Implementierungsleitfaden ISiK-Terminplanung

ISiKMedizinischeBehandlungseinheit (HealthcareService)

ISiKMedizinischeBehandlungseinheit (HealthcareService)

ISiKMedizinischeBehandlungseinheit

Unter einer medizinischen Behandlungseinheit wird hier im weiteren Sinne eine Dienstleistung (diagnostisch, therapeutisch, im weiten Sinne gesundheitsfördernd etc.) zum Zweck einer Terminbuchung verstanden. Hierfür können von der Fachabteilung (Organization) unabhängige Kalender gepflegt werden. Im Kontext der Terminplanung können somit angebotene Leistungen (z.B. CT/MRT-Untersuchungen, chirurgische Eingriffe, Beratungsstunden zur Geburt etc.) abgebildet werden.

Der Kontext zu diesem Profil wird mit folgender User Story veranschaulicht:

User Story: Ein Patient erhält von seiner Hausärztin einen Überweisungsschein für eine weitere diagnostische Untersuchung in Form einer Kapselendoskopie der Speiseröhre. Der Patient nutzt ein Patientenportal, um unter Angabe der benötigten diagnostische Leistung nach einem verfügbaren Termin zu suchen und findet einen passenden Termin bei der Fachabteilung für Gastroenterologie eines örtlichen Krankenhauses.

Hintergrund: Die Suche nach verfügbaren Terminenblöcken (Slot) unter Einbeziehung der Dienstleistung entspricht der Angabe des Überweisungsscheins, ermöglicht hier zugleich eine präzisere Suche und vergrößert darüber hinaus den Raum möglicher Termine über verschiedene Abteilungen (und Institutionen im Patientenportal) hinweg.

Bestätigungsrelevanz

Verbindlichkeit	SHALL

Metadaten

Canonical	https://gematik.de/fhir/isik/StructureDefinition/ISiKMedizinischeBehandlungseinheit
Status	active
Version	5.0.0-rc
Basis	http://hl7.org/fhir/StructureDefinition/HealthcareService

