Implementierungsleitfaden ISiK-Medikation

Element id

List.id

Short description

serverseitige, interne ID des Datensatzes

Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Comments

bedingtes Pflichtfeld/bedingtes MS: Alle von einem Server bereitgestellten Ressourcen MÜSSEN über eine id verfügen. Von Clients erzeugte Ressourcen, die im Kontext einer CREATE-Interaktion übermittelt werden, MÜSSEN NICHT über eine idverfügen.

Data type

Meta

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

0..1

There are no (further) constraints on this element

Element id

List.meta.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

List.meta.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a

versionId

0..1

Element id

List.meta.versionId

Short description

Eindeutiger Name der serverseitigen Version des Datensatzes

Definition

The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

Comments

Alle von einem Server bereitgestellten Ressourcen SOLLEN über eine versionID verfügen. Von Clients erzeugte Ressourcen, die im Kontext einer CREATE-Interaktion übermittelt werden, MÜSSEN NICHT über eine versionIDverfügen.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

lastUpdated

0..1

instant

Element id

List.meta.lastUpdated

Short description

Zeitpunkt der letzten Änderung

Definition

When the resource last changed - e.g. when the version changed.

Comments

Alle von einem Server bereitgestellten Ressourcen SOLLEN über ein lastUpdate verfügen. Von Clients erzeugte Ressourcen, die im Kontext einer CREATE-Interaktion übermittelt werden, MÜSSEN NICHT über ein lastUpdateverfügen.

Data type

instant

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

source

0..1

There are no (further) constraints on this element

Element id

List.meta.source

Short description

Identifies where the resource comes from

Definition

A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

Comments

In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

Data type

canonical(StructureDefinition)

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

profile

0..*

There are no (further) constraints on this element

Element id

List.meta.profile

Short description

Profiles this resource claims to conform to

Definition

A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

Comments

It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

Data type

canonical(StructureDefinition)

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

security

0..*

CodingBinding

There are no (further) constraints on this element

Element id

List.meta.security

Short description

Security Labels applied to this resource

Definition

Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

Comments

The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

Data type

All Security Labels (extensible)

Binding

Security Labels from the Healthcare Privacy and Security Classification System.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

tag

0..*

There are no (further) constraints on this element

Element id

List.meta.tag

Short description

Tags applied to this resource

Definition

Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

Comments

The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

Data type

Binding

Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

CommonTags (example)

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

implicitRules

Σ ?!

0..1

There are no (further) constraints on this element

Element id

List.implicitRules

Short description

A set of rules under which this content was created

Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

language

0..1

codeBinding

There are no (further) constraints on this element

Element id

List.language

Short description

Language of the resource content

Definition

The base language in which the resource is written.

Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Data type

Binding

A human language.

CommonLanguages (preferred)

Binding extensions

maxValueSet	AllLanguages

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

text

0..1

Narrative

There are no (further) constraints on this element

Element id

List.text

Short description

Text summary of the resource, for human interpretation

Alternate names

narrative, html, xhtml, display

Definition

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

Data type

Narrative

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: Act.text?

contained

0..*

Resource

There are no (further) constraints on this element

Element id

List.contained

Short description

Contained, inline Resources

Alternate names

inline resources, anonymous resources, contained resources

Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Data type

Resource

Mappings

rim: N/A

extension

0..*

There are no (further) constraints on this element

Element id

List.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: N/A

modifierExtension

?! C

0..*

There are no (further) constraints on this element

Element id

List.modifierExtension

Short description

Extensions that cannot be ignored

Alternate names

extensions, user content

Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: N/A

identifier

0..*

There are no (further) constraints on this element

Element id

List.identifier

Short description

Business identifier

Definition

Identifier for the List assigned for business purposes outside the context of FHIR.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

w5: FiveWs.identifier
rim: .id

status

S Σ ?!

1..1

codeBinding

Element id

List.status

Short description

(Aktualitäts-)Status der Liste

Definition

Indicates the current state of this list.

Comments

Begründung des Must-Support: Erforderliche Angabe im FHIR-Standard

Data type

Binding

The current state of the list.

ListStatus (required)

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

w5: FiveWs.status
rim: .status[current=active;retired=obsolete;entered-in-error=nullified]

mode

S Σ ?!

1..1

codeBinding

Element id

List.mode

Short description

Listenmodus

Definition

How this list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

Requirements

Lists are used in various ways, and it must be known in what way it is safe to use them.

Comments

Begründung des Must-Support: Erforderliche Angabe im FHIR-Standard

Beispiel: eingelesene Medikationspläne werden als snapshot repräsentiert. Kontinuierlich fortgeschriebene Listen, z.B. im Rahmen der hausinternen Behandlung, sind als 'working' codiert.

Data type

MedikationsListeListModeVS (required)

Binding

The processing mode that applies to this list.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

w5: FiveWs.class
rim: .outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value

title

0..1

There are no (further) constraints on this element

Element id

List.title

Short description

Descriptive name for the list

Definition

A label for the list assigned by the author.

Requirements

Allows customization beyond just the code identifying the kind of list.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

Dr. Jane's Patients

Mappings

rim: .title

code

S Σ

1..1

Element id

List.code

Short description

Art der Liste.

Definition

This code defines the purpose of the list - why it was created.

Requirements

Lists often contain subsets of resources rather than an exhaustive list. The code identifies what type of subset is included.

