HdBe-TreatmentDirective2

Profile	Description	Status	URL
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.	draft	https://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.

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.

Consent	I		Consent	Element Id Consent Short description TreatmentDirective Alternate names BehandelAanwijzing Definition A record of a healthcare consumer’s choices, which permits or denies identified recipient(s) or recipient role(s) to perform one or more actions within a given policy context, for specific purposes and periods of time. Comments 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. Data Type Consent Constraints dom-2:If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.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-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-6:A resource should have narrative for robust management text.`div`.exists() dom-5:If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` ppc-4:IF Scope=adr, there must be a patient `patient.exists() or scope.coding.where(system='something' and code='adr').exists().not()` ppc-5:IF Scope=treatment, there must be a patient `patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not()` ppc-2:IF Scope=privacy, there must be a patient `patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not()` ppc-3:IF Scope=research, there must be a patient `patient.exists() or scope.coding.where(system='something' and code='research').exists().not()` ppc-1:Either a Policy or PolicyRule `policy.exists() or policyRule.exists()` HdBe-TreatmentDirective2-1:`extension.additionalAdvanceDirective` may only be used for AdvanceDirective references in addition to first reference in `.source[x]`. `extension.where(url = 'https://fhir.healthdata.be/StructureDefinition/ext-TreatmentDirective2.AdvanceDirective').empty() or source.exists()` HdBe-TreatmentDirective2-2:If the specificationOther extension is used, `.provision.type` MUST be absent and vice versa `(extension.where(url = 'https://fhir.healthdata.be/StructureDefinition/ext-TreatmentDirective2.SpecificitionOther').exists() and provision.type.exists()).not()` Mappings rim:Entity. Role, or Act workflow:Event v2:CON rim:FinancialConsent zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.1 HdBe-TreatmentDirective2:TreatmentDirective
extension	I	0..*	Extension	Element Id Consent.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 Sliced: Unordered, Open, by url(Value) 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 rim:N/A
comment	I	0..1	Extension(string)	Element Id Consent.extension:comment Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. 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(string) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-Comment 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 rim:N/A
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id Consent.extension:comment.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-Comment Mappings rim:N/A
value[x]		0..1		Element Id Consent.extension:comment.value[x] Short description Comment Alternate names Toelichting Definition The comment may include further information such as the reason why a treatment directive has been drawn up, persons who assisted the patient in agreeing the treatment directive but who are not otherwise involved in the agreement as a representative, etc. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.13 HdBe-TreatmentDirective2:TreatmentDirective.Comment
valueString			string	There are no (further) constraints on this element Data Type string
additionalAdvanceDirective	I	0..*	Extension(Reference(HdBe AdvanceDirective))	Element Id Consent.extension:additionalAdvanceDirective Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments The cardinality of the `Consent.source[x]` element does not comply with the cardinality of the AdvanceDirective concept (NL-CM:2.2.8) specified in the HCIM TreatmentDirective2. This is solved by adding an extension that can be used to provide additional sources after `Consent.source[x]` is populated. Data Type Extension(Reference(HdBe AdvanceDirective)) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-TreatmentDirective2.AdvanceDirective 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 rim:N/A
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id Consent.extension:additionalAdvanceDirective.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-TreatmentDirective2.AdvanceDirective Mappings rim:N/A
value[x]	I	0..1		Element Id Consent.extension:additionalAdvanceDirective.value[x] Short description AdvanceDirective Alternate names Wilsverklaring Definition A (written) statement in which a person indicates wishes concerning future medical action, in the event that this person is at that point no longer (deemed) capable of taking decisions on the matter. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.8 HdBe-TreatmentDirective2:TreatmentDirective.AdvanceDirective
valueReference			Reference(HdBe AdvanceDirective)	There are no (further) constraints on this element Data Type Reference(HdBe AdvanceDirective)
modifierExtension	?! I	0..*	Extension	Element Id Consent.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 Sliced: Unordered, Open, by url(Value) 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 rim:N/A
specificationOther	?! I	0..1	Extension(string)	Element Id Consent.modifierExtension:specificationOther Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. 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(string) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-TreatmentDirective2.SpecificationOther 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 rim:N/A
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id Consent.modifierExtension:specificationOther.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-TreatmentDirective2.SpecificationOther Mappings rim:N/A
value[x]	I	0..1		Element Id Consent.modifierExtension:specificationOther.value[x] Short description SpecificationOther Alternate names SpecificatieAnders Definition Specification of the treatment decision when the decision is 'Other'. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.4 HdBe-TreatmentDirective2:TreatmentDirective.SpecificationOther
valueString			string	There are no (further) constraints on this element Data Type string
identifier	Σ	0..*	Identifier	There are no (further) constraints on this element Element Id Consent.identifier Short description Identifier for this record (external references) Definition Unique identifier for this copy of the Consent Statement. Comments This identifier identifies this copy of the consent. Where this identifier is also used elsewhere as the identifier for a consent record (e.g. a CDA consent document) then the consent details are expected to be the same. Data Type Identifier Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General { "system": "urn:ietf:rfc:3986", "value": "Local eCMS identifier" } Mappings rim:n/a v2:CX / EI (occasionally, more often EI maps to a resource id or a URL) rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd:Identifier workflow:Event.identifier w5:FiveWs.identifier rim:.id
status	Σ ?!	1..1	codeBinding	Element Id Consent.status Short description draft \| proposed \| active \| rejected \| inactive \| entered-in-error Definition Indicates the current state of this consent. Requirements The Consent Directive that is pointed to might be in various lifecycle states, e.g., a revoked Consent Directive. Comments This element is implicitly mapped to the concepts MostRecentReviewDate and DateExpired. Unless the status is explicitly recorded, the following guidance applies: When MostRecentReviewDate is in the past and DateExpired is absent or in the future, `.status` will usually be set to active. When DateExpired is in the past, `.status` will usually be set to inactive. When MostRecentReviewDate is absent or in the future, which is not possible following the CBB, `.status` will usually be set to draft. Data Type code Binding Indicates the state of the consent. ConsentState (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a workflow:Event.status w5:FiveWs.status v2:HL7 Table 0498 - Consent Status rim:.statusCode zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.5 zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.6 HdBe-TreatmentDirective2:TreatmentDirective.MostRecentReviewDate HdBe-TreatmentDirective2:TreatmentDirective.DateExpired
scope	Σ ?!	1..1	CodeableConceptBinding	Element Id Consent.scope Short description Which of the four areas this resource covers (extensible) Definition A selector of the type of consent being presented: ADR, Privacy, Treatment, Research. This list is now extensible. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data Type CodeableConcept Binding The four anticipated uses for the Consent Resource. ConsentScopeCodes (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/consentscope", "code": "treatment" } ] } Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
category	Σ	1..*	CodeableConceptBinding	Element Id Consent.category Short description Classification of the consent statement - for indexing/retrieval Definition A classification of the type of consents found in the statement. This element supports indexing and retrieval of consent statements. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data Type CodeableConcept Binding A classification of the type of consents found in a consent statement. ConsentCategoryCodes (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "coding": [ { "system": "http://snomed.info/sct", "code": "129125009" } ] } Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD workflow:Event.code w5:FiveWs.class v2:HL7 Table 0497 - Consent Type rim:CNTRCT
patient	Σ I	0..1	Reference(Patient \| HdBe Patient)	Element Id Consent.patient Short description Who the consent applies to Definition The patient/healthcare consumer to whom this consent applies. Comments Commonly, the patient the consent pertains to is the author, but for young and old people, it may be some other person. Data Type Reference(Patient \| HdBe Patient) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Event.subject w5:FiveWs.subject[x] rim:Role w5:FiveWs.subject
dateTime	Σ	0..1	dateTime	Element Id Consent.dateTime Short description MostRecentReviewDate Alternate names MeestRecenteBespreekdatum Definition The date on which the treatment directive has been agreed is with the patient and / or his representative (s). This can be the first time that the treatment directive have been discussed, but an existing treatment directive may also have been discussed again. The content of the treatment directive may have changed or remained the same. Comments This is not the time of the original consent, but the time that this statement was made or derived. Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a workflow:Event.occurrence[x] w5:FiveWs.recorded v2:Field 13/ Consent Decision Date rim:FinancialConsent effectiveTime zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.5 HdBe-TreatmentDirective2:TreatmentDirective.MostRecentReviewDate
performer	Σ I	0..*	Reference(Organization \| Patient \| Practitioner \| RelatedPerson \| PractitionerRole)	There are no (further) constraints on this element Element Id Consent.performer Short description Who is agreeing to the policy and rules Alternate names consentor Definition Either the Grantor, which is the entity responsible for granting the rights listed in a Consent Directive or the Grantee, which is the entity responsible for complying with the Consent Directive, including any obligations or limitations on authorizations and enforcement of prohibitions. Comments Commonly, the patient the consent pertains to is the consentor, but particularly for young and old people, it may be some other person - e.g. a legal guardian. Data Type Reference(Organization \| Patient \| Practitioner \| RelatedPerson \| PractitionerRole) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Event.performer w5:FiveWs.actor v2:Field 24/ ConsenterID
organization	Σ I	0..*	Reference(Organization)	There are no (further) constraints on this element Element Id Consent.organization Short description Custodian of the consent Alternate names custodian Definition The organization that manages the consent, and the framework within which it is executed. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Organization) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Event.performer w5:FiveWs.witness
