Patient medication uses several FHIR bundles to cover all aspects-

  • Medication with name, description, identifier (PZN)
  • MedicationStatement (permanent medication) with relation between medication and patient
  • MedicationRequest (prescription) with dosage, dispense, substitution  (aut-idem) and physician authorization
  • MedicationRequestPZN (prescription) combines prescription and product information

Medication

Medication represents a pharmaceutical product assigned to a patient. Medications are assigned to a patient and may be searched. A search request (GET) for patient medication returns a bundle of one or more FHIR items of type KBV_PR_AW_Medikament.

Example for a SEARCH request for the medication of a specific patient
{{baseURL}}/{{tenant}}/Medication?page=1&subject=Patient/6006

Example: this search requests fetches all Medications of patient 6006 using paging to limit the number of results


Data of a specific medication may be fetched using a read request (GET) with the identifier of the specific medication. The request returns a FHIR item of type KBV_PR_AW_Medikament.

Example of a READ request for a specific medication item
{{baseURL}}/{{tenant}}/Medication/egMNGiQHERUmzlrP

Example: this read request returns the FHIR item for a medication item with ID egMNGiQHERUmzlrP. The ID may be retrieved by a search request sent before this request.


Example of a FHIR item for a medication item
<Medication xmlns="http://hl7.org/fhir">
    <id value="egMNGiQHERUmzlrP"/>
    <meta>
        <versionId value="1"/>
        <lastUpdated value="2022-08-03T18:44:24+00:00"/>
        <profile value="https://fhir.kbv.de/StructureDefinition/KBV_PR_AW_Medikament|1.2.0"/>
    </meta>
    <text>
        <status value="extensions"/>
        <div xmlns="http://www.w3.org/1999/xhtml">Medikament von PatientLuca Fink</div>
    </text>
    <code>
        <coding>
            <system value="http://fhir.de/CodeSystem/ifa/pzn"/>
            <code value="01231440"/>
        </coding>
        <text value="SINUPRET DRAGEES 2X10X50St"/>
    </code>
    <form>
        <coding>
            <system value="https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_DARREICHUNGSFORM"/>
            <code value="UTA"/>
        </coding>
    </form>
    <amount>
        <numerator>
            <value value="1000"/>
            <unit value="St"/>
        </numerator>
        <denominator>
            <value value="1"/>
        </denominator>
    </amount>
</Medication>

Medication Statement

A medication statement represents a relation between a pharmaceutical product and a patient if the patients uses this product as part of his permanent medication. Medications Statements are assigned to a patient and may be searched. A search request for patient medication returns a bundle of one or more FHIR items of type KBV_PR_AW_Dauermedikation.

Example for a SEARCH request for a medication statement
{{baseURL}}/{{tenant}}/MedicationStatement?page=1&subject=Patient/6006

Example: this search requests fetches all Medications of patient 6006 using paging to limit the number of results


As medication statement does not contain any relevant information but the reference between medication and patient we currently do nor provide a read request for a specific statement.

Example of a FHIR item for a medication statement
<MedicationStatement xmlns="http://hl7.org/fhir">
    <id value="Zemu6XkBDrpsrArZE1A46I7EAgEKNLAS"/>
    <meta>
        <versionId value="1"/>
        <lastUpdated value="2022-08-03T18:51:45+00:00"/>
        <profile value="https://fhir.kbv.de/StructureDefinition/KBV_PR_AW_Dauermedikation|1.2.0"/>
    </meta>
    <text>
        <status value="extensions"/>
        <div xmlns="http://www.w3.org/1999/xhtml">Dauermedikation von Patient Luca Fink</div>
    </text>
    <extension url="https://fhir.kbv.de/StructureDefinition/KBV_EX_Base_Additional_Comment">
        <valueString value=""/>
    </extension>
    <status value="active"/>
    <medicationReference>
        <reference value="Medication/egMNGiQHERUmzlrP"/>
    </medicationReference>
    <subject>
        <reference value="Patient/6tVbNJZq1buNwKmp6UKpd8CpLceNDlRF/_history/1"/>
    </subject>
</MedicationStatement>


Medication Request

A medication request represents a prescription. Medication requests are assigned to a patient and may be searched. A search request for patient medication returns a bundle of one or more FHIR items of type KBV_PR_AW_Verordnung_Arzneimittel.

