generated: '2026-08-04'
method: derived
source: >-
  openapi/modernizing-medicine-ema-proprietary-api-openapi.json (search parameters and path shapes),
  openapi/modernizing-medicine-certified-fhir-api-openapi.json, and
  conformance/modernizing-medicine-fhir-capabilitystatement.json (31 declared resource types)
model: HL7 FHIR R4
note: >-
  Both ModMed APIs project the same clinical/practice core as FHIR R4 resources — the Certified FHIR
  API as US Core read/search, the EMA Proprietary API as a /fhir/v2 read-write projection. The
  relationships below are derived from the reference search parameters each operation actually
  declares (e.g. Coverage?patient=), not from an authored ERD. Cardinality follows FHIR R4 semantics.
root_entity: Patient
tenancy:
  key: firm
  shape: >-
    firm_url_prefix path segment (EMA Proprietary API) or firm host subdomain (Certified FHIR API);
    every resource id is scoped to one practice
entities:
- name: Patient
  apis: [ema-proprietary, certified-fhir]
  operations: [read, search, create, update]
  identifiers: [identifier, email, phone, family, given, birthdate]
  note: Supports us-core-race / us-core-ethnicity search parameters
- name: Practitioner
  apis: [ema-proprietary, certified-fhir]
  operations: [read, search, create]
  note: Create is limited to REFERRING practitioners on the proprietary API
- name: PractitionerRole
  apis: [certified-fhir]
- name: Organization
  apis: [ema-proprietary, certified-fhir]
  note: Create is limited to referring institutions on the proprietary API
- name: Location
  apis: [ema-proprietary, certified-fhir]
- name: Encounter
  apis: [ema-proprietary, certified-fhir]
- name: Appointment
  apis: [ema-proprietary]
  operations: [read, search, create, update]
- name: Slot
  apis: [ema-proprietary]
  note: Not paginated
- name: Coverage
  apis: [ema-proprietary, certified-fhir]
- name: InsurancePlan
  apis: [ema-proprietary]
- name: Account
  apis: [ema-proprietary]
- name: ChargeItem
  apis: [ema-proprietary]
  note: Inbound charges have their own sub-paths (/ChargeItem/inbound, /ChargeItem/chg/{id})
- name: DocumentReference
  apis: [ema-proprietary, certified-fhir]
- name: MedicationStatement
  apis: [ema-proprietary]
- name: MedicationRequest
  apis: [certified-fhir]
- name: MedicationDispense
  apis: [certified-fhir]
- name: AllergyIntolerance
  apis: [ema-proprietary, certified-fhir]
- name: Condition
  apis: [ema-proprietary, certified-fhir]
- name: FamilyMemberHistory
  apis: [ema-proprietary]
- name: ServiceRequest
  apis: [ema-proprietary, certified-fhir]
- name: DiagnosticReport
  apis: [ema-proprietary, certified-fhir]
- name: Specimen
  apis: [certified-fhir]
- name: Task
  apis: [ema-proprietary]
  note: Tasks/Recalls
- name: Composition
  apis: [ema-proprietary]
  note: Transcription create only
- name: RelatedPerson
  apis: [ema-proprietary, certified-fhir]
- name: Observation
  apis: [certified-fhir]
- name: Immunization
  apis: [certified-fhir]
- name: Procedure
  apis: [certified-fhir]
- name: CarePlan
  apis: [certified-fhir]
- name: CareTeam
  apis: [certified-fhir]
- name: Goal
  apis: [certified-fhir]
- name: Device
  apis: [certified-fhir]
- name: Provenance
  apis: [certified-fhir]
- name: Questionnaire
  apis: [certified-fhir]
- name: QuestionnaireResponse
  apis: [certified-fhir]
- name: Group
  apis: [certified-fhir]
  note: Bulk export cohort — /Group/$export
- name: Endpoint
  apis: [certified-fhir]
  note: Public service-base-URL directory required by the Cures Act
- name: ValueSet
  apis: [ema-proprietary, certified-fhir]
  note: Firm-specific code lists (appointment types etc.)
relationships:
- from: Account
  to: Patient
  type: belongs_to
  via: patient
- from: AllergyIntolerance
  to: Patient
  type: belongs_to
  via: patient
- from: Appointment
  to: Patient
  type: belongs_to
  via: patient
- from: Appointment
  to: Practitioner
  type: belongs_to
  via: practitioner
- from: Appointment
  to: Location
  type: belongs_to
  via: location
- from: ChargeItem
  to: Patient
  type: belongs_to
  via: patient
- from: ChargeItem
  to: Encounter
  type: belongs_to
  via: context
- from: Condition
  to: Patient
  type: belongs_to
  via: patient
- from: Coverage
  to: Patient
  type: belongs_to
  via: patient
- from: DiagnosticReport
  to: Patient
  type: belongs_to
  via: patient
- from: DiagnosticReport
  to: Encounter
  type: belongs_to
  via: encounter
- from: DocumentReference
  to: Patient
  type: belongs_to
  via: patient
- from: DocumentReference
  to: Encounter
  type: belongs_to
  via: encounter
- from: Encounter
  to: Patient
  type: belongs_to
  via: patient
- from: Encounter
  to: Appointment
  type: belongs_to
  via: appointment
- from: FamilyMemberHistory
  to: Patient
  type: belongs_to
  via: patient
- from: InsurancePlan
  to: Organization
  type: belongs_to
  via: owned-by
- from: MedicationStatement
  to: Patient
  type: belongs_to
  via: patient
- from: Patient
  to: Practitioner
  type: has_one
  via: general-practitioner
- from: ServiceRequest
  to: Patient
  type: belongs_to
  via: patient
- from: ServiceRequest
  to: Encounter
  type: belongs_to
  via: encounter
- from: ServiceRequest
  to: Practitioner
  type: belongs_to
  via: requester
- from: Task
  to: Patient
  type: belongs_to
  via: patient
- from: Endpoint
  to: Organization
  type: belongs_to
  via: managingOrganization