Implementierungsleitfaden ISiK-Medikation

ISiKMedikationsListe (List)

ISiKMedikationsListe (List)

ISiK Medikationsliste

Dieses Profil ermöglicht die Zusammenführung einzelner MedikationsInformationen eines Patienten in ISiK Szenarien.

Bestätigungsrelevanz

Verbindlichkeit	SHALL

Metadaten

Canonical	https://gematik.de/fhir/isik/StructureDefinition/ISiKMedikationsListe
Status	active
Version	4.0.3
Basis	http://hl7.org/fhir/StructureDefinition/List

Inhalt

ISiKMedikationsListe (List)	I		List	There are no (further) constraints on this element Element id List Short description A list is a curated collection of resources Alternate names Collection, WorkingList, Organizer Definition A list is a curated collection of resources. Data type List Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() lst-1: A list can only have an emptyReason if it is empty `emptyReason.empty() or entry.empty()` lst-2: The deleted flag can only be used if the mode of the list is "changes" `mode = 'changes' or entry.deleted.empty()` lst-3: An entry date can only be used if the mode of the list is "working" `mode = 'working' or entry.date.empty()` Mappings rim: Entity. Role, or Act rim: Act[classCode<ORG,moodCode=EVN]
id	Σ	0..1	string	There are no (further) constraints on this element Element id List.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type string
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id List.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
implicitRules	Σ ?!	0..1	uri	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 uri 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 code Binding A human language. CommonLanguages (preferred) 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	I	0..*	Extension	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 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 Extension 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	?! I	0..*	Extension	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 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 Extension 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..*	Identifier	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 Identifier 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 code 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 code Binding The processing mode that applies to this list. MedikationsListeListModeVS (required) 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	Σ	0..1	string	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 string 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	CodeableConcept	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 CodeableConcept Binding What the purpose of a list is. ExampleUseCodesForList (example) 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
id		0..1	string	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 string Mappings rim: n/a
extension	I	0..*	Extension	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 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 Extension Sliced: 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..*	Coding	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 Coding Sliced: 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: CE.1-8, CE.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 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 Coding 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: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	string	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 string Mappings rim: n/a
extension	I	0..*	Extension	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 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 Extension Sliced: 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 uri 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: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	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 string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.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 code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern medications Mappings v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	S Σ	0..1	string	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 string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	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 boolean 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	Σ	0..1	string	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 string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.9. But note many systems use CE.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
id		0..1	string	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 string Mappings rim: n/a
extension	I	0..*	Extension	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 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 Extension Sliced: 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 I	1..1	string	There are no (further) constraints on this element Element id List.subject.reference Short description Literal reference, Relative, internal or absolute URL 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 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 string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
type	Σ	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 uri 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	Σ	0..1	Identifier	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 Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .identifier
display	Σ	0..1	string	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 string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
encounter	S	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]
id		0..1	string	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 string Mappings rim: n/a
extension	I	0..*	Extension	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 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 Extension Sliced: 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 I	1..1	string	There are no (further) constraints on this element Element id List.encounter.reference Short description Literal reference, Relative, internal or absolute URL 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 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 string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
type	Σ	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. 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 uri 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	Σ	0..1	Identifier	There are no (further) constraints on this element Element id List.encounter.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 Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .identifier
display	Σ	0..1	string	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 string 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	dateTime	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 dateTime 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	Σ	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 CodeableConcept 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 I	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 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]
id		0..1	string	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 string Mappings rim: n/a
extension	I	0..*	Extension	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 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 Extension 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 ?! I	0..*	Extension	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 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 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 Extension 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	CodeableConcept	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 CodeableConcept Binding Codes that provide further information about the reason and meaning of the item in the list. PatientMedicineChangeTypes (example) 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	?! I	0..1	boolean	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 boolean 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	S	0..1	dateTime	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 dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .availabilityTime
item	S	1..1	Reference(MedicationStatement)	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
id		0..1	string	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 string Mappings rim: n/a
extension	I	0..*	Extension	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 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 Extension Sliced: 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 I	1..1	string	There are no (further) constraints on this element Element id List.entry.item.reference Short description Literal reference, Relative, internal or absolute URL 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 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 string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
type	Σ	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. 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 uri 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	Σ	0..1	Identifier	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 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 Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .identifier
display	Σ	0..1	string	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 string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
emptyReason	I	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 CodeableConcept Binding If a list is empty, why it is empty. ListEmptyReasons (preferred) 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]