source[x]	Σ I	0..1		Element Id Consent.source[x] Short description Source from which this consent is taken Definition The source on which this consent statement is based. The source might be a scanned original paper form, or a reference to a consent that links back to such a source, a reference to a document repository (e.g. XDS) that stores the original consent document. Comments The source can be contained inline (Attachment), referenced directly (Consent), referenced in a consent repository (DocumentReference), or simply by an identifier (Identifier), e.g. a CDA document id. Sliced: Unordered, Open, by $this(Type) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:Field 19 Informational Material Supplied Indicator
sourceAttachment			Attachment	There are no (further) constraints on this element Data Type Attachment
sourceReference	Σ I	0..1	Reference(Consent \| DocumentReference \| Contract \| QuestionnaireResponse \| HdBe AdvanceDirective)	Element Id Consent.source[x]:sourceReference Short description AdvanceDirective Alternate names Wilsverklaring Definition A (written) statement in which a person indicates wishes concerning future medical action, in the event that this person is at that point no longer (deemed) capable of taking decisions on the matter. Comments The source can be contained inline (Attachment), referenced directly (Consent), referenced in a consent repository (DocumentReference), or simply by an identifier (Identifier), e.g. a CDA document id. Data Type Reference(Consent \| DocumentReference \| Contract \| QuestionnaireResponse \| HdBe AdvanceDirective) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:Field 19 Informational Material Supplied Indicator zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.8 HdBe-TreatmentDirective2:TreatmentDirective.AdvanceDirective
policy		0..*	BackboneElement	There are no (further) constraints on this element Element Id Consent.policy Short description Policies covered by this consent Definition The references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
authority	I	0..1	uri	There are no (further) constraints on this element Element Id Consent.policy.authority Short description Enforcement source for policy Definition Entity or Organization having regulatory jurisdiction or accountability for enforcing policies pertaining to Consent Directives. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
uri	I	0..1	uri	Element Id Consent.policy.uri Short description Specific policy covered by this consent Definition The references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law. Comments Either `.policy` or `.policyRule` should exist following core constraint ppc-1. If no explicit value is recorded, a fallback is to populate `.policy.uri` with https://www.belgielex.be/ if the treatment directive is recorded following Belgium law and regulations. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
policyRule	Σ I	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element Id Consent.policyRule Short description Regulation that this consents to Definition A reference to the specific base computable regulation or policy. Requirements Might be a unique identifier of a policy set in XACML, or other rules engine. Comments If the policyRule is absent, computable consent would need to be constructed from the elements of the Consent resource. Data Type CodeableConcept Binding Regulatory policy examples. ConsentPolicyRuleCodes (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
verification	Σ	0..*	BackboneElement	There are no (further) constraints on this element Element Id Consent.verification Short description Consent Verified by patient or family Definition Whether a treatment instruction (e.g. artificial respiration yes or no) was verified with the patient, his/her family or another authorized person. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
verified	Σ	1..1	boolean	There are no (further) constraints on this element Element Id Consent.verification.verified Short description Has been verified Definition Has the instruction been verified. Data Type boolean Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
verifiedWith	I	0..1	Reference(Patient \| RelatedPerson)	There are no (further) constraints on this element Element Id Consent.verification.verifiedWith Short description Person who verified Definition Who verified the instruction (Patient, Relative or other Authorized Person). Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Patient \| RelatedPerson) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
verificationDate		0..1	dateTime	There are no (further) constraints on this element Element Id Consent.verification.verificationDate Short description When consent verified Definition Date verification was collected. Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
provision	Σ	0..1	BackboneElement	There are no (further) constraints on this element Element Id Consent.provision Short description Constraints to the base Consent.policyRule Definition An exception to the base policy of this consent. An exception can be an addition or removal of access permissions. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
extension	I	0..*	Extension	Element Id Consent.provision.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) 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 rim:N/A
reasonForEnding	I	0..1	Extension(string)	Element Id Consent.provision.extension:reasonForEnding Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. 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(string) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-TreatmentDirective2.ReasonForEnding 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 rim:N/A
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id Consent.provision.extension:reasonForEnding.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-TreatmentDirective2.ReasonForEnding Mappings rim:N/A
value[x]		0..1		Element Id Consent.provision.extension:reasonForEnding.value[x] Short description ReasonForEnding Alternate names RedenBeeindigd Definition Reason why the agreement on a treatment directive no longer applies. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.7 HdBe-TreatmentDirective2:TreatmentDirective.ReasonForEnding
valueString			string	There are no (further) constraints on this element Data Type string
type	Σ I	0..1	codeBinding	Element Id Consent.provision.type Short description TreatmentDecision Alternate names BehandelBesluit Definition The joint decision taken with regard to the desirability of performing the indicated treatment. If the agreement is 'Other', 'Specification Other' shall contain the instructions for whether or not to carry out the treatment. Implementers SHALL support the SpecificationOther extension on `.provision.type` for this. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type code Binding Use ConceptMap 'TreatmentDecision-to-ConsentProvisionType' to translate zib terminology to profile terminology in ValueSet 'ConsentProvisionType' ConsentProvisionType (required) Permitted Values TreatmentDecision_to_ConsentProvisionType Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.2 HdBe-TreatmentDirective2:TreatmentDirective.TreatmentDecision
period	Σ I	0..1	Period	There are no (further) constraints on this element Element Id Consent.provision.period Short description Timeframe for this rule Definition The timeframe in this rule is valid. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data Type Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1:If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim:n/a v2:DR rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
start	Σ I	0..1	dateTime	There are no (further) constraints on this element Element Id Consent.provision.period.start Short description Starting time with inclusive boundary Definition The start of the period. The boundary is inclusive. Comments If the low element is missing, the meaning is that the low boundary is not known. Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:DR.1 rim:./low
end	Σ I	0..1	dateTime	Element Id Consent.provision.period.end Short description DateExpired Alternate names DatumBeeindigd Definition The date on which the treatment directive has been withdrawn and therefore no longer applies. An explicit decision must be taken about the 'date expired', in consultation between the responsible care provider and the patient or his representative(s).Any future termination can only be entered as a condition. Often this will be linked to 1 or more events. Comments The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03. Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:DR.2 rim:./high zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.6 HdBe-TreatmentDirective2:TreatmentDirective.DateExpired
actor		0..*	BackboneElement	Element Id Consent.provision.actor Short description Who\|what controlled by this rule (or group, by role) Definition Who or what is controlled by this rule. Use group to identify a set of actors by some property they share (e.g. 'admitting officers'). Data Type BackboneElement Sliced: Unordered, Open, by role(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
(All Slices)				There are no (further) constraints on this element
role		1..1	CodeableConceptBinding	There are no (further) constraints on this element Element Id Consent.provision.actor.role Short description How the actor is involved Definition How the individual is involved in the resources content that is described in the exception. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data Type CodeableConcept Binding How an actor is involved in the consent considerations. SecurityRoleType (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
reference	I	1..1	Reference(Device \| Group \| CareTeam \| Organization \| Patient \| Practitioner \| RelatedPerson \| PractitionerRole)	There are no (further) constraints on this element Element Id Consent.provision.actor.reference Short description Resource for the actor (or group, by role) Definition The resource that identifies the actor. To identify actors by type, use group to identify a set of actors by some property they share (e.g. 'admitting officers'). Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Device \| Group \| CareTeam \| Organization \| Patient \| Practitioner \| RelatedPerson \| PractitionerRole) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
agreementParty		0..*	BackboneElement	Element Id Consent.provision.actor:agreementParty Short description AgreementParty Alternate names AfspraakPartij Definition Container of the Agreement concept.This container contains all data elements of the Agreement concept. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.9 HdBe-TreatmentDirective2:TreatmentDirective.AgreementParty
role		1..1	CodeableConceptBinding	Element Id Consent.provision.actor:agreementParty.role Short description How the actor is involved Definition How the individual is involved in the resources content that is described in the exception. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data Type CodeableConcept Binding How an actor is involved in the consent considerations. SecurityRoleType (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v3-RoleCode", "code": "CONSENTER" } ] } Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
reference	I	1..1	pattern HealthProfessional Reference(Device \| Group \| CareTeam \| Organization \| Patient \| Practitioner \| RelatedPerson \| PractitionerRole \| HdBe Patient \| HdBe ContactPerson \| HdBe HealthProfessional PractitionerRole)	Element Id Consent.provision.actor:agreementParty.reference Short description Patient / Representative / HealthProfessional Alternate names Patient, Vertegenwoordiger, Zorgverlener Definition Patient as the person with whom the agreement was made. Person who represents the patient in health care matters and with whom the agreement has been made (too). HealthProfessional who has made de agreement regarding the treatement directive. Comments Each occurrence of the CBB HealthProfessional is normally represented by two FHIR resources: a PractitionerRole resource (instance of HdBe-HealthProfessional-PractitionerRole) and a Practitioner resource (instance of HdBe-HealthProfessional-Practitioner). The Practitioner resource is referenced from the PractitionerRole instance. For this reason, sending systems should fill the reference to the PractitionerRole instance here, and not the Practitioner resource. Receiving systems can then retrieve the reference to the Practitioner resource from that PractitionerRole instance. In rare circumstances, there is only a Practitioner instance, in which case it is that instance which will be referenced here. However, since this should be the exception, the HdBe-HealthProfessional-Practitioner profile is not explicitly mentioned as a target profile. Data Type pattern HealthProfessional Reference(Device \| Group \| CareTeam \| Organization \| Patient \| Practitioner \| RelatedPerson \| PractitionerRole \| HdBe Patient \| HdBe ContactPerson \| HdBe HealthProfessional PractitionerRole) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.10 zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.11 zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.12 HdBe-TreatmentDirective2:TreatmentDirective.AgreementParty.Patient HdBe-TreatmentDirective2:TreatmentDirective.AgreementParty.Representative HdBe-TreatmentDirective2:TreatmentDirective.AgreementParty.HealthProfessional
