application/fhir+xml"],"rest":[{"mode":"server","resource":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation","valueCode":"SHALL"}],"type":"Patient","profile":"https://gematik.de/fhir/epa/StructureDefinition/epa-patient","_profile":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation","valueCode":"SHALL"}]},"supportedProfile":["https://gematik.de/fhir/ti/StructureDefinition/ti-patient"],"_supportedProfile":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation","valueCode":"SHALL"}]}],"interaction":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation","valueCode":"SHALL"},{"extension":[{"url":"statusCode","valueString":"200"},{"url":"description","valueString":"Successful operation"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"extension":[{"url":"statusCode","valueString":"400"},{"url":"description","valueString":"Unknown search parameter"},{"url":"responseType","valueString":"TIOperationOutcome"},{"url":"errorCode","valueString":"MSG_PARAM_UNKNOWN"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"extension":[{"url":"statusCode","valueString":"400"},{"url":"description","valueString":"Invalid query parameter(s)"},{"url":"responseType","valueString":"TIOperationOutcome"},{"url":"errorCode","valueString":"MSG_BAD_SYNTAX"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"extension":[{"url":"statusCode","valueString":"400"},{"url":"description","valueString":"Invalid request"},{"url":"responseType","valueString":"TIOperationOutcome"},{"url":"errorCode","valueString":"MSG_BAD_FORMAT"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"extension":[{"url":"statusCode","valueString":"404"},{"url":"description","valueString":"Unknown resource type"},{"url":"responseType","valueString":"TIOperationOutcome"},{"url":"errorCode","valueString":"MSG_UNKNOWN_TYPE"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"}],"code":"search-type"},{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation","valueCode":"SHALL"},{"extension":[{"url":"statusCode","valueString":"200"},{"url":"description","valueString":"Successful operation"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"extension":[{"url":"statusCode","valueString":"400"},{"url":"description","valueString":"Invalid request"},{"url":"responseType","valueString":"TIOperationOutcome"},{"url":"errorCode","valueString":"MSG_BAD_FORMAT"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"extension":[{"url":"statusCode","valueString":"404"},{"url":"description","valueString":"Unknown resource type"},{"url":"responseType","valueString":"TIOperationOutcome"},{"url":"errorCode","valueString":"MSG_UNKNOWN_TYPE"}],"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":"TIOperationOutcome"},{"url":"errorCode","valueString":"MSG_RESOURCE_ID_FAIL"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"}],"code":"history-type"},{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation","valueCode":"SHALL"},{"extension":[{"url":"statusCode","valueString":"200"},{"url":"description","valueString":"Successful operation"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"extension":[{"url":"statusCode","valueString":"400"},{"url":"description","valueString":"Invalid request"},{"url":"responseType","valueString":"TIOperationOutcome"},{"url":"errorCode","valueString":"MSG_BAD_FORMAT"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"extension":[{"url":"statusCode","valueString":"404"},{"url":"description","valueString":"Unknown resource type"},{"url":"responseType","valueString":"TIOperationOutcome"},{"url":"errorCode","valueString":"MSG_UNKNOWN_TYPE"}],"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":"TIOperationOutcome"},{"url":"errorCode","valueString":"MSG_RESOURCE_ID_FAIL"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"}],"code":"read"},{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation","valueCode":"SHALL"},{"extension":[{"url":"statusCode","valueString":"200"},{"url":"description","valueString":"Successful operation"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"extension":[{"url":"statusCode","valueString":"400"},{"url":"description","valueString":"Invalid request"},{"url":"responseType","valueString":"TIOperationOutcome"},{"url":"errorCode","valueString":"MSG_BAD_FORMAT"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"extension":[{"url":"statusCode","valueString":"404"},{"url":"description","valueString":"Unknown resource type"},{"url":"responseType","valueString":"TIOperationOutcome"},{"url":"errorCode","valueString":"MSG_UNKNOWN_TYPE"}],"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":"TIOperationOutcome"},{"url":"errorCode","valueString":"MSG_RESOURCE_ID_FAIL"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"}],"code":"history-instance"},{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation","valueCode":"SHALL"},{"extension":[{"url":"statusCode","valueString":"200"},{"url":"description","valueString":"Successful