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HdBe-TreatmentDirective2

ProfileDescriptionStatusURL
HdBe-TreatmentDirective2

A treatment directive contains a joint decision between a health professional (for example a general practitioner) and a patient or his representative(s) about the desirability of performing a certain treatment, such as resuscitation, before this treatment becomes (acute) necessary. When the need arises and the treatment cannot be discussed with the patient or representative (s), that decision is an important indication for the treating health professional (for example an ER doctor). The term treatment limit is a synonym of the term treatment directive.

drafthttps://fhir.healthdata.be/StructureDefinition/HdBe-TreatmentDirective2
Information

A straightforward and fitting mapping of TreatmentDirective2 to FHIR was not possible. The main considerations were between mapping to the Consent and CarePlan resource. Unfortunately, the Consent resource does not have full support for treatment directives yet as its main focus was modelling Patient's privacy consents. However, it seems to be the most fitting resource for the CBB intention. The CBB describes a mutual agreement about treatments, not necessarily the direct actions or policy for treatments. The latter would be more fitting in the CarePlan resource. Future migration to a higher version of FHIR or the CBB will result in the reevaluation of the mapping.


idΣ0..1string
metaΣ0..1Meta
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..*Resource
id0..1string
extensionI0..*Extension
url1..1uriFixed Value
valueStringstring
id0..1string
extensionI0..*Extension
url1..1uriFixed Value
valueReferenceReference(HdBe-AdvanceDirective)
id0..1string
extensionI0..*Extension
url1..1uriFixed Value
valueStringstring
identifierΣ0..*Identifier
statusΣ ?!1..1codeBinding
scopeΣ ?!1..1CodeableConceptBindingPattern
treatmentDirectiveCodeΣ1..1CodeableConceptBindingPattern
patientΣ I0..1Reference(Patient | HdBe-Patient)
dateTimeΣ0..1dateTime
performerΣ I0..*Reference(Organization | Patient | Practitioner | RelatedPerson | PractitionerRole)
organizationΣ I0..*Reference(Organization)
sourceAttachmentAttachment
sourceReferenceΣ I0..1Reference(Consent | DocumentReference | Contract | QuestionnaireResponse | HdBe-AdvanceDirective)
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
authorityI0..1uri
uriI0..1uri
policyRuleΣ I0..1CodeableConceptBinding
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
verifiedΣ1..1boolean
verifiedWithI0..1Reference(Patient | RelatedPerson)
verificationDate0..1dateTime
id0..1string
id0..1string
extensionI0..*Extension
url1..1uriFixed Value
valueStringstring
modifierExtensionΣ ?! I0..*Extension
typeΣ I0..1codeBinding
id0..1string
extensionI0..*Extension
startΣ I0..1dateTime
endΣ I0..1dateTime
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
role1..1CodeableConceptBinding
referenceI1..1Reference(Device | Group | CareTeam | Organization | Patient | Practitioner | RelatedPerson | PractitionerRole)
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
role1..1CodeableConceptBindingPattern
referenceI1..1pattern HealthProfessional Reference(Device | Group | CareTeam | Organization | Patient | Practitioner | RelatedPerson | PractitionerRole | HdBe-Patient | HdBe-ContactPerson | HdBe-HealthProfessional PractitionerRole)
actionΣ0..*CodeableConcept
securityLabelΣ0..*CodingBinding
purposeΣ0..*CodingBinding
classΣ0..*CodingBinding
codeΣ0..1CodeableConceptBinding
dataPeriodΣ I0..1Period
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
meaningΣ1..1codeBinding
referenceΣ I1..1Reference(Resource)
provision0..*see (provision)

idΣ0..1string
metaΣ0..1Meta
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..*Resource
id0..1string
extensionI0..*Extension
url1..1uriFixed Value
valueStringstring
id0..1string
extensionI0..*Extension
url1..1uriFixed Value
valueReferenceReference(HdBe-AdvanceDirective)
id0..1string
extensionI0..*Extension
url1..1uriFixed Value
valueStringstring
identifierΣ0..*Identifier
statusΣ ?!1..1codeBinding
scopeΣ ?!1..1CodeableConceptBindingPattern
treatmentDirectiveCodeΣ1..1CodeableConceptBindingPattern
patientΣ I0..1Reference(Patient | HdBe-Patient)
dateTimeΣ0..1dateTime
performerΣ I0..*Reference(Organization | Patient | Practitioner | RelatedPerson | PractitionerRole)
organizationΣ I0..*Reference(Organization)
sourceAttachmentAttachment
sourceReferenceΣ I0..1Reference(Consent | DocumentReference | Contract | QuestionnaireResponse | HdBe-AdvanceDirective)
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
authorityI0..1uri
uriI0..1uri
policyRuleΣ I0..1CodeableConceptBinding
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
verifiedΣ1..1boolean
verifiedWithI0..1Reference(Patient | RelatedPerson)
verificationDate0..1dateTime
id0..1string
id0..1string
extensionI0..*Extension
url1..1uriFixed Value
valueStringstring
modifierExtensionΣ ?! I0..*Extension
typeΣ I0..1codeBinding
id0..1string
extensionI0..*Extension
startΣ I0..1dateTime
endΣ I0..1dateTime
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
role1..1CodeableConceptBinding
referenceI1..1Reference(Device | Group | CareTeam | Organization | Patient | Practitioner | RelatedPerson | PractitionerRole)
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
role1..1CodeableConceptBindingPattern
referenceI1..1pattern HealthProfessional Reference(Device | Group | CareTeam | Organization | Patient | Practitioner | RelatedPerson | PractitionerRole | HdBe-Patient | HdBe-ContactPerson | HdBe-HealthProfessional PractitionerRole)
actionΣ0..*CodeableConcept
securityLabelΣ0..*CodingBinding
purposeΣ0..*CodingBinding
classΣ0..*CodingBinding
codeΣ0..1CodeableConceptBinding
dataPeriodΣ I0..1Period
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
meaningΣ1..1codeBinding
referenceΣ I1..1Reference(Resource)
provision0..*see (provision)

