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

For an example see RED Interchange API - Postman Collection 0118 - Patient - All Medication (Medikament)


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.

For an example see RED Interchange API - Postman Collection 0119 - Patient - Specific Medication


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

For an example see RED Interchange API - Postman Collection 0120 - Patient - All MedicationStatements (Dauermedikation)


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

For an example see RED Interchange API - Postman Collection 0121 - Patient - All MedicationRequests (Verordnung)


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

For an example see RED Interchange API - Postman Collection 0122 - Patient - All MedicationRequests (Verordnung) PZN


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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