<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="ISiKMedikationsListe" />
    <url value="https://gematik.de/fhir/isik/StructureDefinition/ISiKMedikationsListe" />
    <version value="4.0.3" />
    <name value="ISiKMedikationsListe" />
    <title value="ISiK Medikationsliste" />
    <status value="active" />
    <experimental value="false" />
    <date value="2025-03-17" />
    <publisher value="gematik GmbH" />
    <description value="Dieses Profil erm&#246;glicht die Zusammenf&#252;hrung einzelner MedikationsInformationen eines Patienten in ISiK Szenarien." />
    <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.status">
            <path value="List.status" />
            <short value="(Aktualit&#228;ts-)Status der Liste" />
            <comment value="Begr&#252;ndung 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="Begr&#252;ndung des Must-Support: Erforderliche Angabe im FHIR-Standard\n\n  Beispiel: eingelesene Medikationspl&#228;ne werden als snapshot repr&#228;sentiert. Kontinuierlich fortgeschriebene Listen, z.B. im Rahmen der hausinternen Behandlung, sind als &#39;working&#39; 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="Begr&#252;ndung des Must-Support: Dient der Differenzierung zu anderen Listen.\n\n  Hinweis: Es ist mindestens ein Coding mit dem Code &#39;medications&#39; anzugeben. Weitere Codes, z.B. im Kontext anderer Spezifikationen oder Hauscodierungen sind zul&#228;ssig." />
            <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="Begr&#252;ndung 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" />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="List.encounter">
            <path value="List.encounter" />
            <short value="Referenz auf den Abteilungskontakt" />
            <comment value="Begr&#252;ndung des Must-Support: Basisinformation im Krankenhaus-Kontext" />
            <mustSupport value="true" />
        </element>
        <element id="List.encounter.reference">
            <path value="List.encounter.reference" />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="List.date">
            <path value="List.date" />
            <short value="Erstellungsdatum der Liste" />
            <comment value="Begr&#252;ndung 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="Begr&#252;ndung des Must-Support: Nachvollziehbarkeit\n\n    Hinweis: nur zul&#228;ssig im Listenmodus &#39;working&#39;" />
            <mustSupport value="true" />
        </element>
        <element id="List.entry.item">
            <path value="List.entry.item" />
            <short value="Referenz auf die MedikationsInformation" />
            <comment value="Begr&#252;ndung 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": "4.0.3",
    "name": "ISiKMedikationsListe",
    "title": "ISiK Medikationsliste",
    "status": "active",
    "experimental": false,
    "date": "2025-03-17",
    "publisher": "gematik GmbH",
    "description": "Dieses Profil ermöglicht die Zusammenführung einzelner MedikationsInformationen eines Patienten in ISiK Szenarien.",
    "fhirVersion": "4.0.1",
    "kind": "resource",
    "abstract": false,
    "type": "List",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/List",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "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",
                "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",
                "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.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
List.encounter	Referenz auf den Abteilungskontakt	Begründung des Must-Support: Basisinformation im Krankenhaus-Kontext
List.encounter.reference
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
_id	token	SHALL
code	token	SHALL
date	date	SHALL
encounter	reference	SHALL
item	reference	SHALL
patient	reference	SHALL
status	token	SHALL

(Reverse-)Include

Include
List:patient; List:encounter; List:item

CapabilityStatements

Für die Ressource List MÜSSEN die REST-Interaktionen "READ", "CREATE" und "UPDATE" implementiert werden.

Folgende Suchparameter sind für das Bestätigungsverfahren relevant, auch in Kombination:

Der Suchparameter "_id" MUSS unterstützt werden:

Beispiele:

GET [base]/List?_id=103270

Anwendungshinweise: Weitere Informationen zur Suche nach "_id" finden sich in der FHIR-Basisspezifikation - Abschnitt "Parameters for all resources".
Der Suchparameter "code" MUSS unterstützt werden:

Beispiele:

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".
Der Suchparameter "date" MUSS unterstützt werden:

Beispiele:

GET [base]/List?date=2022-03-21

Anwendungshinweise: Weitere Informationen zur Suche nach Date-type Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Date".
Der Suchparameter "encounter" MUSS unterstützt werden:

Beispiele:

GET [base]/List?encounter=Encounter/123

Anwendungshinweise: Weitere Informationen zur Suche nach Reference-type Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Reference Search".
Der verkettete Suchparameter "encounter.identifier" MUSS unterstützt werden:

Beispiele:

GET [base]/List?encounter.identifier=http://mein-krankenhaus.example/fhir/sid/fallnummern|7567867

GET [base]/List?encounter.identifier=7567867

Use Case Zusammenhang: Um bei einem wiederkehrenden Patienten eine Verwechslung des Falls und damit eine falsche Medikation zu vermeiden.

Anwendungshinweise: Weitere Informationen zur Suche nach Reference-type Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Reference Search".