action	Σ	0..*	CodeableConcept	There are no (further) constraints on this element Element Id Consent.provision.action Short description Actions controlled by this rule Definition Actions controlled by this Rule. Comments Note that this is the direct action (not the grounds for the action covered in the purpose element). At present, the only action in the understood and tested scope of this resource is 'read'. Data Type CodeableConcept Binding Detailed codes for the consent action. ConsentActionCodes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
securityLabel	Σ	0..*	CodingBinding	There are no (further) constraints on this element Element Id Consent.provision.securityLabel Short description Security Labels that define affected resources Definition A security label, comprised of 0..* security label fields (Privacy tags), which define which resources are controlled by this exception. Comments If the consent specifies a security label of "R" then it applies to all resources that are labeled "R" or lower. E.g. for Confidentiality, it's a high water mark. For other kinds of security labels, subsumption logic applies. When the purpose of use tag is on the data, access request purpose of use shall not conflict. Data Type Coding Binding Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim:CV orim:fhir:Coding rdfs:subClassOf dt:CDCoding
purpose	Σ	0..*	CodingBinding	There are no (further) constraints on this element Element Id Consent.provision.purpose Short description Context of activities covered by this rule Definition The context of the activities a user is taking - why the user is accessing the data - that are controlled by this rule. Comments When the purpose of use tag is on the data, access request purpose of use shall not conflict. Data Type Coding Binding What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels. v3.PurposeOfUse (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim:CV orim:fhir:Coding rdfs:subClassOf dt:CDCoding
class	Σ	0..*	CodingBinding	There are no (further) constraints on this element Element Id Consent.provision.class Short description e.g. Resource Type, Profile, CDA, etc. Definition The class of information covered by this rule. The type can be a FHIR resource type, a profile on a type, or a CDA document, or some other type that indicates what sort of information the consent relates to. Comments Multiple types are or'ed together. The intention of the contentType element is that the codes refer to profiles or document types defined in a standard or an implementation guide somewhere. Data Type Coding Binding The class (type) of information a consent rule covers. ConsentContentClass (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim:CV orim:fhir:Coding rdfs:subClassOf dt:CDCoding
code	Σ	0..1	CodeableConceptBinding	Element Id Consent.provision.code Short description Treatment Alternate names Behandeling Definition The medical treatment to which the treatment instruction applies. Comments Typical use of this is a Document code with class = CDA. Data Type CodeableConcept Binding If this code is found in an instance, then the exception applies. Treatment (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.3 HdBe-TreatmentDirective2:TreatmentDirective.Treatment
dataPeriod	Σ I	0..1	Period	There are no (further) constraints on this element Element Id Consent.provision.dataPeriod Short description Timeframe for data controlled by this rule Definition Clinical or Operational Relevant period of time that bounds the data controlled by this rule. Comments This has a different sense to the Consent.period - that is when the consent agreement holds. This is the time period of the data that is controlled by the agreement. Data Type Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1:If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim:n/a v2:DR rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
data	Σ	0..*	BackboneElement	There are no (further) constraints on this element Element Id Consent.provision.data Short description Data controlled by this rule Definition The resources controlled by this rule if specific resources are referenced. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:Role
meaning	Σ	1..1	codeBinding	There are no (further) constraints on this element Element Id Consent.provision.data.meaning Short description instance \| related \| dependents \| authoredby Definition How the resource reference is interpreted when testing consent restrictions. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type code Binding How a resource reference is interpreted when testing consent restrictions. ConsentDataMeaning (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
reference	Σ I	1..1	Reference(Resource)	There are no (further) constraints on this element Element Id Consent.provision.data.reference Short description The actual data reference Definition A reference to a specific resource that defines which resources are covered by this consent. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Resource) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
provision		0..*	see (provision)	There are no (further) constraints on this element Element Id Consent.provision.provision Short description Nested Exception Rules Definition Rules which provide exceptions to the base rule or subrules.

Consent	I		Consent	Element Id Consent Short description TreatmentDirective Alternate names BehandelAanwijzing Definition A record of a healthcare consumer’s choices, which permits or denies identified recipient(s) or recipient role(s) to perform one or more actions within a given policy context, for specific purposes and periods of time. Comments 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. Data Type Consent Constraints dom-2:If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.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-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-6:A resource should have narrative for robust management text.`div`.exists() dom-5:If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` ppc-4:IF Scope=adr, there must be a patient `patient.exists() or scope.coding.where(system='something' and code='adr').exists().not()` ppc-5:IF Scope=treatment, there must be a patient `patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not()` ppc-2:IF Scope=privacy, there must be a patient `patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not()` ppc-3:IF Scope=research, there must be a patient `patient.exists() or scope.coding.where(system='something' and code='research').exists().not()` ppc-1:Either a Policy or PolicyRule `policy.exists() or policyRule.exists()` HdBe-TreatmentDirective2-1:`extension.additionalAdvanceDirective` may only be used for AdvanceDirective references in addition to first reference in `.source[x]`. `extension.where(url = 'https://fhir.healthdata.be/StructureDefinition/ext-TreatmentDirective2.AdvanceDirective').empty() or source.exists()` HdBe-TreatmentDirective2-2:If the specificationOther extension is used, `.provision.type` MUST be absent and vice versa `(extension.where(url = 'https://fhir.healthdata.be/StructureDefinition/ext-TreatmentDirective2.SpecificitionOther').exists() and provision.type.exists()).not()` Mappings rim:Entity. Role, or Act workflow:Event v2:CON rim:FinancialConsent zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.1 HdBe-TreatmentDirective2:TreatmentDirective
extension	I	0..*	Extension	Element Id Consent.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 Sliced: Unordered, Open, by url(Value) 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 rim:N/A
comment	I	0..1	Extension(string)	Element Id Consent.extension:comment Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. 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(string) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-Comment 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 rim:N/A
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id Consent.extension:comment.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-Comment Mappings rim:N/A
value[x]		0..1		Element Id Consent.extension:comment.value[x] Short description Comment Alternate names Toelichting Definition The comment may include further information such as the reason why a treatment directive has been drawn up, persons who assisted the patient in agreeing the treatment directive but who are not otherwise involved in the agreement as a representative, etc. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.13 HdBe-TreatmentDirective2:TreatmentDirective.Comment
valueString			string	There are no (further) constraints on this element Data Type string
additionalAdvanceDirective	I	0..*	Extension(Reference(HdBe AdvanceDirective))	Element Id Consent.extension:additionalAdvanceDirective Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments The cardinality of the `Consent.source[x]` element does not comply with the cardinality of the AdvanceDirective concept (NL-CM:2.2.8) specified in the HCIM TreatmentDirective2. This is solved by adding an extension that can be used to provide additional sources after `Consent.source[x]` is populated. Data Type Extension(Reference(HdBe AdvanceDirective)) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-TreatmentDirective2.AdvanceDirective 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 rim:N/A
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id Consent.extension:additionalAdvanceDirective.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-TreatmentDirective2.AdvanceDirective Mappings rim:N/A
value[x]	I	0..1		Element Id Consent.extension:additionalAdvanceDirective.value[x] Short description AdvanceDirective Alternate names Wilsverklaring Definition A (written) statement in which a person indicates wishes concerning future medical action, in the event that this person is at that point no longer (deemed) capable of taking decisions on the matter. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.8 HdBe-TreatmentDirective2:TreatmentDirective.AdvanceDirective
valueReference			Reference(HdBe AdvanceDirective)	There are no (further) constraints on this element Data Type Reference(HdBe AdvanceDirective)
modifierExtension	?! I	0..*	Extension	Element Id Consent.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 Sliced: Unordered, Open, by url(Value) 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 rim:N/A
specificationOther	?! I	0..1	Extension(string)	Element Id Consent.modifierExtension:specificationOther Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. 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(string) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-TreatmentDirective2.SpecificationOther 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 rim:N/A
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id Consent.modifierExtension:specificationOther.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-TreatmentDirective2.SpecificationOther Mappings rim:N/A
value[x]	I	0..1		Element Id Consent.modifierExtension:specificationOther.value[x] Short description SpecificationOther Alternate names SpecificatieAnders Definition Specification of the treatment decision when the decision is 'Other'. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.4 HdBe-TreatmentDirective2:TreatmentDirective.SpecificationOther
valueString			string	There are no (further) constraints on this element Data Type string