Comments

Begründung des Must-Support: Dient der Differenzierung zu anderen Listen.

Hinweis: Es ist mindestens ein Coding mit dem Code 'medications' anzugeben. Weitere Codes, z.B. im Kontext anderer Spezifikationen oder Hauscodierungen sind zulässig.

Data type

ExampleUseCodesForList (example)

Binding

What the purpose of a list is.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

w5: FiveWs.what[x]
rim: .code

0..1

There are no (further) constraints on this element

Element id

List.code.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

List.code.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a

coding

S Σ

1..*

Element id

List.code.coding

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Data type

Slicing

Unordered, Open, by $this(Pattern)

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

medications

S Σ

1..*

CodingPattern

Element id

List.code.coding:medications

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Pattern

{
  "system": "http://terminology.hl7.org/CodeSystem/list-example-use-codes",
  "code": "medications"
}

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

0..1

There are no (further) constraints on this element

Element id

List.code.coding:medications.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

List.code.coding:medications.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a

system

S Σ

1..1

uriPattern

There are no (further) constraints on this element

Element id

List.code.coding:medications.system

Short description

Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Pattern

http://terminology.hl7.org/CodeSystem/list-example-use-codes

Mappings

v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

0..1

There are no (further) constraints on this element

Element id

List.code.coding:medications.version

Short description

Version of the system - if relevant

Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

S Σ

1..1

codePattern

There are no (further) constraints on this element

Element id

List.code.coding:medications.code

Short description

Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Requirements

Need to refer to a particular code in the system.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Pattern

medications

Mappings

v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code

display

S Σ

0..1

There are no (further) constraints on this element

Element id

List.code.coding:medications.display

Short description

Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

There are no (further) constraints on this element

Element id

List.code.coding:medications.userSelected

Short description

If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

text

0..1

There are no (further) constraints on this element

Element id

List.code.text

Short description

Plain text representation of the concept

Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText

subject

S Σ

1..1

Reference(Patient)

Element id

List.subject

Short description

Referenz auf den Patienten

Definition

The common subject (or patient) of the resources that are in the list if there is one.

Requirements

The primary purpose of listing the subject explicitly is to help with finding the right list.

Comments

Begründung des Must-Support: Basisinformation

Data type

Reference(Patient)

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

w5: FiveWs.subject[x]
rim: .participation[typeCode<SUB].role (and sometimes .player)
w5: FiveWs.subject

0..1

There are no (further) constraints on this element

Element id

List.subject.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

List.subject.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a

reference

S Σ C

1..1

Element id

List.subject.reference

Short description

Patienten-Link

Definition

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Comments

Begründung MS: Die Verlinkung auf eine Patienten-Ressource dient der technischen Zuordnung der Dokumentation zu einem Patienten und ermöglicht wichtige API-Funktionen wie verkettete Suche, (Reverse-)Include etc. Im ISik Kontext MUSS die referenzierte Ressource konform zu ISiKPatient sein. Jenseits von ISiK KÖNNEN weitere Instanzen mit anderen Profilen referenziert werden.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ref-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element id

List.subject.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

Comments

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

Data type

Binding

Aa resource (or, for logical models, the URI of the logical model).

ResourceType (extensible)

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

identifier

0..1

There are no (further) constraints on this element

Element id

List.subject.identifier

Short description

Logical reference, when literal reference is not known

Definition

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

Comments

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .identifier

display

0..1

There are no (further) constraints on this element

Element id

List.subject.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

encounter

0..1

Reference(Encounter)

Element id

List.encounter

Short description

Referenz auf den Abteilungskontakt

Definition

The encounter that is the context in which this list was created.

Comments

Begründung des Must-Support: Basisinformation im Krankenhaus-Kontext

Data type

Reference(Encounter)

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

w5: FiveWs.context
rim: inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]

0..1

There are no (further) constraints on this element

Element id

List.encounter.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

List.encounter.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a

reference

S Σ C

1..1

Element id

List.encounter.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Begründung MS: Die Verlinkung auf eine Encounter-Ressource dient der technischen Zuordnung der Dokumentation zu einem Aufenthalt und ermöglicht wichtige API-Funktionen wie verkettete Suche, (Reverse-)Include etc. Im ISik Kontext MUSS die referenzierte Ressource konform zu ISiKKontaktGesundheitseinrichtung sein. Jenseits von ISiK KÖNNEN weitere Instanzen mit anderen Profilen referenziert werden.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ref-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element id

List.encounter.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Comments

Data type

Binding

Aa resource (or, for logical models, the URI of the logical model).

ResourceType (extensible)

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

identifier

0..1

There are no (further) constraints on this element

Element id

List.encounter.identifier

Short description

Logical reference, when literal reference is not known

Definition

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .identifier

display

0..1

There are no (further) constraints on this element

Element id

List.encounter.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

date

S Σ

0..1

Element id

List.date

Short description

Erstellungsdatum der Liste

Definition

The date that the list was prepared.

Requirements

Identifies how current the list is which affects relevance.

Comments

Begründung des Must-Support: Basisinformation

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

w5: FiveWs.recorded
rim: .participation[typeCode<AUT].time[type=TS]

source

0..1

Reference(Practitioner | PractitionerRole | Patient | Device)

There are no (further) constraints on this element

Element id

List.source

Short description

Who and/or what defined the list contents (aka Author)

Alternate names

Author

Definition

The entity responsible for deciding what the contents of the list were. Where the list was created by a human, this is the same as the author of the list.