operation"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"extension":[{"url":"statusCode","valueString":"400"},{"url":"description","valueString":"Invalid request"},{"url":"responseType","valueString":"TIOperationOutcome"},{"url":"errorCode","valueString":"MSG_BAD_FORMAT"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"extension":[{"url":"statusCode","valueString":"404"},{"url":"description","valueString":"Unknown resource type"},{"url":"responseType","valueString":"TIOperationOutcome"},{"url":"errorCode","valueString":"MSG_UNKNOWN_TYPE"}],"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":"TIOperationOutcome"},{"url":"errorCode","valueString":"MSG_RESOURCE_ID_FAIL"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"}],"code":"vread"},{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation","valueCode":"SHALL"},{"extension":[{"url":"statusCode","valueString":"201"},{"url":"description","valueString":"Created, wenn eine neue Ressourceninstanz erstellt wurde"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"extension":[{"url":"statusCode","valueString":"200"},{"url":"description","valueString":"Successful operation"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"extension":[{"url":"statusCode","valueString":"400"},{"url":"description","valueString":"Invalid request"},{"url":"responseType","valueString":"TIOperationOutcome"},{"url":"errorCode","valueString":"MSG_BAD_FORMAT"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"extension":[{"url":"statusCode","valueString":"400"},{"url":"description","valueString":"Invalid request"},{"url":"responseType","valueString":"application/json"},{"url":"errorCode","valueString":"malformedRequest"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"extension":[{"url":"statusCode","valueString":"422"},{"url":"description","valueString":"Unprocessable Content, falls ein falscher Identifier (KVNR) in der Anfrage angegeben wurde"},{"url":"responseType","valueString":"TIOperationOutcome"},{"url":"errorCode","valueString":"MSG_RESOURCE_ID_MISMATCH"}],"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":"TIOperationOutcome"},{"url":"errorCode","valueString":"SVC_IDENTITY_MISMATCH"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"extension":[{"url":"statusCode","valueString":"404"},{"url":"description","valueString":"Unknown resource type"},{"url":"responseType","valueString":"TIOperationOutcome"},{"url":"errorCode","valueString":"MSG_UNKNOWN_TYPE"}],"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":"TIOperationOutcome"},{"url":"errorCode","valueString":"MSG_RESOURCE_ID_FAIL"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"},{"extension":[{"url":"statusCode","valueString":"412"},{"url":"description","valueString":"Precondition Failed, wenn mehrere Ressourceninstanz gefunden wurden"},{"url":"responseType","valueString":"TIOperationOutcome"},{"url":"errorCode","valueString":"UPDATE_MULTIPLE_MATCHES"}],"url":"https://gematik.de/fhir/ti/StructureDefinition/extension-http-response-info"}],"code":"update"}],"versioning":"versioned-update","readHistory":true,"conditionalUpdate":true,"_conditionalUpdate":{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation","valueCode":"SHALL"}]},"searchParam":[{"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation","valueCode":"SHALL"}],"name":"identifier","definition":"http://hl7.org/fhir/SearchParameter/Patient-identifier","type":"token","documentation":"Patient.identifier"}]}]}]}
PUT [base]/epa/patient/api/v1/fhir/Patient?identifier=http://fhir.de/sid/gkv/kvid-10|G995030566
Content-Type: application/fhir+json
x-insurantid: G995030566
X-Request-ID: 3f19049d-5c73-450e-94f3-856b43a9a9c3
{
"resourceType" : "OperationOutcome",
"id" : "ad48bf90-a664-44f4-af14-ee6e81db3df4",
"meta" : {
"profile" : [
🔗 "https://gematik.de/fhir/ti/StructureDefinition/operation-outcome"
]
},
"issue" : [
{
"severity" : "error",
"code" : "forbidden",
"details" : {
"coding" : [
{
"system" : "https://gematik.de/fhir/ti/CodeSystem/operation-outcome-details-codes",
"code" : "SVC_IDENTITY_MISMATCH",
"display" : "Telematik-ID inside ID-Token or KVNR in x-insurantid HTTP header does not match FHIR data"
}
]
}
}
]
}| professionOID |
|---|
| oid_kostentraeger |
Generelle Sicherheitsanforderungen werden hier festgehalten.
Die Protokollierung erfolgt über den Audit Event Service. Weitere Anforderungen sind [gemSpec_Aktensystem_ePAfueralle#Protokollierung] zu entnehmen.