Example for a SEARCH request for a medication request
{{baseURL}}/{{tenant}}/MedicationRequest?page=1&subject=Patient/6006

Example: this search requests fetches all Medication requests of patient 6006 using paging to limit the number of results


Example of a FHIR item for a medication request
<MedicationRequest xmlns="http://hl7.org/fhir">
    <id value="gN7tsKbTW7gyqispAHTPSZuyiFBURWwm"/>
    <meta>
        <versionId value="1"/>
        <lastUpdated value="2022-08-04T07:15:54+00:00"/>
        <profile value="https://fhir.kbv.de/StructureDefinition/KBV_PR_AW_Verordnung_Arzneimittel|1.2.0"/>
    </meta>
    <text>
        <status value="extensions"/>
        <div xmlns="http://www.w3.org/1999/xhtml">(V1) | Patient Luca Fink | Medication Status active | zuletzt bearbeitet 2022-08-04T07:15:54+00:00</div>
    </text>
    <status value="active"/>
    <intent value="order"/>
    <medicationReference>
        <reference value="Medication/egMNGiQHERUmzlrP"/>
    </medicationReference>
    <subject>
        <reference value="Patient/6tVbNJZq1buNwKmp6UKpd8CpLceNDlRF/_history/1"/>
    </subject>
    <authoredOn value="2022-08-04"/>
    <requester>
        <reference value="Practitioner/3xZjkMngCnOE9p1IFpiAeDvUZHDvnCHn/_history/1"/>
    </requester>
    <dosageInstruction>
        <text value="0-0-0-0"/>
    </dosageInstruction>
    <dispenseRequest>
        <quantity>
            <value value="1"/>
            <system value="http://unitsofmeasure.org"/>
            <code value="{Package}"/>
        </quantity>
    </dispenseRequest>
    <substitution>
        <allowedBoolean value="true"/>
    </substitution>
</MedicationRequest>


Extended Medication Request

This request type combines medication request and medication information and returns all products prescribed for a patient with the extended product information. Medications requests of this type are assigned to a patient and may be searched. A search request for patient medication returns a bundle of one or more FHIR items combining data from KBV_PR_AW_Verordnung_Arzneimittel and KBV_PR_AW_Medikament.

Example for a SEARCH request for an extended medication request
{{baseURL}}/{{tenant}}/MedicationRequestPZN?page=1&subject=Patient/6006


Example of the result of an extended medication request
<MedicationRequest xmlns="http://hl7.org/fhir">
    <id value="egQFFh8WOkx6BYyd"/>
    <meta>
        <versionId value="1"/>
        <lastUpdated value="2022-08-04T09:20:40+00:00"/>
        <profile value="https://fhir.kbv.de/StructureDefinition/KBV_PR_AW_Medikament|1.2.0"/>
    </meta>
    <text>
        <status value="extensions"/>
        <div xmlns="http://www.w3.org/1999/xhtml">Medikament von PatientLuca Fink</div>
    </text>
    <status value="active"/>
    <intent value="order"/>
    <medicationReference>
        <reference value="Medication/egQFFh8WOkx6BYyd"/>
    </medicationReference>
    <subject>
        <reference value="Patient/6tVbNJZq1buNwKmp6UKpd8CpLceNDlRF/_history/1"/>
    </subject>
    <authoredOn value="2022-08-04"/>
    <requester>
        <reference value="Practitioner/wK7hhpbEIG1qkSdvRCCd3AEA3W4lBfDB/_history/1"/>
    </requester>
    <dosageInstruction>
        <text value="0-1-0-0"/>
    </dosageInstruction>
    <dispenseRequest>
        <quantity>
            <value value="1"/>
            <system value="http://unitsofmeasure.org"/>
            <code value="{Package}"/>
        </quantity>
    </dispenseRequest>
    <substitution>
        <allowedBoolean value="true"/>
    </substitution>
    <code>
        <coding>
            <system value="http://fhir.de/CodeSystem/ifa/pzn"/>
            <code value="05481263"/>
        </coding>
        <text value="METFORMIN AL 500 180St N3"/>
    </code>
    <form>
        <coding>
            <system value="https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_DARREICHUNGSFORM"/>
            <code value="FTA"/>
        </coding>
    </form>
    <amount>
        <numerator>
            <value value="180"/>
            <unit value="St"/>
        </numerator>
        <denominator>
            <value value="1"/>
        </denominator>
    </amount>
</MedicationRequest>
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