identifier	Σ	0..*	Identifier	There are no (further) constraints on this element Element Id Consent.identifier Short description Identifier for this record (external references) Definition Unique identifier for this copy of the Consent Statement. Comments This identifier identifies this copy of the consent. Where this identifier is also used elsewhere as the identifier for a consent record (e.g. a CDA consent document) then the consent details are expected to be the same. Data Type Identifier Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General { "system": "urn:ietf:rfc:3986", "value": "Local eCMS identifier" } Mappings rim:n/a v2:CX / EI (occasionally, more often EI maps to a resource id or a URL) rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd:Identifier workflow:Event.identifier w5:FiveWs.identifier rim:.id
status	Σ ?!	1..1	codeBinding	Element Id Consent.status Short description draft \| proposed \| active \| rejected \| inactive \| entered-in-error Definition Indicates the current state of this consent. Requirements The Consent Directive that is pointed to might be in various lifecycle states, e.g., a revoked Consent Directive. Comments This element is implicitly mapped to the concepts MostRecentReviewDate and DateExpired. Unless the status is explicitly recorded, the following guidance applies: When MostRecentReviewDate is in the past and DateExpired is absent or in the future, `.status` will usually be set to active. When DateExpired is in the past, `.status` will usually be set to inactive. When MostRecentReviewDate is absent or in the future, which is not possible following the CBB, `.status` will usually be set to draft. Data Type code Binding Indicates the state of the consent. ConsentState (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a workflow:Event.status w5:FiveWs.status v2:HL7 Table 0498 - Consent Status rim:.statusCode zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.5 zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.6 HdBe-TreatmentDirective2:TreatmentDirective.MostRecentReviewDate HdBe-TreatmentDirective2:TreatmentDirective.DateExpired
scope	Σ ?!	1..1	CodeableConceptBinding	Element Id Consent.scope Short description Which of the four areas this resource covers (extensible) Definition A selector of the type of consent being presented: ADR, Privacy, Treatment, Research. This list is now extensible. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data Type CodeableConcept Binding The four anticipated uses for the Consent Resource. ConsentScopeCodes (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/consentscope", "code": "treatment" } ] } Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
category	Σ	1..*	CodeableConceptBinding	Element Id Consent.category Short description Classification of the consent statement - for indexing/retrieval Definition A classification of the type of consents found in the statement. This element supports indexing and retrieval of consent statements. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data Type CodeableConcept Binding A classification of the type of consents found in a consent statement. ConsentCategoryCodes (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "coding": [ { "system": "http://snomed.info/sct", "code": "129125009" } ] } Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD workflow:Event.code w5:FiveWs.class v2:HL7 Table 0497 - Consent Type rim:CNTRCT
patient	Σ I	0..1	Reference(Patient \| HdBe Patient)	Element Id Consent.patient Short description Who the consent applies to Definition The patient/healthcare consumer to whom this consent applies. Comments Commonly, the patient the consent pertains to is the author, but for young and old people, it may be some other person. Data Type Reference(Patient \| HdBe Patient) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Event.subject w5:FiveWs.subject[x] rim:Role w5:FiveWs.subject
dateTime	Σ	0..1	dateTime	Element Id Consent.dateTime Short description MostRecentReviewDate Alternate names MeestRecenteBespreekdatum Definition The date on which the treatment directive has been agreed is with the patient and / or his representative (s). This can be the first time that the treatment directive have been discussed, but an existing treatment directive may also have been discussed again. The content of the treatment directive may have changed or remained the same. Comments This is not the time of the original consent, but the time that this statement was made or derived. Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a workflow:Event.occurrence[x] w5:FiveWs.recorded v2:Field 13/ Consent Decision Date rim:FinancialConsent effectiveTime zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.5 HdBe-TreatmentDirective2:TreatmentDirective.MostRecentReviewDate
performer	Σ I	0..*	Reference(Organization \| Patient \| Practitioner \| RelatedPerson \| PractitionerRole)	There are no (further) constraints on this element Element Id Consent.performer Short description Who is agreeing to the policy and rules Alternate names consentor Definition Either the Grantor, which is the entity responsible for granting the rights listed in a Consent Directive or the Grantee, which is the entity responsible for complying with the Consent Directive, including any obligations or limitations on authorizations and enforcement of prohibitions. Comments Commonly, the patient the consent pertains to is the consentor, but particularly for young and old people, it may be some other person - e.g. a legal guardian. Data Type Reference(Organization \| Patient \| Practitioner \| RelatedPerson \| PractitionerRole) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Event.performer w5:FiveWs.actor v2:Field 24/ ConsenterID
organization	Σ I	0..*	Reference(Organization)	There are no (further) constraints on this element Element Id Consent.organization Short description Custodian of the consent Alternate names custodian Definition The organization that manages the consent, and the framework within which it is executed. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Organization) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Event.performer w5:FiveWs.witness
source[x]	Σ I	0..1		Element Id Consent.source[x] Short description Source from which this consent is taken Definition The source on which this consent statement is based. The source might be a scanned original paper form, or a reference to a consent that links back to such a source, a reference to a document repository (e.g. XDS) that stores the original consent document. Comments The source can be contained inline (Attachment), referenced directly (Consent), referenced in a consent repository (DocumentReference), or simply by an identifier (Identifier), e.g. a CDA document id. Sliced: Unordered, Open, by $this(Type) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:Field 19 Informational Material Supplied Indicator
sourceAttachment			Attachment	There are no (further) constraints on this element Data Type Attachment
sourceReference	Σ I	0..1	Reference(Consent \| DocumentReference \| Contract \| QuestionnaireResponse \| HdBe AdvanceDirective)	Element Id Consent.source[x]:sourceReference Short description AdvanceDirective Alternate names Wilsverklaring Definition A (written) statement in which a person indicates wishes concerning future medical action, in the event that this person is at that point no longer (deemed) capable of taking decisions on the matter. Comments The source can be contained inline (Attachment), referenced directly (Consent), referenced in a consent repository (DocumentReference), or simply by an identifier (Identifier), e.g. a CDA document id. Data Type Reference(Consent \| DocumentReference \| Contract \| QuestionnaireResponse \| HdBe AdvanceDirective) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:Field 19 Informational Material Supplied Indicator zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.8 HdBe-TreatmentDirective2:TreatmentDirective.AdvanceDirective
policy		0..*	BackboneElement	There are no (further) constraints on this element Element Id Consent.policy Short description Policies covered by this consent Definition The references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
authority	I	0..1	uri	There are no (further) constraints on this element Element Id Consent.policy.authority Short description Enforcement source for policy Definition Entity or Organization having regulatory jurisdiction or accountability for enforcing policies pertaining to Consent Directives. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
uri	I	0..1	uri	Element Id Consent.policy.uri Short description Specific policy covered by this consent Definition The references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law. Comments Either `.policy` or `.policyRule` should exist following core constraint ppc-1. If no explicit value is recorded, a fallback is to populate `.policy.uri` with https://www.belgielex.be/ if the treatment directive is recorded following Belgium law and regulations. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
policyRule	Σ I	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element Id Consent.policyRule Short description Regulation that this consents to Definition A reference to the specific base computable regulation or policy. Requirements Might be a unique identifier of a policy set in XACML, or other rules engine. Comments If the policyRule is absent, computable consent would need to be constructed from the elements of the Consent resource. Data Type CodeableConcept Binding Regulatory policy examples. ConsentPolicyRuleCodes (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
verification	Σ	0..*	BackboneElement	There are no (further) constraints on this element Element Id Consent.verification Short description Consent Verified by patient or family Definition Whether a treatment instruction (e.g. artificial respiration yes or no) was verified with the patient, his/her family or another authorized person. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
verified	Σ	1..1	boolean	There are no (further) constraints on this element Element Id Consent.verification.verified Short description Has been verified Definition Has the instruction been verified. Data Type boolean Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
verifiedWith	I	0..1	Reference(Patient \| RelatedPerson)	There are no (further) constraints on this element Element Id Consent.verification.verifiedWith Short description Person who verified Definition Who verified the instruction (Patient, Relative or other Authorized Person). Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Patient \| RelatedPerson) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
verificationDate		0..1	dateTime	There are no (further) constraints on this element Element Id Consent.verification.verificationDate Short description When consent verified Definition Date verification was collected. Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
provision	Σ	0..1	BackboneElement	There are no (further) constraints on this element Element Id Consent.provision Short description Constraints to the base Consent.policyRule Definition An exception to the base policy of this consent. An exception can be an addition or removal of access permissions. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
extension	I	0..*	Extension	Element Id Consent.provision.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) 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 rim:N/A
reasonForEnding	I	0..1	Extension(string)	Element Id Consent.provision.extension:reasonForEnding Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. 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(string) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-TreatmentDirective2.ReasonForEnding 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 rim:N/A
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id Consent.provision.extension:reasonForEnding.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-TreatmentDirective2.ReasonForEnding Mappings rim:N/A
value[x]		0..1		Element Id Consent.provision.extension:reasonForEnding.value[x] Short description ReasonForEnding Alternate names RedenBeeindigd Definition Reason why the agreement on a treatment directive no longer applies. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.7 HdBe-TreatmentDirective2:TreatmentDirective.ReasonForEnding
valueString			string	There are no (further) constraints on this element Data Type string