Requirements

Allows follow-up as well as context.

Comments

The primary source is the entity that made the decisions what items are in the list. This may be software or user.

Data type

Reference(Practitioner | PractitionerRole | Patient | Device)

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

w5: FiveWs.author
rim: .participation[typeCode<AUT].role[classCode=REL].player[classCode=PSN,determinerCode=INST] or .participation[typeCode<AUT].role[classCode=REL].player[classCode=DEV,determinerCode=INST]

orderedBy

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

List.orderedBy

Short description

What order the list has

Definition

What order applies to the items in the list.

Requirements

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Comments

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Data type

Binding

What order applies to the items in a list.

ListOrderCodes (preferred)

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .outboundRelationship[typeCode=COMP].sequenceNumber > 1

note

0..*

Annotation

There are no (further) constraints on this element

Element id

List.note

Short description

Comments about the list

Definition

Comments that apply to the overall list.

Data type

Annotation

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .inboundRelationship[typeCode=SUBJ].act.text

entry

S C

0..*

BackboneElement

Element id

List.entry

Short description

Listeneintrag

Definition

Entries in this list.

Comments

If there are no entries in the list, an emptyReason SHOULD be provided.

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: lst-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]

0..1

There are no (further) constraints on this element

Element id

List.entry.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

List.entry.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a

modifierExtension

Σ ?! C

0..*

There are no (further) constraints on this element

Element id

List.entry.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Comments

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: N/A

flag

0..1

There are no (further) constraints on this element

Element id

List.entry.flag

Short description

Status/Workflow information about this item

Definition

The flag allows the system constructing the list to indicate the role and significance of the item in the list.

Requirements

This field is present to support various clinical uses of lists, such as a discharge summary medication list, where flags specify whether the medication was added, modified, or deleted from the list.

Comments

The flag can only be understood in the context of the List.code. If the flag means that the entry has actually been deleted from the list, the deleted element SHALL be true. Deleted can only be used if the List.mode is "changes".

Data type

PatientMedicineChangeTypes (example)

Binding

Codes that provide further information about the reason and meaning of the item in the list.

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .outBoundRelationship[typeCode=COMP].target[classCode=OBS"].value

deleted

?! C

0..1

There are no (further) constraints on this element

Element id

List.entry.deleted

Short description

If this item is actually marked as deleted

Definition

True if this item is marked as deleted in the list.

Requirements

The flag element may contain codes that an application processing the list does not understand. However there can be no ambiguity if a list item is actually marked as "deleted".

Comments

If the flag means that the entry has actually been deleted from the list, the deleted element SHALL be true. Both flag and deleted can only be used if the List.mode is "changes". A deleted entry should be displayed in narrative as deleted. This element is labeled as a modifier because it indicates that an item is (to be) no longer in the list.

Meaning when missing

List items are generally only treated as deleted when this element explicitly carries a value of true. Systems SHOULD always populate this value when mode is 'changes'

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: lst-2

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: added: .updateMode=("A","AR") retained: .updateMode="NC" updated: .updateMode="R" deleted: .updateMode="D"

date

0..1

Element id

List.entry.date

Short description

Datum des Listeneintrags

Definition

When this item was added to the list.

Requirements

The date may be significant for understanding the meaning of items in a working list.

Comments

Begründung des Must-Support: Nachvollziehbarkeit

Hinweis: nur zulässig im Listenmodus 'working'

Data type

Reference(MedicationStatement)

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .availabilityTime

item

1..1

Element id

List.entry.item

Short description

Referenz auf die MedikationsInformation

Definition

A reference to the actual resource from which data was derived.

Comments

Begründung des Must-Support: Basisinformation (eigentlicher Zweck der Liste ist das Verbinden mehrerer MedikationsInformationen)

Data type

Reference(MedicationStatement)

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .target or .role or .role.entity

0..1

There are no (further) constraints on this element

Element id

List.entry.item.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

List.entry.item.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a

reference

S Σ C

1..1

There are no (further) constraints on this element

Element id

List.entry.item.reference

Short description

Literal reference, Relative, internal or absolute URL

Definition

Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ref-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

type

0..1

uriBinding

There are no (further) constraints on this element

Element id

List.entry.item.type

Short description

Type the reference refers to (e.g. "Patient")

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Comments

Data type

Binding

Aa resource (or, for logical models, the URI of the logical model).

ResourceType (extensible)

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

identifier

0..1

There are no (further) constraints on this element

Element id

List.entry.item.identifier

Short description

Logical reference, when literal reference is not known

Definition

Comments

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .identifier

display

0..1

There are no (further) constraints on this element

Element id

List.entry.item.display

Short description

Text alternative for the resource

Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Data type

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: N/A

emptyReason

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

List.emptyReason

Short description

Why list is empty

Definition

If the list is empty, why the list is empty.

Requirements

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Comments

The various reasons for an empty list make a significant interpretation to its interpretation. Note that this code is for use when the entire list has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

Data type

Binding

If a list is empty, why it is empty.

