HdBe-TreatmentDirective2

Profile	Status	URL
HdBe-TreatmentDirective2	draft	https://fhir.healthdata.be/StructureDefinition/LogicalModel/HdBe-TreatmentDirective2

TreatmentDirective		TreatmentDirective	There are no (further) constraints on this element Element Id TreatmentDirective Short description TreatmentDirective Definition Root concept of the TreatmentDirective2 information model. This concept contains all data elements of the TreatmentDirective2 information model. Data Type TreatmentDirective
TreatmentDecision	1..1	CodeableConceptBinding	There are no (further) constraints on this element Element Id TreatmentDirective.TreatmentDecision Short description TreatmentDecision 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. Data Type CodeableConcept Binding TreatmentDecision codes TreatmentDecision (required)
Treatment	1..1	CodeableConceptBinding	There are no (further) constraints on this element Element Id TreatmentDirective.Treatment Short description Treatment Definition The medical treatment to which the treatment instruction applies. Data Type CodeableConcept Binding Treatment codes Treatment (extensible)
SpecificationOther	0..1	string	There are no (further) constraints on this element Element Id TreatmentDirective.SpecificationOther Short description SpecificationOther Definition Specification of the treatment decision when the decision is 'Other'. Data Type string
MostRecentReviewDate	1..1	dateTime	There are no (further) constraints on this element Element Id TreatmentDirective.MostRecentReviewDate Short description MostRecentReviewDate 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. Data Type dateTime
DateExpired	0..1	dateTime	There are no (further) constraints on this element Element Id TreatmentDirective.DateExpired Short description DateExpired Definition The date on which the treatment directive has been withdrawn and therefore no longer applies.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. Data Type dateTime
ReasonForEnding	0..1	string	There are no (further) constraints on this element Element Id TreatmentDirective.ReasonForEnding Short description ReasonForEnding Definition Reason why the agreement on a treatment directive no longer applies. Data Type string
AdvanceDirective	0..*	Reference(HdBe AdvanceDirective)	There are no (further) constraints on this element Element Id TreatmentDirective.AdvanceDirective Short description AdvanceDirective 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. Data Type Reference(HdBe AdvanceDirective)
AgreementParty	2..*	BackboneElement	There are no (further) constraints on this element Element Id TreatmentDirective.AgreementParty Short description AgreementParty Definition Container of the Agreement concept.This container contains all data elements of the Agreement concept. Data Type BackboneElement
Patient	0..1	Reference(HdBe Patient)	There are no (further) constraints on this element Element Id TreatmentDirective.AgreementParty.Patient Short description Patient Definition Patient as the person with whom the agreement was made. Data Type Reference(HdBe Patient)
Representative	0..1	Reference(HdBe ContactPerson)	There are no (further) constraints on this element Element Id TreatmentDirective.AgreementParty.Representative Short description Representative Definition Person who represents the patient in health care matters and with whom the agreement has been made (too). Data Type Reference(HdBe ContactPerson)
HealthProfessional	0..1	Reference(HdBe HealthProfessional)	There are no (further) constraints on this element Element Id TreatmentDirective.AgreementParty.HealthProfessional Short description HealthProfessional Definition HealthProfessional who has made de agreement regarding the treatement directive. Data Type Reference(HdBe HealthProfessional)
Comment	0..1	string	There are no (further) constraints on this element Element Id TreatmentDirective.Comment Short description Comment 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. Data Type string

TreatmentDirective		0..*
TreatmentDirective.TreatmentDecision	CodeableConcept	1..1
TreatmentDirective.Treatment	CodeableConcept	1..1
TreatmentDirective.SpecificationOther	string	0..1
TreatmentDirective.MostRecentReviewDate	dateTime	1..1
TreatmentDirective.DateExpired	dateTime	0..1
TreatmentDirective.ReasonForEnding	string	0..1
TreatmentDirective.AdvanceDirective	Reference(HdBe AdvanceDirective)	0..*
TreatmentDirective.AgreementParty	BackboneElement	2..*
TreatmentDirective.AgreementParty.Patient	Reference(HdBe Patient)	0..1
TreatmentDirective.AgreementParty.Representative	Reference(HdBe ContactPerson)	0..1
TreatmentDirective.AgreementParty.HealthProfessional	Reference(HdBe HealthProfessional)	0..1
TreatmentDirective.Comment	string	0..1

TreatmentDirective2
Definition	Base definition for all elements in a resource.
Cardinality	0...*
Invariants	ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim:n/a
TreatmentDirective2.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	System.String
Mappings	rim:n/a
TreatmentDirective2.extension
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.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
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.
Slicing	Unordered, Open, by url(Value)
Invariants	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
TreatmentDirective2.TreatmentDirective
Definition	Root concept of the TreatmentDirective2 information model. This concept contains all data elements of the TreatmentDirective2 information model.
Cardinality	0...*

Example instances

TreatmentDirective
TreatmentDecision	385643006 - To be done (code by SNOMED CT)
Treatment	305351004 - Admission to intensive care unit (code by SNOMED CT)
SpecificationOther
MostRecentReviewDate	2012-09-11
DateExpired	2012-10-15
ReasonForEnding	Recovered and released from the hospital.
AdvanceDirective	Reference to AdvanceDirective (Power of attorney granted)
AgreementParty	---
AgreementParty.Patient
AgreementParty.Representative	Reference to ContactPerson (Jan Pieter Mark (Piet) van Putten)
AgreementParty.HealthProfessional	Reference to HealthProfessional (J.H.R. Peters, Doctor)
Comment

TreatmentDirective
TreatmentDecision	74964007 - Other (code by SNOMED CT)
Treatment	89666000 - Cardiopulmonary resuscitation (code by SNOMED CT)
SpecificationOther	First consult with husband
MostRecentReviewDate	2012-09-11
DateExpired
ReasonForEnding
AdvanceDirective
AgreementParty	---
AgreementParty.Patient
AgreementParty.Representative	Reference to ContactPerson (Jan Pieter Mark (Piet) van Putten)
AgreementParty.HealthProfessional
Comment

zib TreatmentDirective2-v1.0 difference

Concept	Category	Description
`Treatment`	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.
`Treatment`	terminology	Changed codes to the one found in TreatmentDirective2-v2.0(2022EN).
`TreatmentDecision`	terminology	Replaced zib codes to SNOMED codes.

Terminology Bindings

Path	Name	Strength	URL
TreatmentDecision	TreatmentDecision	required	https://fhir.healthdata.be/ValueSet/TreatmentDecision
Treatment	Treatment	extensible	https://fhir.healthdata.be/ValueSet/Treatment