idΣ0..1string
metaΣ0..1Meta
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..*Resource
id0..1string
extensionI0..*Extension
url1..1uriFixed Value
valueStringstring
id0..1string
extensionI0..*Extension
url1..1uriFixed Value
valueReferenceReference(HdBe-AdvanceDirective)
id0..1string
extensionI0..*Extension
url1..1uriFixed Value
valueStringstring
identifierΣ0..*Identifier
statusΣ ?!1..1codeBinding
scopeΣ ?!1..1CodeableConceptBindingPattern
treatmentDirectiveCodeΣ1..1CodeableConceptBindingPattern
patientΣ I0..1Reference(Patient | HdBe-Patient)
dateTimeΣ0..1dateTime
performerΣ I0..*Reference(Organization | Patient | Practitioner | RelatedPerson | PractitionerRole)
organizationΣ I0..*Reference(Organization)
sourceAttachmentAttachment
sourceReferenceΣ I0..1Reference(Consent | DocumentReference | Contract | QuestionnaireResponse | HdBe-AdvanceDirective)
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
authorityI0..1uri
uriI0..1uri
policyRuleΣ I0..1CodeableConceptBinding
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
verifiedΣ1..1boolean
verifiedWithI0..1Reference(Patient | RelatedPerson)
verificationDate0..1dateTime
id0..1string
id0..1string
extensionI0..*Extension
url1..1uriFixed Value
valueStringstring
modifierExtensionΣ ?! I0..*Extension
typeΣ I0..1codeBinding
id0..1string
extensionI0..*Extension
startΣ I0..1dateTime
endΣ I0..1dateTime
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
role1..1CodeableConceptBinding
referenceI1..1Reference(Device | Group | CareTeam | Organization | Patient | Practitioner | RelatedPerson | PractitionerRole)
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
role1..1CodeableConceptBindingPattern
referenceI1..1pattern HealthProfessional Reference(Device | Group | CareTeam | Organization | Patient | Practitioner | RelatedPerson | PractitionerRole | HdBe-Patient | HdBe-ContactPerson | HdBe-HealthProfessional PractitionerRole)
actionΣ0..*CodeableConcept
securityLabelΣ0..*CodingBinding
purposeΣ0..*CodingBinding
classΣ0..*CodingBinding
codeΣ0..1CodeableConceptBinding
dataPeriodΣ I0..1Period
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
meaningΣ1..1codeBinding
referenceΣ I1..1Reference(Resource)
provision0..*see (provision)

Mapping FHIR profile to CBB

PathmapCBBcomment
ConsentTreatmentDirective2HdBe-TreatmentDirective2
Consent.extension:comment.value[x]TreatmentDirective2.CommentHdBe-TreatmentDirective2
Consent.extension:additionalAdvanceDirective.value[x]TreatmentDirective2.AdvanceDirectiveHdBe-TreatmentDirective2
Consent.modifierExtension:specificationOther.value[x]TreatmentDirective2.SpecificationOtherHdBe-TreatmentDirective2
Consent.statusTreatmentDirective2.MostRecentReviewDateHdBe-TreatmentDirective2MostRecentReviewDate (implicit, main mapping is on `Consent.dateTime`)
Consent.statusTreatmentDirective2.DateExpiredHdBe-TreatmentDirective2DateExpired (implicit, main mapping is on `Consent.provision.period.end`)
Consent.dateTimeTreatmentDirective2.MostRecentReviewDateHdBe-TreatmentDirective2
Consent.source[x]:sourceReferenceTreatmentDirective2.AdvanceDirectiveHdBe-TreatmentDirective2
Consent.provision.extension:reasonForEnding.value[x]TreatmentDirective2.ReasonForEndingHdBe-TreatmentDirective2
Consent.provision.typeTreatmentDirective2.TreatmentDecisionHdBe-TreatmentDirective2
Consent.provision.period.endTreatmentDirective2.DateExpiredHdBe-TreatmentDirective2
Consent.provision.actor:agreementPartyTreatmentDirective2.AgreementPartyHdBe-TreatmentDirective2
Consent.provision.actor:agreementParty.referenceTreatmentDirective2.AgreementParty.PatientHdBe-TreatmentDirective2
Consent.provision.actor:agreementParty.referenceTreatmentDirective2.AgreementParty.RepresentativeHdBe-TreatmentDirective2
Consent.provision.actor:agreementParty.referenceTreatmentDirective2.AgreementParty.HealthProfessionalHdBe-TreatmentDirective2
Consent.provision.codeTreatmentDirective2.TreatmentHdBe-TreatmentDirective2

zib-TreatmentDirective2 difference

Concept Category Description
provision.code terminology Changed binding strenght from Required to Extensible because it is very likely other codes may be relevant in the future. This is already the case with the zibs in release 2020 versus the pre-release of 2022 where new codes have been added.
provision.type terminology Changed ValueSet and related ConceptMap to have SNOMED codes instead of zib internal codes.
policy.uri textual Replaced Dutch context in the guidance on how to populate the policy. Instead of a suggestion for wetten.overheid.nl the URL https://www.belgielex.be/ is now given.



Terminology Bindings

PathNameStrengthURLConceptMap
Consent.provision.typeconsent-provision-type|4.0.1requiredhttp://hl7.org/fhir/ValueSet/consent-provision-type|4.0.1
Consent.provision.codeTreatmentextensiblehttps://fhir.healthdata.be/ValueSet/TreatmentNo bound ConceptMap