ListEmptyReasons (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: lst-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .inboundRelationship[typeCode=SUBJ,code<ListEmptyReason].value[type=CD]

<id value="ISiKMedikationsListe" />
<url value="https://gematik.de/fhir/isik/StructureDefinition/ISiKMedikationsListe" />
<version value="5.1.0" />
<name value="ISiKMedikationsListe" />
<title value="ISiK Medikationsliste" />
<status value="active" />
<experimental value="false" />
<date value="2025-10-23" />
<publisher value="gematik GmbH" />
<description value="Dieses Profil ermöglicht die Zusammenführung einzelner MedikationsInformationen eines Patienten in ISiK Szenarien.\n\nDie MedicationList verweist auf MedicationStatement-Ressourcen und bildet Medikationen ab, die aktuell eingenommen, im Krankenhaus verabreicht oder aus externen Quellen dokumentiert wurden - etwa durch Patientenangaben, Medikationspläne oder Entlassbriefe.\nIm Unterschied zum eMP der ePA ist die ISiK-MedikationsListe dynamisch generierbar und systemseitig aktualisierbar. Sie kann auch Informationen enthalten, die außerhalb des eigenen Hauses erfasst wurden – sofern diese dem System strukturiert vorliegen (z.B. durch eMP-Import).\nEin Import aus dem eMP ist möglich, aber nicht verpflichtend." />
<fhirVersion value="4.0.1" />
<kind value="resource" />
<abstract value="false" />
<type value="List" />
<baseDefinition value="http://hl7.org/fhir/StructureDefinition/List" />
<derivation value="constraint" />
<differential>
<element id="List.id">
<path value="List.id" />
<short value="serverseitige, interne ID des Datensatzes" />
<comment value="**bedingtes Pflichtfeld/bedingtes MS:** Alle von einem Server bereitgestellten Ressourcen MÜSSEN über eine `id` verfügen.\n  Von Clients erzeugte Ressourcen, die im Kontext einer CREATE-Interaktion übermittelt werden, MÜSSEN NICHT über eine `id`verfügen." />
<mustSupport value="true" />
</element>
<element id="List.meta.versionId">
<path value="List.meta.versionId" />
<short value="Eindeutiger Name der serverseitigen Version des Datensatzes" />
<comment value="Alle von einem Server bereitgestellten Ressourcen SOLLEN über eine `versionID` verfügen.\n  Von Clients erzeugte Ressourcen, die im Kontext einer CREATE-Interaktion übermittelt werden, MÜSSEN NICHT über eine `versionID`verfügen." />
</element>
<element id="List.meta.lastUpdated">
<path value="List.meta.lastUpdated" />
<short value="Zeitpunkt der letzten Änderung" />
<comment value="Alle von einem Server bereitgestellten Ressourcen SOLLEN über ein `lastUpdate` verfügen.\n  Von Clients erzeugte Ressourcen, die im Kontext einer CREATE-Interaktion übermittelt werden, MÜSSEN NICHT über ein `lastUpdate`verfügen." />
</element>
<element id="List.status">
<path value="List.status" />
<short value="(Aktualitäts-)Status der Liste" />
<comment value="Begründung des Must-Support: Erforderliche Angabe im FHIR-Standard" />
<mustSupport value="true" />
</element>
<element id="List.mode">
<path value="List.mode" />
<short value="Listenmodus" />
<comment value="Begründung des Must-Support: Erforderliche Angabe im FHIR-Standard\n\n  Beispiel: eingelesene Medikationspläne werden als snapshot repräsentiert. Kontinuierlich fortgeschriebene Listen, z.B. im Rahmen der hausinternen Behandlung, sind als 'working' codiert." />
<mustSupport value="true" />
<binding>
<strength value="required" />
<valueSet value="https://gematik.de/fhir/isik/ValueSet/MedikationsListeListModeVS" />
</binding>
</element>
<element id="List.code">
<path value="List.code" />
<short value="Art der Liste." />
<comment value="Begründung des Must-Support: Dient der Differenzierung zu anderen Listen.\n\n  Hinweis: Es ist mindestens ein Coding mit dem Code 'medications' anzugeben. Weitere Codes, z.B. im Kontext anderer Spezifikationen oder Hauscodierungen sind zulässig." />
<min value="1" />
<mustSupport value="true" />
</element>
<element id="List.code.coding">