type	Σ I	0..1	codeBinding	Element Id Consent.provision.type Short description TreatmentDecision Alternate names BehandelBesluit Definition The joint decision taken with regard to the desirability of performing the indicated treatment. If the agreement is 'Other', 'Specification Other' shall contain the instructions for whether or not to carry out the treatment. Implementers SHALL support the SpecificationOther extension on `.provision.type` for this. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type code Binding Use ConceptMap 'TreatmentDecision-to-ConsentProvisionType' to translate zib terminology to profile terminology in ValueSet 'ConsentProvisionType' ConsentProvisionType (required) Permitted Values TreatmentDecision_to_ConsentProvisionType Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.2 HdBe-TreatmentDirective2:TreatmentDirective.TreatmentDecision
period	Σ I	0..1	Period	There are no (further) constraints on this element Element Id Consent.provision.period Short description Timeframe for this rule Definition The timeframe in this rule is valid. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data Type Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1:If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim:n/a v2:DR rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
start	Σ I	0..1	dateTime	There are no (further) constraints on this element Element Id Consent.provision.period.start Short description Starting time with inclusive boundary Definition The start of the period. The boundary is inclusive. Comments If the low element is missing, the meaning is that the low boundary is not known. Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:DR.1 rim:./low
end	Σ I	0..1	dateTime	Element Id Consent.provision.period.end Short description DateExpired Alternate names DatumBeeindigd Definition The date on which the treatment directive has been withdrawn and therefore no longer applies. An explicit decision must be taken about the 'date expired', in consultation between the responsible care provider and the patient or his representative(s).Any future termination can only be entered as a condition. Often this will be linked to 1 or more events. Comments The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03. Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:DR.2 rim:./high zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.6 HdBe-TreatmentDirective2:TreatmentDirective.DateExpired
actor		0..*	BackboneElement	Element Id Consent.provision.actor Short description Who\|what controlled by this rule (or group, by role) Definition Who or what is controlled by this rule. Use group to identify a set of actors by some property they share (e.g. 'admitting officers'). Data Type BackboneElement Sliced: Unordered, Open, by role(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
(All Slices)				There are no (further) constraints on this element
role		1..1	CodeableConceptBinding	There are no (further) constraints on this element Element Id Consent.provision.actor.role Short description How the actor is involved Definition How the individual is involved in the resources content that is described in the exception. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data Type CodeableConcept Binding How an actor is involved in the consent considerations. SecurityRoleType (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
reference	I	1..1	Reference(Device \| Group \| CareTeam \| Organization \| Patient \| Practitioner \| RelatedPerson \| PractitionerRole)	There are no (further) constraints on this element Element Id Consent.provision.actor.reference Short description Resource for the actor (or group, by role) Definition The resource that identifies the actor. To identify actors by type, use group to identify a set of actors by some property they share (e.g. 'admitting officers'). Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Device \| Group \| CareTeam \| Organization \| Patient \| Practitioner \| RelatedPerson \| PractitionerRole) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
agreementParty		0..*	BackboneElement	Element Id Consent.provision.actor:agreementParty Short description AgreementParty Alternate names AfspraakPartij Definition Container of the Agreement concept.This container contains all data elements of the Agreement concept. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.9 HdBe-TreatmentDirective2:TreatmentDirective.AgreementParty
role		1..1	CodeableConceptBinding	Element Id Consent.provision.actor:agreementParty.role Short description How the actor is involved Definition How the individual is involved in the resources content that is described in the exception. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data Type CodeableConcept Binding How an actor is involved in the consent considerations. SecurityRoleType (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v3-RoleCode", "code": "CONSENTER" } ] } Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
reference	I	1..1	pattern HealthProfessional Reference(Device \| Group \| CareTeam \| Organization \| Patient \| Practitioner \| RelatedPerson \| PractitionerRole \| HdBe Patient \| HdBe ContactPerson \| HdBe HealthProfessional PractitionerRole)	Element Id Consent.provision.actor:agreementParty.reference Short description Patient / Representative / HealthProfessional Alternate names Patient, Vertegenwoordiger, Zorgverlener Definition Patient as the person with whom the agreement was made. Person who represents the patient in health care matters and with whom the agreement has been made (too). HealthProfessional who has made de agreement regarding the treatement directive. Comments Each occurrence of the CBB HealthProfessional is normally represented by two FHIR resources: a PractitionerRole resource (instance of HdBe-HealthProfessional-PractitionerRole) and a Practitioner resource (instance of HdBe-HealthProfessional-Practitioner). The Practitioner resource is referenced from the PractitionerRole instance. For this reason, sending systems should fill the reference to the PractitionerRole instance here, and not the Practitioner resource. Receiving systems can then retrieve the reference to the Practitioner resource from that PractitionerRole instance. In rare circumstances, there is only a Practitioner instance, in which case it is that instance which will be referenced here. However, since this should be the exception, the HdBe-HealthProfessional-Practitioner profile is not explicitly mentioned as a target profile. Data Type pattern HealthProfessional Reference(Device \| Group \| CareTeam \| Organization \| Patient \| Practitioner \| RelatedPerson \| PractitionerRole \| HdBe Patient \| HdBe ContactPerson \| HdBe HealthProfessional PractitionerRole) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.10 zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.11 zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.12 HdBe-TreatmentDirective2:TreatmentDirective.AgreementParty.Patient HdBe-TreatmentDirective2:TreatmentDirective.AgreementParty.Representative HdBe-TreatmentDirective2:TreatmentDirective.AgreementParty.HealthProfessional
action	Σ	0..*	CodeableConcept	There are no (further) constraints on this element Element Id Consent.provision.action Short description Actions controlled by this rule Definition Actions controlled by this Rule. Comments Note that this is the direct action (not the grounds for the action covered in the purpose element). At present, the only action in the understood and tested scope of this resource is 'read'. Data Type CodeableConcept Binding Detailed codes for the consent action. ConsentActionCodes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
securityLabel	Σ	0..*	CodingBinding	There are no (further) constraints on this element Element Id Consent.provision.securityLabel Short description Security Labels that define affected resources Definition A security label, comprised of 0..* security label fields (Privacy tags), which define which resources are controlled by this exception. Comments If the consent specifies a security label of "R" then it applies to all resources that are labeled "R" or lower. E.g. for Confidentiality, it's a high water mark. For other kinds of security labels, subsumption logic applies. When the purpose of use tag is on the data, access request purpose of use shall not conflict. Data Type Coding Binding Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim:CV orim:fhir:Coding rdfs:subClassOf dt:CDCoding
purpose	Σ	0..*	CodingBinding	There are no (further) constraints on this element Element Id Consent.provision.purpose Short description Context of activities covered by this rule Definition The context of the activities a user is taking - why the user is accessing the data - that are controlled by this rule. Comments When the purpose of use tag is on the data, access request purpose of use shall not conflict. Data Type Coding Binding What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels. v3.PurposeOfUse (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim:CV orim:fhir:Coding rdfs:subClassOf dt:CDCoding
class	Σ	0..*	CodingBinding	There are no (further) constraints on this element Element Id Consent.provision.class Short description e.g. Resource Type, Profile, CDA, etc. Definition The class of information covered by this rule. The type can be a FHIR resource type, a profile on a type, or a CDA document, or some other type that indicates what sort of information the consent relates to. Comments Multiple types are or'ed together. The intention of the contentType element is that the codes refer to profiles or document types defined in a standard or an implementation guide somewhere. Data Type Coding Binding The class (type) of information a consent rule covers. ConsentContentClass (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim:CV orim:fhir:Coding rdfs:subClassOf dt:CDCoding
code	Σ	0..1	CodeableConceptBinding	Element Id Consent.provision.code Short description Treatment Alternate names Behandeling Definition The medical treatment to which the treatment instruction applies. Comments Typical use of this is a Document code with class = CDA. Data Type CodeableConcept Binding If this code is found in an instance, then the exception applies. Treatment (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.3 HdBe-TreatmentDirective2:TreatmentDirective.Treatment
dataPeriod	Σ I	0..1	Period	There are no (further) constraints on this element Element Id Consent.provision.dataPeriod Short description Timeframe for data controlled by this rule Definition Clinical or Operational Relevant period of time that bounds the data controlled by this rule. Comments This has a different sense to the Consent.period - that is when the consent agreement holds. This is the time period of the data that is controlled by the agreement. Data Type Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1:If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim:n/a v2:DR rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
data	Σ	0..*	BackboneElement	There are no (further) constraints on this element Element Id Consent.provision.data Short description Data controlled by this rule Definition The resources controlled by this rule if specific resources are referenced. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:Role
meaning	Σ	1..1	codeBinding	There are no (further) constraints on this element Element Id Consent.provision.data.meaning Short description instance \| related \| dependents \| authoredby Definition How the resource reference is interpreted when testing consent restrictions. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type code Binding How a resource reference is interpreted when testing consent restrictions. ConsentDataMeaning (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
reference	Σ I	1..1	Reference(Resource)	There are no (further) constraints on this element Element Id Consent.provision.data.reference Short description The actual data reference Definition A reference to a specific resource that defines which resources are covered by this consent. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Resource) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
provision		0..*	see (provision)	There are no (further) constraints on this element Element Id Consent.provision.provision Short description Nested Exception Rules Definition Rules which provide exceptions to the base rule or subrules.