Weitere Informationen zur Suche nach verketteten Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Chained Parameters".
Der Suchparameter "item" MUSS unterstützt werden:

Beispiele:

GET [base]/List?item=MedicationStatement/131415

Anwendungshinweise: Weitere Informationen zur Suche nach Reference-type Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Reference Search".
Der Suchparameter "patient" MUSS unterstützt werden:

Beispiele:

GET [base]/List?patient=Patient/123

Anwendungshinweise: Weitere Informationen zur Suche nach Reference-type Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Reference Search".
Der verkettete Suchparameter "patient.identifier" MUSS unterstützt werden:

Beispiele:

GET [base]/List?patient.identifier=http://mein-krankenhaus.example/fhir/sid/patienten|1032702

GET [base]/List?patient.identifier=1032702

Use Case Zusammenhang: Um bei der Medikationsliste eine Verwechslung zwischen verschiedenen Patienten vermeiden.

Anwendungshinweise: Weitere Informationen zur Suche nach Token-type Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Token Search".

Weitere Informationen zur Suche nach verketteten Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Chained Parameters".
Der Suchparameter "status" MUSS unterstützt werden:

Beispiele:

GET [base]/List?status=current

Anwendungshinweise: Weitere Informationen zur Suche nach Token-type Parametern finden sich in der FHIR-Basisspezifikation - Abschnitt "Token Search".

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

<List xmlns="http://hl7.org/fhir">
    <id value="ExampleISiKMedikationsListe" />
    <meta>
        <profile value="https://gematik.de/fhir/isik/StructureDefinition/ISiKMedikationsListe" />
    </meta>
    <status value="current" />
    <mode value="working" />
    <code>
        <coding>
            <system value="http://terminology.hl7.org/CodeSystem/list-example-use-codes" />
            <code value="medications" />
        </coding>
    </code>
    <subject>
        <reference value="Patient/PatientinMusterfrau" />
    </subject>
    <encounter>
        <reference value="Encounter/Fachabteilungskontakt" />
    </encounter>
    <date value="2021-07-04" />
    <entry>
        <date value="2021-07-01" />
        <item>
            <reference value="MedicationStatement/ExampleISiKMedikationsInformation1" />
        </item>
    </entry>
    <entry>
        <date value="2021-07-04" />
        <item>
            <reference value="MedicationStatement/ExampleISiKMedikationsInformation2" />
        </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

<List xmlns="http://hl7.org/fhir">
    <id value="ExampleISiKMedikationsListeParkinson" />
    <meta>
        <profile value="https://gematik.de/fhir/isik/StructureDefinition/ISiKMedikationsListe" />
    </meta>
    <status value="current" />
    <mode value="working" />
    <code>
        <coding>
            <system value="http://terminology.hl7.org/CodeSystem/list-example-use-codes" />
            <code value="medications" />
        </coding>
    </code>
    <subject>
        <reference value="Patient/PatientinMusterfrau" />
    </subject>
    <encounter>
        <reference value="Encounter/Fachabteilungskontakt" />
    </encounter>
    <date value="2024-02-20" />
    <entry>
        <date value="2024-02-20" />
        <item>
            <reference value="MedicationStatement/ExampleISiKMedikationsInformationParkinson1" />
        </item>
    </entry>
    <entry>
        <date value="2024-02-20" />
        <item>
            <reference value="MedicationStatement/ExampleISiKMedikationsInformationParkinson2" />
        </item>
    </entry>
    <entry>
        <date value="2024-02-20" />
        <item>
            <reference value="MedicationStatement/ExampleISiKMedikationsInformationParkinson3" />
        </item>
    </entry>
    <entry>
        <date value="2024-02-20" />
        <item>
            <reference value="MedicationStatement/ExampleISiKMedikationsInformationParkinson4" />
        </item>
    </entry>
    <entry>
        <date value="2024-02-20" />
        <item>
            <reference value="MedicationStatement/ExampleISiKMedikationsInformationParkinson5" />
        </item>
    </entry>
</List>

{
    "resourceType": "List",
    "id": "ExampleISiKMedikationsListeParkinson",
    "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": "2024-02-20",
    "entry":  [
        {
            "date": "2024-02-20",
            "item": {
                "reference": "MedicationStatement/ExampleISiKMedikationsInformationParkinson1"
            }
        },
        {
            "date": "2024-02-20",
            "item": {
                "reference": "MedicationStatement/ExampleISiKMedikationsInformationParkinson2"
            }
        },
        {
            "date": "2024-02-20",
            "item": {
                "reference": "MedicationStatement/ExampleISiKMedikationsInformationParkinson3"
            }
        },
        {
            "date": "2024-02-20",
            "item": {
                "reference": "MedicationStatement/ExampleISiKMedikationsInformationParkinson4"
            }
        },
        {
            "date": "2024-02-20",
            "item": {
                "reference": "MedicationStatement/ExampleISiKMedikationsInformationParkinson5"
            }
        }
    ]
}

ExampleISiKMedikationsListeParkinson