<path value="List.code.coding" />
<slicing>
<discriminator>
<type value="pattern" />
<path value="$this" />
</discriminator>
<rules value="open" />
</slicing>
<min value="1" />
<mustSupport value="true" />
</element>
<element id="List.code.coding:medications">
<path value="List.code.coding" />
<sliceName value="medications" />
<min value="1" />
<max value="*" />
<patternCoding>
<system value="http://terminology.hl7.org/CodeSystem/list-example-use-codes" />
<code value="medications" />
</patternCoding>
<mustSupport value="true" />
</element>
<element id="List.code.coding:medications.system">
<path value="List.code.coding.system" />
<min value="1" />
<mustSupport value="true" />
</element>
<element id="List.code.coding:medications.code">
<path value="List.code.coding.code" />
<min value="1" />
<mustSupport value="true" />
</element>
<element id="List.code.coding:medications.display">
<path value="List.code.coding.display" />
<mustSupport value="true" />
</element>
<element id="List.subject">
<path value="List.subject" />
<short value="Referenz auf den Patienten" />
<comment value="Begründung des Must-Support: Basisinformation" />
<min value="1" />
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
</type>
<mustSupport value="true" />
</element>
<element id="List.subject.reference">
<path value="List.subject.reference" />
<short value="Patienten-Link" />
<comment value="**Begründung MS:** Die Verlinkung auf eine Patienten-Ressource dient der technischen Zuordnung der Dokumentation zu einem Patienten und ermöglicht wichtige API-Funktionen wie verkettete Suche, (Reverse-)Include etc.\nIm ISik Kontext MUSS die referenzierte Ressource konform zu [ISiKPatient](https://gematik.de/fhir/isik/StructureDefinition/ISiKPatient) sein.\nJenseits von ISiK KÖNNEN weitere Instanzen mit anderen Profilen referenziert werden." />
<min value="1" />
<mustSupport value="true" />
</element>
<element id="List.encounter">
<path value="List.encounter" />
<short value="Referenz auf den Abteilungskontakt" />
<comment value="Begründung des Must-Support: Basisinformation im Krankenhaus-Kontext" />
<mustSupport value="true" />
</element>
<element id="List.encounter.reference">
<path value="List.encounter.reference" />
<comment value="**Begründung MS:** Die Verlinkung auf eine Encounter-Ressource dient der technischen Zuordnung der Dokumentation zu einem Aufenthalt und ermöglicht wichtige API-Funktionen wie verkettete Suche, (Reverse-)Include etc.\nIm ISik Kontext MUSS die referenzierte Ressource konform zu [ISiKKontaktGesundheitseinrichtung](https://gematik.de/fhir/isik/StructureDefinition/ISiKKontaktGesundheitseinrichtung) sein.\nJenseits von ISiK KÖNNEN weitere Instanzen mit anderen Profilen referenziert werden." />
<min value="1" />
<mustSupport value="true" />
</element>
<element id="List.date">
<path value="List.date" />
<short value="Erstellungsdatum der Liste" />
<comment value="Begründung des Must-Support: Basisinformation" />
<mustSupport value="true" />
</element>
<element id="List.entry">
<path value="List.entry" />
<short value="Listeneintrag" />
<mustSupport value="true" />
</element>
<element id="List.entry.date">
<path value="List.entry.date" />
<short value="Datum des Listeneintrags" />
<comment value="Begründung des Must-Support: Nachvollziehbarkeit\n\n    Hinweis: nur zulässig im Listenmodus 'working'" />
<mustSupport value="true" />
</element>
<element id="List.entry.item">
<path value="List.entry.item" />
<short value="Referenz auf die MedikationsInformation" />
<comment value="Begründung des Must-Support: Basisinformation (eigentlicher Zweck der Liste ist das Verbinden mehrerer MedikationsInformationen)" />
<type>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationStatement" />
</type>
<mustSupport value="true" />
</element>
<element id="List.entry.item.reference">
<path value="List.entry.item.reference" />
<min value="1" />
<mustSupport value="true" />
</element>
</differential>