Consent	I		Consent	Element Id Consent Short description TreatmentDirective Alternate names BehandelAanwijzing Definition A record of a healthcare consumer’s choices, which permits or denies identified recipient(s) or recipient role(s) to perform one or more actions within a given policy context, for specific purposes and periods of time. Comments 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. Data Type Consent Constraints dom-2:If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.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-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-6:A resource should have narrative for robust management text.`div`.exists() dom-5:If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` ppc-4:IF Scope=adr, there must be a patient `patient.exists() or scope.coding.where(system='something' and code='adr').exists().not()` ppc-5:IF Scope=treatment, there must be a patient `patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not()` ppc-2:IF Scope=privacy, there must be a patient `patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not()` ppc-3:IF Scope=research, there must be a patient `patient.exists() or scope.coding.where(system='something' and code='research').exists().not()` ppc-1:Either a Policy or PolicyRule `policy.exists() or policyRule.exists()` HdBe-TreatmentDirective2-1:`extension.additionalAdvanceDirective` may only be used for AdvanceDirective references in addition to first reference in `.source[x]`. `extension.where(url = 'https://fhir.healthdata.be/StructureDefinition/ext-TreatmentDirective2.AdvanceDirective').empty() or source.exists()` HdBe-TreatmentDirective2-2:If the specificationOther extension is used, `.provision.type` MUST be absent and vice versa `(extension.where(url = 'https://fhir.healthdata.be/StructureDefinition/ext-TreatmentDirective2.SpecificitionOther').exists() and provision.type.exists()).not()` Mappings rim:Entity. Role, or Act workflow:Event v2:CON rim:FinancialConsent zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.1 HdBe-TreatmentDirective2:TreatmentDirective
extension	I	0..*	Extension	Element Id Consent.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 Sliced: Unordered, Open, by url(Value) 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 rim:N/A
comment	I	0..1	Extension(string)	Element Id Consent.extension:comment Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. 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(string) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-Comment 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 rim:N/A
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id Consent.extension:comment.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-Comment Mappings rim:N/A
value[x]		0..1		Element Id Consent.extension:comment.value[x] Short description Comment Alternate names Toelichting Definition The comment may include further information such as the reason why a treatment directive has been drawn up, persons who assisted the patient in agreeing the treatment directive but who are not otherwise involved in the agreement as a representative, etc. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.13 HdBe-TreatmentDirective2:TreatmentDirective.Comment
valueString			string	There are no (further) constraints on this element Data Type string
additionalAdvanceDirective	I	0..*	Extension(Reference(HdBe AdvanceDirective))	Element Id Consent.extension:additionalAdvanceDirective Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments The cardinality of the `Consent.source[x]` element does not comply with the cardinality of the AdvanceDirective concept (NL-CM:2.2.8) specified in the HCIM TreatmentDirective2. This is solved by adding an extension that can be used to provide additional sources after `Consent.source[x]` is populated. Data Type Extension(Reference(HdBe AdvanceDirective)) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-TreatmentDirective2.AdvanceDirective 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 rim:N/A
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id Consent.extension:additionalAdvanceDirective.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-TreatmentDirective2.AdvanceDirective Mappings rim:N/A
value[x]	I	0..1		Element Id Consent.extension:additionalAdvanceDirective.value[x] Short description AdvanceDirective Alternate names Wilsverklaring Definition A (written) statement in which a person indicates wishes concerning future medical action, in the event that this person is at that point no longer (deemed) capable of taking decisions on the matter. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.8 HdBe-TreatmentDirective2:TreatmentDirective.AdvanceDirective
valueReference			Reference(HdBe AdvanceDirective)	There are no (further) constraints on this element Data Type Reference(HdBe AdvanceDirective)
modifierExtension	?! I	0..*	Extension	Element Id Consent.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 Sliced: Unordered, Open, by url(Value) 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 rim:N/A
specificationOther	?! I	0..1	Extension(string)	Element Id Consent.modifierExtension:specificationOther Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. 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(string) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-TreatmentDirective2.SpecificationOther 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 rim:N/A
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id Consent.modifierExtension:specificationOther.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-TreatmentDirective2.SpecificationOther Mappings rim:N/A
value[x]	I	0..1		Element Id Consent.modifierExtension:specificationOther.value[x] Short description SpecificationOther Alternate names SpecificatieAnders Definition Specification of the treatment decision when the decision is 'Other'. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.4 HdBe-TreatmentDirective2:TreatmentDirective.SpecificationOther
valueString			string	There are no (further) constraints on this element Data Type string
identifier	Σ	0..*	Identifier	There are no (further) constraints on this element Element Id Consent.identifier Short description Identifier for this record (external references) Definition Unique identifier for this copy of the Consent Statement. Comments This identifier identifies this copy of the consent. Where this identifier is also used elsewhere as the identifier for a consent record (e.g. a CDA consent document) then the consent details are expected to be the same. Data Type Identifier Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General { "system": "urn:ietf:rfc:3986", "value": "Local eCMS identifier" } Mappings rim:n/a v2:CX / EI (occasionally, more often EI maps to a resource id or a URL) rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd:Identifier workflow:Event.identifier w5:FiveWs.identifier rim:.id
status	Σ ?!	1..1	codeBinding	Element Id Consent.status Short description draft \| proposed \| active \| rejected \| inactive \| entered-in-error Definition Indicates the current state of this consent. Requirements The Consent Directive that is pointed to might be in various lifecycle states, e.g., a revoked Consent Directive. Comments This element is implicitly mapped to the concepts MostRecentReviewDate and DateExpired. Unless the status is explicitly recorded, the following guidance applies: When MostRecentReviewDate is in the past and DateExpired is absent or in the future, `.status` will usually be set to active. When DateExpired is in the past, `.status` will usually be set to inactive. When MostRecentReviewDate is absent or in the future, which is not possible following the CBB, `.status` will usually be set to draft. Data Type code Binding Indicates the state of the consent. ConsentState (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a workflow:Event.status w5:FiveWs.status v2:HL7 Table 0498 - Consent Status rim:.statusCode zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.5 zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.6 HdBe-TreatmentDirective2:TreatmentDirective.MostRecentReviewDate HdBe-TreatmentDirective2:TreatmentDirective.DateExpired
scope	Σ ?!	1..1	CodeableConceptBinding	Element Id Consent.scope Short description Which of the four areas this resource covers (extensible) Definition A selector of the type of consent being presented: ADR, Privacy, Treatment, Research. This list is now extensible. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data Type CodeableConcept Binding The four anticipated uses for the Consent Resource. ConsentScopeCodes (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/consentscope", "code": "treatment" } ] } Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
category	Σ	1..*	CodeableConceptBinding	Element Id Consent.category Short description Classification of the consent statement - for indexing/retrieval Definition A classification of the type of consents found in the statement. This element supports indexing and retrieval of consent statements. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data Type CodeableConcept Binding A classification of the type of consents found in a consent statement. ConsentCategoryCodes (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "coding": [ { "system": "http://snomed.info/sct", "code": "129125009" } ] } Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD workflow:Event.code w5:FiveWs.class v2:HL7 Table 0497 - Consent Type rim:CNTRCT
patient	Σ I	0..1	Reference(Patient \| HdBe Patient)	Element Id Consent.patient Short description Who the consent applies to Definition The patient/healthcare consumer to whom this consent applies. Comments Commonly, the patient the consent pertains to is the author, but for young and old people, it may be some other person. Data Type Reference(Patient \| HdBe Patient) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Event.subject w5:FiveWs.subject[x] rim:Role w5:FiveWs.subject
dateTime	Σ	0..1	dateTime	Element Id Consent.dateTime Short description MostRecentReviewDate Alternate names MeestRecenteBespreekdatum Definition The date on which the treatment directive has been agreed is with the patient and / or his representative (s). This can be the first time that the treatment directive have been discussed, but an existing treatment directive may also have been discussed again. The content of the treatment directive may have changed or remained the same. Comments This is not the time of the original consent, but the time that this statement was made or derived. Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a workflow:Event.occurrence[x] w5:FiveWs.recorded v2:Field 13/ Consent Decision Date rim:FinancialConsent effectiveTime zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.5 HdBe-TreatmentDirective2:TreatmentDirective.MostRecentReviewDate
