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Copy file name to clipboardExpand all lines: docs/emed/index.md
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# CH-EMED-EPR
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# CHEMEDEPR
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CH-EMED-EPR is a FHIR equivalent to CDA-CH-EMED.
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Its specification are entirely described in [https://build.fhir.org/ig/CARA-ch/ch-emed-epr/](https://build.fhir.org/ig/CARA-ch/ch-emed-epr/).
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[CH EMED EPR](https://fhir.ch/ig/ch-emed-epr/index.html) is a FHIR implementation guide that specifies mostly the eMedication service's exchange format.
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It is built upon [CH-EMED](http://build.fhir.org/ig/hl7ch/ch-emed/) (the Swiss eMedication profile), [CH-CORE](https://build.fhir.org/ig/hl7ch/ch-core/) and [CH-Term](http://fhir.ch/ig/ch-term/index.html).
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It is built upon [CHEMED](https://fhir.ch/ig/ch-emed/index.html) (the Swiss eMedication profile), [CHCORE](https://fhir.ch/ig/ch-core/index.html) and [CHTerm](http://fhir.ch/ig/ch-term/index.html).
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In particular, CH-EMED contains a lot of documentation about the use of the profile, it is highly recommended reading it.
Copy file name to clipboardExpand all lines: docs/transactions/iti43.md
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## On-demand documents
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Generation rules for CH-EMED-EPR [PML (Medication List)](https://build.fhir.org/ig/CARA-ch/ch-emed-epr/document_pml.html) and [PMLC (Medication Card)](https://build.fhir.org/ig/CARA-ch/ch-emed-epr/document_pmlc.html) documents are described in the [CH-EMED-EPR IG](https://build.fhir.org/ig/CARA-ch/ch-emed-epr/).
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Generation rules for CHEMEDEPR [PML (Medication List)](https://fhir.ch/ig/ch-emed-epr/document_pml.html) and [PMLC (Medication Card)](https://fhir.ch/ig/ch-emed-epr/document_pmlc.html) documents are described in the [CHEMEDEPR IG](https://fhir.ch/ig/ch-emed-epr/).
Copy file name to clipboardExpand all lines: docs/transactions/iti57.md
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This transaction is implemented, but only for the *deletionStatus* attribute. This implies that the only possible update in the service is the deletion of a document.
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### Deleting a CH-EMED-EPR document
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### Deleting a CHEMEDEPR document
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The rules are similar to [ITI-41](iti41.md) replacement.
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* Patient / representative can only request the removal of a document published by the same patient. Hence a patient cannot request the removal of a document published by a healthcare professional.
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* Deletion rights related to HCP are not implemented yet and will be subject to further discussion before implementation. For now, patients are allowed to delete documents provided by HCPs and HCPs are not allowed to delete any documents.
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* Document administrator may only request the removal of any document published by either a patient, representative, or healthcare professional.
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* Only approved documents at the end of a treatment chain can be requested to be deleted.
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* Requested deletion of a CH-EMED-EPR document will also flag for deletion the chain of replaced documents by this document, if it exists.
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* Requested deletion of a CHEMEDEPR document will also flag for deletion the chain of replaced documents by this document, if it exists.
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* Documents to be deleted must exist in the repository.
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* Currently the service just permanently deletes the requested documents, no archival or flagging is done.
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### Deleting an APPC document
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* Deleting an [APPC](https://www.ihe.net/uploadedFiles/Documents/ITI/IHE_ITI_Suppl_APPC.pdf) document means that the patient is opting out. It triggers an archive and removal of all the documents for this patient: [CH-EMED-EPR](https://build.fhir.org/ig/CARA-ch/ch-emed-epr/) and APPC (including and any deprecated ones) documents are both concerned.
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* Deleting an [APPC](https://www.ihe.net/uploadedFiles/Documents/ITI/IHE_ITI_Suppl_APPC.pdf) document means that the patient is opting out. It triggers an archive and removal of all the documents for this patient: [CHEMEDEPR](https://fhir.ch/ig/ch-emed-epr/) and APPC (including and any deprecated ones) documents are both concerned.
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* Only the patients or their representatives can request the deletion of their own APPC documents.
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* A policy administrator can request the removal of any patient's APPC of their own reference community.
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* The APPC document has to be approved
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* This implies that direct deletion of a deprecated (replaced) APPC document is not possible.
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* Unapproved APPC document deletion can only occur at opt-out.
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* Currently the service just permanently deletes the requested APPC document and all the CH-EMED-EPR documents and any other information stored by the PMP concerning this patient, no archival or flagging is done.
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* Currently the service just permanently deletes the requested APPC document and all the CHEMEDEPR documents and any other information stored by the PMP concerning this patient, no archival or flagging is done.