</StructureDefinition>

{

"resourceType": "StructureDefinition",
"id": "ISiKMedikationsListe",
"url": "https://gematik.de/fhir/isik/StructureDefinition/ISiKMedikationsListe",
"version": "5.1.0",
"name": "ISiKMedikationsListe",
"title": "ISiK Medikationsliste",
"status": "active",
"experimental": false,
"date": "2025-10-23",
"publisher": "gematik GmbH",
"description": "Dieses Profil ermöglicht die Zusammenführung einzelner MedikationsInformationen eines Patienten in ISiK Szenarien.\n\nDie MedicationList verweist auf MedicationStatement-Ressourcen und bildet Medikationen ab, die aktuell eingenommen, im Krankenhaus verabreicht oder aus externen Quellen dokumentiert wurden - etwa durch Patientenangaben, Medikationspläne oder Entlassbriefe.\nIm Unterschied zum eMP der ePA ist die ISiK-MedikationsListe dynamisch generierbar und systemseitig aktualisierbar. Sie kann auch Informationen enthalten, die außerhalb des eigenen Hauses erfasst wurden – sofern diese dem System strukturiert vorliegen (z.B. durch eMP-Import).\nEin Import aus dem eMP ist möglich, aber nicht verpflichtend.",
"fhirVersion": "4.0.1",
"kind": "resource",
"abstract": false,
"type": "List",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/List",
"derivation": "constraint",
"differential": {
"element": [
{
"id": "List.id",
"path": "List.id",
"short": "serverseitige, interne ID des Datensatzes",
"comment": "**bedingtes Pflichtfeld/bedingtes MS:** Alle von einem Server bereitgestellten Ressourcen MÜSSEN über eine `id` verfügen.\n  Von Clients erzeugte Ressourcen, die im Kontext einer CREATE-Interaktion übermittelt werden, MÜSSEN NICHT über eine `id`verfügen.",
"mustSupport": true
},
{
"id": "List.meta.versionId",
"path": "List.meta.versionId",
"short": "Eindeutiger Name der serverseitigen Version des Datensatzes",
"comment": "Alle von einem Server bereitgestellten Ressourcen SOLLEN über eine `versionID` verfügen.\n  Von Clients erzeugte Ressourcen, die im Kontext einer CREATE-Interaktion übermittelt werden, MÜSSEN NICHT über eine `versionID`verfügen."
},
{
"id": "List.meta.lastUpdated",
"path": "List.meta.lastUpdated",
"short": "Zeitpunkt der letzten Änderung",
"comment": "Alle von einem Server bereitgestellten Ressourcen SOLLEN über ein `lastUpdate` verfügen.\n  Von Clients erzeugte Ressourcen, die im Kontext einer CREATE-Interaktion übermittelt werden, MÜSSEN NICHT über ein `lastUpdate`verfügen."
},
{
"id": "List.status",
"path": "List.status",
"short": "(Aktualitäts-)Status der Liste",
"comment": "Begründung des Must-Support: Erforderliche Angabe im FHIR-Standard",
"mustSupport": true
},
{
"id": "List.mode",
"path": "List.mode",
"short": "Listenmodus",
"comment": "Begründung des Must-Support: Erforderliche Angabe im FHIR-Standard\n\n  Beispiel: eingelesene Medikationspläne werden als snapshot repräsentiert. Kontinuierlich fortgeschriebene Listen, z.B. im Rahmen der hausinternen Behandlung, sind als 'working' codiert.",
"mustSupport": true,
"binding": {
"strength": "required",
"valueSet": "https://gematik.de/fhir/isik/ValueSet/MedikationsListeListModeVS"
}
},
{
"id": "List.code",
"path": "List.code",
"short": "Art der Liste.",
"comment": "Begründung des Must-Support: Dient der Differenzierung zu anderen Listen.\n\n  Hinweis: Es ist mindestens ein Coding mit dem Code 'medications' anzugeben. Weitere Codes, z.B. im Kontext anderer Spezifikationen oder Hauscodierungen sind zulässig.",
"min": 1,
"mustSupport": true
},
{
"id": "List.code.coding",
"path": "List.code.coding",
"slicing": {
"discriminator": [
{
"type": "pattern",
"path": "$this"
}
],
"rules": "open"
},
"min": 1,
"mustSupport": true
},
{
"id": "List.code.coding:medications",
"path": "List.code.coding",
"sliceName": "medications",
"min": 1,
"max": "*",
"patternCoding": {
"system": "http://terminology.hl7.org/CodeSystem/list-example-use-codes",
"code": "medications"
},
"mustSupport": true
},
{
"id": "List.code.coding:medications.system",
"path": "List.code.coding.system",
"min": 1,
"mustSupport": true
},
{
"id": "List.code.coding:medications.code",
"path": "List.code.coding.code",
"min": 1,
"mustSupport": true
},
{
"id": "List.code.coding:medications.display",
"path": "List.code.coding.display",
"mustSupport": true
},
{
"id": "List.subject",
"path": "List.subject",
"short": "Referenz auf den Patienten",
"comment": "Begründung des Must-Support: Basisinformation",
"min": 1,
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Patient"
]
}
],
"mustSupport": true
},
{
"id": "List.subject.reference",
"path": "List.subject.reference",
"short": "Patienten-Link",
"comment": "**Begründung MS:** Die Verlinkung auf eine Patienten-Ressource dient der technischen Zuordnung der Dokumentation zu einem Patienten und ermöglicht wichtige API-Funktionen wie verkettete Suche, (Reverse-)Include etc.\nIm ISik Kontext MUSS die referenzierte Ressource konform zu [ISiKPatient](https://gematik.de/fhir/isik/StructureDefinition/ISiKPatient) sein.\nJenseits von ISiK KÖNNEN weitere Instanzen mit anderen Profilen referenziert werden.",
"min": 1,
"mustSupport": true
},
{
"id": "List.encounter",
"path": "List.encounter",
"short": "Referenz auf den Abteilungskontakt",
"comment": "Begründung des Must-Support: Basisinformation im Krankenhaus-Kontext",
"mustSupport": true
},
{
"id": "List.encounter.reference",
"path": "List.encounter.reference",
"comment": "**Begründung MS:** Die Verlinkung auf eine Encounter-Ressource dient der technischen Zuordnung der Dokumentation zu einem Aufenthalt und ermöglicht wichtige API-Funktionen wie verkettete Suche, (Reverse-)Include etc.\nIm ISik Kontext MUSS die referenzierte Ressource konform zu [ISiKKontaktGesundheitseinrichtung](https://gematik.de/fhir/isik/StructureDefinition/ISiKKontaktGesundheitseinrichtung) sein.\nJenseits von ISiK KÖNNEN weitere Instanzen mit anderen Profilen referenziert werden.",
"min": 1,
"mustSupport": true
},
{
"id": "List.date",
"path": "List.date",
"short": "Erstellungsdatum der Liste",
"comment": "Begründung des Must-Support: Basisinformation",
"mustSupport": true
},
{
"id": "List.entry",
"path": "List.entry",
"short": "Listeneintrag",
"mustSupport": true
},
{
"id": "List.entry.date",
"path": "List.entry.date",
"short": "Datum des Listeneintrags",
"comment": "Begründung des Must-Support: Nachvollziehbarkeit\n\n    Hinweis: nur zulässig im Listenmodus 'working'",
"mustSupport": true
},
{
"id": "List.entry.item",
"path": "List.entry.item",
"short": "Referenz auf die MedikationsInformation",
"comment": "Begründung des Must-Support: Basisinformation (eigentlicher Zweck der Liste ist das Verbinden mehrerer MedikationsInformationen)",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/MedicationStatement"
]
}
],
"mustSupport": true
},
{
"id": "List.entry.item.reference",
"path": "List.entry.item.reference",
"min": 1,
"mustSupport": true
}
]
}