performer	Σ I	0..*	Reference(Organization \| Patient \| Practitioner \| RelatedPerson \| PractitionerRole)	There are no (further) constraints on this element Element Id Consent.performer Short description Who is agreeing to the policy and rules Alternate names consentor Definition Either the Grantor, which is the entity responsible for granting the rights listed in a Consent Directive or the Grantee, which is the entity responsible for complying with the Consent Directive, including any obligations or limitations on authorizations and enforcement of prohibitions. Comments Commonly, the patient the consent pertains to is the consentor, but particularly for young and old people, it may be some other person - e.g. a legal guardian. Data Type Reference(Organization \| Patient \| Practitioner \| RelatedPerson \| PractitionerRole) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Event.performer w5:FiveWs.actor v2:Field 24/ ConsenterID
organization	Σ I	0..*	Reference(Organization)	There are no (further) constraints on this element Element Id Consent.organization Short description Custodian of the consent Alternate names custodian Definition The organization that manages the consent, and the framework within which it is executed. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Organization) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Event.performer w5:FiveWs.witness
source[x]	Σ I	0..1		Element Id Consent.source[x] Short description Source from which this consent is taken Definition The source on which this consent statement is based. The source might be a scanned original paper form, or a reference to a consent that links back to such a source, a reference to a document repository (e.g. XDS) that stores the original consent document. Comments The source can be contained inline (Attachment), referenced directly (Consent), referenced in a consent repository (DocumentReference), or simply by an identifier (Identifier), e.g. a CDA document id. Sliced: Unordered, Open, by $this(Type) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:Field 19 Informational Material Supplied Indicator
sourceAttachment			Attachment	There are no (further) constraints on this element Data Type Attachment
sourceReference	Σ I	0..1	Reference(Consent \| DocumentReference \| Contract \| QuestionnaireResponse \| HdBe AdvanceDirective)	Element Id Consent.source[x]:sourceReference Short description AdvanceDirective Alternate names Wilsverklaring Definition A (written) statement in which a person indicates wishes concerning future medical action, in the event that this person is at that point no longer (deemed) capable of taking decisions on the matter. Comments The source can be contained inline (Attachment), referenced directly (Consent), referenced in a consent repository (DocumentReference), or simply by an identifier (Identifier), e.g. a CDA document id. Data Type Reference(Consent \| DocumentReference \| Contract \| QuestionnaireResponse \| HdBe AdvanceDirective) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:Field 19 Informational Material Supplied Indicator zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.8 HdBe-TreatmentDirective2:TreatmentDirective.AdvanceDirective
policy		0..*	BackboneElement	There are no (further) constraints on this element Element Id Consent.policy Short description Policies covered by this consent Definition The references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
authority	I	0..1	uri	There are no (further) constraints on this element Element Id Consent.policy.authority Short description Enforcement source for policy Definition Entity or Organization having regulatory jurisdiction or accountability for enforcing policies pertaining to Consent Directives. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
uri	I	0..1	uri	Element Id Consent.policy.uri Short description Specific policy covered by this consent Definition The references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law. Comments Either `.policy` or `.policyRule` should exist following core constraint ppc-1. If no explicit value is recorded, a fallback is to populate `.policy.uri` with https://www.belgielex.be/ if the treatment directive is recorded following Belgium law and regulations. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
policyRule	Σ I	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element Id Consent.policyRule Short description Regulation that this consents to Definition A reference to the specific base computable regulation or policy. Requirements Might be a unique identifier of a policy set in XACML, or other rules engine. Comments If the policyRule is absent, computable consent would need to be constructed from the elements of the Consent resource. Data Type CodeableConcept Binding Regulatory policy examples. ConsentPolicyRuleCodes (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
verification	Σ	0..*	BackboneElement	There are no (further) constraints on this element Element Id Consent.verification Short description Consent Verified by patient or family Definition Whether a treatment instruction (e.g. artificial respiration yes or no) was verified with the patient, his/her family or another authorized person. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
verified	Σ	1..1	boolean	There are no (further) constraints on this element Element Id Consent.verification.verified Short description Has been verified Definition Has the instruction been verified. Data Type boolean Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
verifiedWith	I	0..1	Reference(Patient \| RelatedPerson)	There are no (further) constraints on this element Element Id Consent.verification.verifiedWith Short description Person who verified Definition Who verified the instruction (Patient, Relative or other Authorized Person). Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Patient \| RelatedPerson) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
verificationDate		0..1	dateTime	There are no (further) constraints on this element Element Id Consent.verification.verificationDate Short description When consent verified Definition Date verification was collected. Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
provision	Σ	0..1	BackboneElement	There are no (further) constraints on this element Element Id Consent.provision Short description Constraints to the base Consent.policyRule Definition An exception to the base policy of this consent. An exception can be an addition or removal of access permissions. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
extension	I	0..*	Extension	Element Id Consent.provision.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) 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 rim:N/A
reasonForEnding	I	0..1	Extension(string)	Element Id Consent.provision.extension:reasonForEnding Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. 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(string) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-TreatmentDirective2.ReasonForEnding 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 rim:N/A
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id Consent.provision.extension:reasonForEnding.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-TreatmentDirective2.ReasonForEnding Mappings rim:N/A
value[x]		0..1		Element Id Consent.provision.extension:reasonForEnding.value[x] Short description ReasonForEnding Alternate names RedenBeeindigd Definition Reason why the agreement on a treatment directive no longer applies. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.7 HdBe-TreatmentDirective2:TreatmentDirective.ReasonForEnding
valueString			string	There are no (further) constraints on this element Data Type string
type	Σ I	0..1	codeBinding	Element Id Consent.provision.type Short description TreatmentDecision Alternate names BehandelBesluit Definition The joint decision taken with regard to the desirability of performing the indicated treatment. If the agreement is 'Other', 'Specification Other' shall contain the instructions for whether or not to carry out the treatment. Implementers SHALL support the SpecificationOther extension on `.provision.type` for this. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type code Binding Use ConceptMap 'TreatmentDecision-to-ConsentProvisionType' to translate zib terminology to profile terminology in ValueSet 'ConsentProvisionType' ConsentProvisionType (required) Permitted Values TreatmentDecision_to_ConsentProvisionType Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.2 HdBe-TreatmentDirective2:TreatmentDirective.TreatmentDecision
period	Σ I	0..1	Period	There are no (further) constraints on this element Element Id Consent.provision.period Short description Timeframe for this rule Definition The timeframe in this rule is valid. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data Type Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1:If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim:n/a v2:DR rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
start	Σ I	0..1	dateTime	There are no (further) constraints on this element Element Id Consent.provision.period.start Short description Starting time with inclusive boundary Definition The start of the period. The boundary is inclusive. Comments If the low element is missing, the meaning is that the low boundary is not known. Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:DR.1 rim:./low
end	Σ I	0..1	dateTime	Element Id Consent.provision.period.end Short description DateExpired Alternate names DatumBeeindigd Definition The date on which the treatment directive has been withdrawn and therefore no longer applies. An explicit decision must be taken about the 'date expired', in consultation between the responsible care provider and the patient or his representative(s).Any future termination can only be entered as a condition. Often this will be linked to 1 or more events. Comments The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03. Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:DR.2 rim:./high zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.6 HdBe-TreatmentDirective2:TreatmentDirective.DateExpired
actor		0..*	BackboneElement	Element Id Consent.provision.actor Short description Who\|what controlled by this rule (or group, by role) Definition Who or what is controlled by this rule. Use group to identify a set of actors by some property they share (e.g. 'admitting officers'). Data Type BackboneElement Sliced: Unordered, Open, by role(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
(All Slices)				There are no (further) constraints on this element
role		1..1	CodeableConceptBinding	There are no (further) constraints on this element Element Id Consent.provision.actor.role Short description How the actor is involved Definition How the individual is involved in the resources content that is described in the exception. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data Type CodeableConcept Binding How an actor is involved in the consent considerations. SecurityRoleType (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