Copy file name to clipboardExpand all lines: docs/workflows/aggregation.md
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|Term|Definition|References|
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|----|----------|----------|
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|Medication plan (current medication)|The medication plan is the documentation of all the medication information for a patient at a certain point of time.<br/>The medication plan can be presented as a [medication card](https://github.com/ehealthsuisse/EPD-by-example/blob/main/files/MedicationCardDocument.md) or as an [eMediplan](https://emediplan.ch/) (eMediplan is not supported by the service, it is another way of displaying the medication plan).|See [IHE Pharmacy Community Medication List (PML)](https://www.ihe.net/uploadedFiles/Documents/Pharmacy/IHE_Pharmacy_Suppl_PML.pdf) and IPAG's definition ([FR](https://www.fmh.ch/files/pdf24/rapport-gtip-ipag-sur-la-cybermedication.pdf), [DE](https://www.fmh.ch/files/pdf24/ipag-bericht-emedikation.pdf)), § 2.1 and § 2.5.|
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|Medication treatment|A medication treatment corresponds to one single medication the patient was planned to take in the past or is planned to take presently or in the future, including its name, dosage, frequency of intake, etc.<br/>Medication treatments are created every time an [MTP document](https://build.fhir.org/ig/CARA-ch/ch-emed-epr/document_mtp.html) is received.<br/> This service considers two kinds of medication treatments: "simple" and "prescribed".<br/> Simple medication treatments are created with just one [MTP document](https://build.fhir.org/ig/CARA-ch/ch-emed-epr/document_mtp.html) (by the patient or a healthcare professional).<br/> Prescribed medication treatments are created by healthcare professionals only, with an [MTP document](https://build.fhir.org/ig/CARA-ch/ch-emed-epr/document_mtp.html) followed by a [PRE document](https://build.fhir.org/ig/CARA-ch/ch-emed-epr/document_pre.html).|See [IHE Pharmacy MTP supplement](https://www.ihe.net/uploadedFiles/Documents/Pharmacy/IHE_Pharmacy_Suppl_MTP.pdf), as well as [HL7's Medication Treatment Plan FHIR document](https://build.fhir.org/ig/hl7ch/ch-emed//medication-treatment-plan-document.html).|
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|Medication treatment instance|A medication treatment instance is a concept of this eMedication service.<br/> A medication treatment can change over time: the dosage, medication, active substance, comments, etc. can be updated.<br/> The medication treatment instance represents the state of a medication at a current point of time. <br/>Medication treatment instance creation depends on the type of medication treatment. For "simple" (ie. not prescribed) treatments, a single medication treatment instance is created when the [MTP document](https://build.fhir.org/ig/CARA-ch/ch-emed-epr/document_mtp.html) is received. <br/> For _prescribed_ medication treatments (ie. medication treatments for which there is a [MTP document](https://build.fhir.org/ig/CARA-ch/ch-emed-epr/document_mtp.html) and at least one [PRE document](https://build.fhir.org/ig/CARA-ch/ch-emed-epr/document_pre.html)), a new instance is created every time a [PRE document](https://build.fhir.org/ig/CARA-ch/ch-emed-epr/document_pre.html) is received.<br/>Each medication treatment instance appears in a single line within the medication card. Instances associated with the same treatment are visually grouped.|-|
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|Medication statement|A medication statement represents a given medication (form, dosage, GTIN/ATC, ingredients etc.)|See the [definition in the implementation guide](https://build.fhir.org/ig/CARA-ch/ch-emed-epr/StructureDefinition-ch-emed-epr-medicationstatement-treatmentplan.html).|
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|Medication treatment|A medication treatment corresponds to one single medication the patient was planned to take in the past or is planned to take presently or in the future, including its name, dosage, frequency of intake, etc.<br/>Medication treatments are created every time an [MTP document](https://fhir.ch/ig/ch-emed-epr/document_mtp.html) is received.<br/> This service considers two kinds of medication treatments: "simple" and "prescribed".<br/> Simple medication treatments are created with just one [MTP document](https://fhir.ch/ig/ch-emed-epr/document_mtp.html) (by the patient or a healthcare professional).<br/> Prescribed medication treatments are created by healthcare professionals only, with an [MTP document](https://fhir.ch/ig/ch-emed-epr/document_mtp.html) followed by a [PRE document](https://fhir.ch/ig/ch-emed-epr/document_pre.html).|See [IHE Pharmacy MTP supplement](https://www.ihe.net/uploadedFiles/Documents/Pharmacy/IHE_Pharmacy_Suppl_MTP.pdf), as well as [HL7's Medication Treatment Plan FHIR document](https://fhir.ch/ig/ch-emed/medication-treatment-plan-document.html).|
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|Medication treatment instance|A medication treatment instance is a concept of this eMedication service.<br/> A medication treatment can change over time: the dosage, medication, active substance, comments, etc. can be updated.<br/> The medication treatment instance represents the state of a medication at a current point of time. <br/>Medication treatment instance creation depends on the type of medication treatment. For "simple" (ie. not prescribed) treatments, a single medication treatment instance is created when the [MTP document](https://fhir.ch/ig/ch-emed-epr/document_mtp.html) is received. <br/> For _prescribed_ medication treatments (ie. medication treatments for which there is a [MTP document](https://fhir.ch/ig/ch-emed-epr/document_mtp.html) and at least one [PRE document](https://fhir.ch/ig/ch-emed-epr/document_pre.html)), a new instance is created every time a [PRE document](https://fhir.ch/ig/ch-emed-epr/document_pre.html) is received.<br/>Each medication treatment instance appears in a single line within the medication card. Instances associated with the same treatment are visually grouped.|-|
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|Medication statement|A medication statement represents a given medication (form, dosage, GTIN/ATC, ingredients etc.)|See the [definition in the implementation guide](https://fhir.ch/ig/ch-emed-epr/StructureDefinition-ch-emed-epr-medicationstatement-treatmentplan.html).|
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|Aggregation|The aggregation is the process of determining the current state of each medication treatment within a patient's medication plan, based on the existing medication treatment instances.<br/>This is done depending on the document triggering the aggregation, either by updating existing medication treatments / medication treatment instances, or by creating new medication treatment instances|-|
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## Triggers
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## Scope
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When triggered, aggregation occurs for the medication treatment referenced by the triggering document.
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When the triggering document is a [PRE](https://build.fhir.org/ig/CARA-ch/ch-emed-epr/document_pre.html), it might reference several medication treatments (multi-prescription). In this case the service applies the aggregation process to each referenced medication treatment.
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When the triggering document is a [PRE](https://fhir.ch/ig/ch-emed-epr/document_pre.html), it might reference several medication treatments (multi-prescription). In this case the service applies the aggregation process to each referenced medication treatment.
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