}

ISiK Medikationsliste

Constraints/Invarianten

Terminology-Bindings

Element	Staerke	ValueSet
List.mode	required	https://gematik.de/fhir/isik/ValueSet/MedikationsListeListModeVS

Anmerkungen zu Must-Support-Feldern

Feldname	Kurzbeschreibung	Hinweise
List.id	serverseitige, interne ID des Datensatzes	bedingtes Pflichtfeld/bedingtes MS: Alle von einem Server bereitgestellten Ressourcen MÜSSEN über eine `id` verfügen. Von Clients erzeugte Ressourcen, die im Kontext einer CREATE-Interaktion übermittelt werden, MÜSSEN NICHT über eine `id`verfügen.
List.status	(Aktualitäts-)Status der Liste	Begründung des Must-Support: Erforderliche Angabe im FHIR-Standard
List.mode	Listenmodus	Begründung des Must-Support: Erforderliche Angabe im FHIR-Standard Beispiel: eingelesene Medikationspläne werden als snapshot repräsentiert. Kontinuierlich fortgeschriebene Listen, z.B. im Rahmen der hausinternen Behandlung, sind als 'working' codiert.
List.code	Art der Liste.	Begründung des Must-Support: Dient der Differenzierung zu anderen Listen. Hinweis: Es ist mindestens ein Coding mit dem Code 'medications' anzugeben. Weitere Codes, z.B. im Kontext anderer Spezifikationen oder Hauscodierungen sind zulässig.
List.code.coding
List.code.coding:medications
List.code.coding:medications.system
List.code.coding:medications.code
List.code.coding:medications.display
List.subject	Referenz auf den Patienten	Begründung des Must-Support: Basisinformation
List.subject.reference	Patienten-Link	Begründung MS: Die Verlinkung auf eine Patienten-Ressource dient der technischen Zuordnung der Dokumentation zu einem Patienten und ermöglicht wichtige API-Funktionen wie verkettete Suche, (Reverse-)Include etc. Im ISik Kontext MUSS die referenzierte Ressource konform zu ISiKPatient sein. Jenseits von ISiK KÖNNEN weitere Instanzen mit anderen Profilen referenziert werden.
List.encounter	Referenz auf den Abteilungskontakt	Begründung des Must-Support: Basisinformation im Krankenhaus-Kontext
List.encounter.reference		Begründung MS: Die Verlinkung auf eine Encounter-Ressource dient der technischen Zuordnung der Dokumentation zu einem Aufenthalt und ermöglicht wichtige API-Funktionen wie verkettete Suche, (Reverse-)Include etc. Im ISik Kontext MUSS die referenzierte Ressource konform zu ISiKKontaktGesundheitseinrichtung sein. Jenseits von ISiK KÖNNEN weitere Instanzen mit anderen Profilen referenziert werden.
List.date	Erstellungsdatum der Liste	Begründung des Must-Support: Basisinformation
List.entry	Listeneintrag
List.entry.date	Datum des Listeneintrags	Begründung des Must-Support: Nachvollziehbarkeit `Hinweis: nur zulässig im Listenmodus 'working'`
List.entry.item	Referenz auf die MedikationsInformation	Begründung des Must-Support: Basisinformation (eigentlicher Zweck der Liste ist das Verbinden mehrerer MedikationsInformationen)
List.entry.item.reference

Interaktionen

Interaktion	Verbindlichkeit
create	SHALL
read	SHALL
update	SHALL
search-type	SHALL