reference	I	1..1	Reference(Device \| Group \| CareTeam \| Organization \| Patient \| Practitioner \| RelatedPerson \| PractitionerRole)	There are no (further) constraints on this element Element Id Consent.provision.actor.reference Short description Resource for the actor (or group, by role) Definition The resource that identifies the actor. To identify actors by type, use group to identify a set of actors by some property they share (e.g. 'admitting officers'). Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Device \| Group \| CareTeam \| Organization \| Patient \| Practitioner \| RelatedPerson \| PractitionerRole) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
agreementParty		0..*	BackboneElement	Element Id Consent.provision.actor:agreementParty Short description AgreementParty Alternate names AfspraakPartij Definition Container of the Agreement concept.This container contains all data elements of the Agreement concept. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.9 HdBe-TreatmentDirective2:TreatmentDirective.AgreementParty
role		1..1	CodeableConceptBinding	Element Id Consent.provision.actor:agreementParty.role Short description How the actor is involved Definition How the individual is involved in the resources content that is described in the exception. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data Type CodeableConcept Binding How an actor is involved in the consent considerations. SecurityRoleType (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/v3-RoleCode", "code": "CONSENTER" } ] } Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
reference	I	1..1	pattern HealthProfessional Reference(Device \| Group \| CareTeam \| Organization \| Patient \| Practitioner \| RelatedPerson \| PractitionerRole \| HdBe Patient \| HdBe ContactPerson \| HdBe HealthProfessional PractitionerRole)	Element Id Consent.provision.actor:agreementParty.reference Short description Patient / Representative / HealthProfessional Alternate names Patient, Vertegenwoordiger, Zorgverlener Definition Patient as the person with whom the agreement was made. Person who represents the patient in health care matters and with whom the agreement has been made (too). HealthProfessional who has made de agreement regarding the treatement directive. Comments Each occurrence of the CBB HealthProfessional is normally represented by two FHIR resources: a PractitionerRole resource (instance of HdBe-HealthProfessional-PractitionerRole) and a Practitioner resource (instance of HdBe-HealthProfessional-Practitioner). The Practitioner resource is referenced from the PractitionerRole instance. For this reason, sending systems should fill the reference to the PractitionerRole instance here, and not the Practitioner resource. Receiving systems can then retrieve the reference to the Practitioner resource from that PractitionerRole instance. In rare circumstances, there is only a Practitioner instance, in which case it is that instance which will be referenced here. However, since this should be the exception, the HdBe-HealthProfessional-Practitioner profile is not explicitly mentioned as a target profile. Data Type pattern HealthProfessional Reference(Device \| Group \| CareTeam \| Organization \| Patient \| Practitioner \| RelatedPerson \| PractitionerRole \| HdBe Patient \| HdBe ContactPerson \| HdBe HealthProfessional PractitionerRole) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.10 zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.11 zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.12 HdBe-TreatmentDirective2:TreatmentDirective.AgreementParty.Patient HdBe-TreatmentDirective2:TreatmentDirective.AgreementParty.Representative HdBe-TreatmentDirective2:TreatmentDirective.AgreementParty.HealthProfessional
action	Σ	0..*	CodeableConcept	There are no (further) constraints on this element Element Id Consent.provision.action Short description Actions controlled by this rule Definition Actions controlled by this Rule. Comments Note that this is the direct action (not the grounds for the action covered in the purpose element). At present, the only action in the understood and tested scope of this resource is 'read'. Data Type CodeableConcept Binding Detailed codes for the consent action. ConsentActionCodes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
securityLabel	Σ	0..*	CodingBinding	There are no (further) constraints on this element Element Id Consent.provision.securityLabel Short description Security Labels that define affected resources Definition A security label, comprised of 0..* security label fields (Privacy tags), which define which resources are controlled by this exception. Comments If the consent specifies a security label of "R" then it applies to all resources that are labeled "R" or lower. E.g. for Confidentiality, it's a high water mark. For other kinds of security labels, subsumption logic applies. When the purpose of use tag is on the data, access request purpose of use shall not conflict. Data Type Coding Binding Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim:CV orim:fhir:Coding rdfs:subClassOf dt:CDCoding
purpose	Σ	0..*	CodingBinding	There are no (further) constraints on this element Element Id Consent.provision.purpose Short description Context of activities covered by this rule Definition The context of the activities a user is taking - why the user is accessing the data - that are controlled by this rule. Comments When the purpose of use tag is on the data, access request purpose of use shall not conflict. Data Type Coding Binding What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels. v3.PurposeOfUse (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim:CV orim:fhir:Coding rdfs:subClassOf dt:CDCoding
class	Σ	0..*	CodingBinding	There are no (further) constraints on this element Element Id Consent.provision.class Short description e.g. Resource Type, Profile, CDA, etc. Definition The class of information covered by this rule. The type can be a FHIR resource type, a profile on a type, or a CDA document, or some other type that indicates what sort of information the consent relates to. Comments Multiple types are or'ed together. The intention of the contentType element is that the codes refer to profiles or document types defined in a standard or an implementation guide somewhere. Data Type Coding Binding The class (type) of information a consent rule covers. ConsentContentClass (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim:CV orim:fhir:Coding rdfs:subClassOf dt:CDCoding
code	Σ	0..1	CodeableConceptBinding	Element Id Consent.provision.code Short description Treatment Alternate names Behandeling Definition The medical treatment to which the treatment instruction applies. Comments Typical use of this is a Document code with class = CDA. Data Type CodeableConcept Binding If this code is found in an instance, then the exception applies. Treatment (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD zib-treatmentdirective2-v1.0-2020EN:NL-CM:2.2.3 HdBe-TreatmentDirective2:TreatmentDirective.Treatment
dataPeriod	Σ I	0..1	Period	There are no (further) constraints on this element Element Id Consent.provision.dataPeriod Short description Timeframe for data controlled by this rule Definition Clinical or Operational Relevant period of time that bounds the data controlled by this rule. Comments This has a different sense to the Consent.period - that is when the consent agreement holds. This is the time period of the data that is controlled by the agreement. Data Type Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1:If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim:n/a v2:DR rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
data	Σ	0..*	BackboneElement	There are no (further) constraints on this element Element Id Consent.provision.data Short description Data controlled by this rule Definition The resources controlled by this rule if specific resources are referenced. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:Role
meaning	Σ	1..1	codeBinding	There are no (further) constraints on this element Element Id Consent.provision.data.meaning Short description instance \| related \| dependents \| authoredby Definition How the resource reference is interpreted when testing consent restrictions. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type code Binding How a resource reference is interpreted when testing consent restrictions. ConsentDataMeaning (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
reference	Σ I	1..1	Reference(Resource)	There are no (further) constraints on this element Element Id Consent.provision.data.reference Short description The actual data reference Definition A reference to a specific resource that defines which resources are covered by this consent. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Resource) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
provision		0..*	see (provision)	There are no (further) constraints on this element Element Id Consent.provision.provision Short description Nested Exception Rules Definition Rules which provide exceptions to the base rule or subrules.

Mapping FHIR profile to CBB

Path	map	CBB	comment
Consent	TreatmentDirective	HdBe-TreatmentDirective2
Consent.extension:comment.value[x]	TreatmentDirective.Comment	HdBe-TreatmentDirective2
Consent.extension:additionalAdvanceDirective.value[x]	TreatmentDirective.AdvanceDirective	HdBe-TreatmentDirective2
Consent.modifierExtension:specificationOther.value[x]	TreatmentDirective.SpecificationOther	HdBe-TreatmentDirective2
Consent.status	TreatmentDirective.MostRecentReviewDate	HdBe-TreatmentDirective2	MostRecentReviewDate (implicit, main mapping is on `Consent.dateTime`)
Consent.status	TreatmentDirective.DateExpired	HdBe-TreatmentDirective2	DateExpired (implicit, main mapping is on `Consent.provision.period.end`)
Consent.dateTime	TreatmentDirective.MostRecentReviewDate	HdBe-TreatmentDirective2
Consent.source[x]:sourceReference	TreatmentDirective.AdvanceDirective	HdBe-TreatmentDirective2
Consent.provision.extension:reasonForEnding.value[x]	TreatmentDirective.ReasonForEnding	HdBe-TreatmentDirective2
Consent.provision.type	TreatmentDirective.TreatmentDecision	HdBe-TreatmentDirective2
Consent.provision.period.end	TreatmentDirective.DateExpired	HdBe-TreatmentDirective2
Consent.provision.actor:agreementParty	TreatmentDirective.AgreementParty	HdBe-TreatmentDirective2
Consent.provision.actor:agreementParty.reference	TreatmentDirective.AgreementParty.Patient	HdBe-TreatmentDirective2
Consent.provision.actor:agreementParty.reference	TreatmentDirective.AgreementParty.Representative	HdBe-TreatmentDirective2
Consent.provision.actor:agreementParty.reference	TreatmentDirective.AgreementParty.HealthProfessional	HdBe-TreatmentDirective2
Consent.provision.code	TreatmentDirective.Treatment	HdBe-TreatmentDirective2

zib-TreatmentDirective2 difference

Concept	Category	Description
`Consent.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.
`Consent.provision.type`	terminology	Changed ValueSet and related ConceptMap to have SNOMED codes instead of zib internal codes.
`Consent.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

Path	Name	Strength	URL	ConceptMap
Consent.provision.type	consent-provision-type\|4.0.1	required	http://hl7.org/fhir/ValueSet/consent-provision-type\|4.0.1	https://fhir.healthdata.be/ConceptMap/TreatmentDecision-to-ConsentProvisionType
Consent.provision.code	Treatment	extensible	https://fhir.healthdata.be/ValueSet/Treatment	No bound ConceptMap