Parameter	Typ	Verbindlichkeit	Hinweise
_id	token	SHALL	Beispiel: `GET [base]/List?_id=103270` `Anwendungshinweise: Weitere Informationen zur Suche nach '_id' finden sich in der [FHIR-Basisspezifikation - Abschnitt 'Parameters for all resources'](https://hl7.org/fhir/R4/search.html#all).`
code	token	SHALL	Beispiel: `GET [base]/List?code=http://terminology.hl7.org/CodeSystem/list-example-use-codes\|medications` `Anwendungshinweise: Weitere Informationen zur Suche nach Token-type Parametern finden sich in der [FHIR-Basisspezifikation - Abschnitt 'Token Search'](https://hl7.org/fhir/R4/search.html#token).`
date	date	SHALL	Beispiel: `GET [base]/List?date=2022-03-21` `Anwendungshinweise: Weitere Informationen zur Suche nach Date-type Parametern finden sich in der [FHIR-Basisspezifikation - Abschnitt 'Date'](https://hl7.org/fhir/R4/search.html#date).`
encounter	reference	SHALL	Beispiel: `GET [base]/List?encounter=Encounter/123` `Anwendungshinweise: Weitere Informationen zur Suche nach Reference-type Parametern finden sich in der [FHIR-Basisspezifikation - Abschnitt 'Reference Search'](https://www.hl7.org/fhir/R4/search.html#reference).`
item	reference	SHALL	Beispiel: `GET [base]/List?item=MedicationStatement/131415` `Anwendungshinweise: Weitere Informationen zur Suche nach Reference-type Parametern finden sich in der [FHIR-Basisspezifikation - Abschnitt 'Reference Search'](https://www.hl7.org/fhir/R4/search.html#reference).`
patient	reference	SHALL	Beispiel: `GET [base]/List?patient=Patient/123` `Anwendungshinweise: Weitere Informationen zur Suche nach Reference-type Parametern finden sich in der [FHIR-Basisspezifikation - Abschnitt 'Reference Search'](https://www.hl7.org/fhir/R4/search.html#reference).`
status	token	SHALL	Beispiel: `GET [base]/List?status=current` `Anwendungshinweise: Weitere Informationen zur Suche nach Token-type Parametern finden sich in der [FHIR-Basisspezifikation - Abschnitt 'Token Search'](https://hl7.org/fhir/R4/search.html#token).`
encounter.identifier	reference	SHALL	Beispiele: `GET [base]/List?encounter.identifier=http://mein-krankenhaus.example/fhir/sid/fallnummern\|7567867` `GET [base]/List?encounter.identifier=7567867` Anwendungshinweise: Weitere Informationen zur Suche nach Reference-type Parametern finden sich in der [FHIR-Basisspezifikation - Abschnitt 'Reference Search'](https://www.hl7.org/fhir/R4/search.html#reference). Weitere Informationen zur Suche nach verketteten Parametern finden sich in der [FHIR-Basisspezifikation - Abschnitt 'Chained Parameters'](https://hl7.org/fhir/R4/search.html#chaining).
patient.identifier	reference	SHALL	Beispiele: `GET [base]/List?patient.identifier=http://mein-krankenhaus.example/fhir/sid/patienten\|1032702` `GET [base]/List?patient.identifier=1032702` Anwendungshinweise: Weitere Informationen zur Suche nach Token-type Parametern finden sich in der [FHIR-Basisspezifikation - Abschnitt 'Token Search'](https://hl7.org/fhir/R4/search.html#token). Weitere Informationen zur Suche nach verketteten Parametern finden sich in der [FHIR-Basisspezifikation - Abschnitt 'Chained Parameters'](https://hl7.org/fhir/R4/search.html#chaining).

(Reverse-)Include

Include
List:patient, List:encounter, List:item

Beispiele

ExampleISiKMedikationsListe

List

id : ExampleISiKMedikationsListe

meta

profile : https://gematik.de/fhir/isik/StructureDefinition/ISiKMedikationsListe

status : current

mode : working

code

coding

system : http://terminology.hl7.org/CodeSystem/list-example-use-codes

code : medications

subject

reference : Patient/PatientinMusterfrau

encounter

reference : Encounter/Fachabteilungskontakt

date : 2021-07-04

entry

date : 2021-07-01

item

reference : MedicationStatement/ExampleISiKMedikationsInformation1

entry

date : 2021-07-04

item

reference : MedicationStatement/ExampleISiKMedikationsInformation2

<meta>

</meta>

<code>

</coding>

</code>

</subject>

</encounter>

<item>

</item>

</entry>

<item>

</item>

</entry>

</List>

{

"resourceType": "List",

"id": "ExampleISiKMedikationsListe",

"meta": {

"profile": [

"https://gematik.de/fhir/isik/StructureDefinition/ISiKMedikationsListe"

]

"code": {

"coding": [

{

"system": "http://terminology.hl7.org/CodeSystem/list-example-use-codes",

"code": "medications"

}

]

"status": "current",

"mode": "working",

"subject": {

"reference": "Patient/PatientinMusterfrau"

"encounter": {

"reference": "Encounter/Fachabteilungskontakt"

"date": "2021-07-04",

"entry": [

{

"date": "2021-07-01",

"item": {

"reference": "MedicationStatement/ExampleISiKMedikationsInformation1"

}

{

"date": "2021-07-04",

"item": {

"reference": "MedicationStatement/ExampleISiKMedikationsInformation2"

}

]

}

ExampleISiKMedikationsListe

ExampleISiKMedikationsListeParkinson

Beispiel für eine Medikationsliste zur Behandlung von Morbus Parkinson (vgl. auch die vollständige Darstellung unter

Command 'pagelink' could not render: Page not found.

List

id : ExampleISiKMedikationsListeParkinson

meta

profile : https://gematik.de/fhir/isik/StructureDefinition/ISiKMedikationsListe

status : current

mode : working

code

coding

system : http://terminology.hl7.org/CodeSystem/list-example-use-codes

code : medications

subject

reference : Patient/PatientinMusterfrau

encounter

reference : Encounter/Fachabteilungskontakt

date : 2024-02-20

entry

date : 2024-02-20

item

reference : MedicationStatement/ExampleISiKMedikationsInformationParkinson1

entry

date : 2024-02-20

item

reference : MedicationStatement/ExampleISiKMedikationsInformationParkinson2

entry

date : 2024-02-20

item

reference : MedicationStatement/ExampleISiKMedikationsInformationParkinson3

entry

date : 2024-02-20

item

reference : MedicationStatement/ExampleISiKMedikationsInformationParkinson4

entry

date : 2024-02-20

item

reference : MedicationStatement/ExampleISiKMedikationsInformationParkinson5

<meta>

</meta>

<code>

</coding>

</code>

</subject>

</encounter>

<item>

</item>

</entry>

<item>

</item>

</entry>

<item>

</item>

</entry>

<item>

</item>

</entry>