Inhalt

ISiKMedizinischeBehandlungseinheit (HealthcareService)	I		HealthcareService	There are no (further) constraints on this element Element id HealthcareService Short description The details of a healthcare service available at a location Definition The details of a healthcare service available at a location. Data type HealthcareService Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.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-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-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() Mappings rim: Entity. Role, or Act rim: act[classCode=ACT][moodCode=DEF]
id	Σ	0..1	string	There are no (further) constraints on this element Element id HealthcareService.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type string
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id HealthcareService.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id HealthcareService.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
language		0..1	codeBinding	There are no (further) constraints on this element Element id HealthcareService.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
text		0..1	Narrative	There are no (further) constraints on this element Element id HealthcareService.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id HealthcareService.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. Data type Resource Mappings rim: N/A
extension	I	0..*	Extension	There are no (further) constraints on this element Element id HealthcareService.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 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
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id HealthcareService.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 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
identifier	Σ	0..*	Identifier	There are no (further) constraints on this element Element id HealthcareService.identifier Short description External identifiers for this item Definition External identifiers for this item. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.identifier rim: .id
active	S Σ ?!	1..1	boolean	Element id HealthcareService.active Short description Whether this HealthcareService record is in active use Definition This flag is used to mark the record to not be used. This is not used when a center is closed for maintenance, or for holidays, the notAvailable period is to be used for this. Comments Bedeutung: Ist der HealthcareService in aktiver Verwendung. Hinweis: Historische HealthcareServices können ebenfalls über die ISiK-Schnittstelle ausgetauscht werden. Für diese dürfen jedoch keine Termine vereinbart werden. Das terminführende System MUSS dies bei der Buchung überprüfen. Begründung Kardinalität und Must-Support-Flag (MS): Die Kardinalität 1..1 und das Must-Support-Flag (MS) für das 'active'-Element stellen sicher, dass jede Behandlungseinheit eindeutig als aktiv oder inaktiv gekennzeichnet ist. Dies ist entscheidend für die Ressourcenplanung und Verfügbarkeit von Behandlungseinheiten. Meaning when missing This resource is generally assumed to be active if no value is provided for the active element Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.status rim: .statusCode
providedBy	Σ	0..1	Reference(Organization)	There are no (further) constraints on this element Element id HealthcareService.providedBy Short description Organization that provides this service Definition The organization that provides this healthcare service. Comments This property is recommended to be the same as the Location's managingOrganization, and if not provided should be interpreted as such. If the Location does not have a managing Organization, then this property should be populated. Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .scopingRole.Organization
category	Σ	0..*	CodeableConcept	There are no (further) constraints on this element Element id HealthcareService.category Short description Broad category of service being performed or delivered Alternate names service category Definition Identifies the broad category of service being performed or delivered. Comments Selecting a Service Category then determines the list of relevant service types that can be selected in the primary service type. Data type CodeableConcept Binding A category of the service(s) that could be provided. ServiceCategory (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.class rim: .code
type	S Σ	1..*	CodeableConcept	Element id HealthcareService.type Short description Type of service that may be delivered or performed Alternate names service type Definition The specific type of service that may be delivered or performed. Comments Bedeutung: Klassifikation der Behandlungsleistung welche durch den HealthcareService erbracht wird Hinweis: Diese Klassifikation SOLL stets auch in Appointment.serviceType und Schedule.serviceType angegeben werden. Seitens der aktuellen Spezifikation werden keine Vorgaben bezüglich der zu verwendenden Terminologie gemacht. Entsprechend verwendete Kataloge müssen als CodeSystem- und ValueSet-Ressourcen exponiert werden. Siehe Suchparameter 'context-type-value' in ISiK Basis - Datenobjekt ValueSet. Begründung Kardinalität: Eine Behandlungseinheit muss mindestens einen Typ haben, sodass im Rahmen der Terminplanung ermittelt werden kann, welcher Akteur für die Durchführung eines Termins zur Verfügung steht. Data type CodeableConcept Binding Additional details about where the content was created (e.g. clinical specialty). ServiceType (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .actrelationship[typeCode=COMP.act[classCode=ACT][moodCode=DEF].code
specialty	S Σ	1..*	CodeableConceptBinding	Element id HealthcareService.specialty Short description Specialties handled by the HealthcareService Definition Collection of specialties handled by the service site. This is more of a medical term. Comments Bedeutung: Fachrichtung der Behandlungsleistung welche durch den HealthcareService erbracht wird Hinweis: Diese Fachrichtung SOLL stets auch in Appointment.specialty und Schedule.specialty angegeben werden. Begründung Kardinalität: Eine Behandlungseinheit kann multiprofessionell sein und mehere Fachbereiche abdecken. Sie muss jedoch mindestens einem Fachbereich zugeordnet sein, sodass die Behandlungseinheit während der Terminplanung als Akteur für passende Termine miteinbezogen wird. Data type CodeableConcept Binding A specialty that a healthcare service may provide. PracticeSettingCodeValueSet (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .actrelationship[typeCode=COMP.act[classCode=ACT][moodCode=DEF].code
id		0..1	string	There are no (further) constraints on this element Element id HealthcareService.specialty.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id HealthcareService.specialty.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) Extensions are always sliced by (at least) url 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
coding	S Σ	1..*	Coding	Element id HealthcareService.specialty.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Begründung Kardinalität Fachrichtung: Die Kardinalität der Fachrichtung-Eigenschaft wird auf 1..1 festgelegt, um sicherzustellen, dass genau eine Fachrichtung per IHE-XDS-Kodierung vorhanden ist. Dies ist notwendig, um die Spezialisierung der Behandlungseinheit eindeutig zu definieren und eine korrekte Zuordnung zu gewährleisten. Begründung Kardinalität ErweiterterFachabteilungsschluessel: Die Kardinalität der ErweiterterFachabteilungsschluessel-Eigenschaft wird auf 0..1 festgelegt, um sicherzustellen, dass optional ein erweiterter Fachabteilungsschlüssel vorhanden sein kann. Data type Coding Sliced: Unordered, Open, by $this(Pattern) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Fachrichtung	S Σ	1..1	CodingBinding	Element id HealthcareService.specialty.coding:Fachrichtung Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Die Wahl des hinterlegten ValueSets (http://ihe-d.de/ValueSets/IHEXDSpracticeSettingCode) wurde mit einem Mitglied der IHE Deutschland Arbeitsgruppe XDS ValueSets (https://www.ihe-d.de/projekte/xds-value-sets-fuer-deutschland/) sowie mit der KBV abgestimmt (Stand:13.6.2024). Data type Coding Binding IHEXDSpracticeSettingCode (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
ErweiterterFachabteilungsschluessel	Σ	0..1	CodingBinding	Element id HealthcareService.specialty.coding:ErweiterterFachabteilungsschluessel Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Dieses ValueSet KANN über ein Mapping (siehe Abschnitt https://wiki.hl7.de/index.php?title=IG:Value_Sets_f%C3%BCr_XDS#DocumentEntry.practiceSettingCode) mit dem ValueSet der Fachrichtung verknüpft werden und darüber ggf. die Integration von Systemen erleichtern. Data type Coding Binding ValueSetFachabteilungsschluesselErweitert (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
text	Σ	0..1	string	There are no (further) constraints on this element Element id HealthcareService.specialty.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
location	Σ	0..*	Reference(Location)	There are no (further) constraints on this element Element id HealthcareService.location Short description Location(s) where service may be provided Definition The location(s) where this healthcare service may be provided. Data type Reference(Location) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.where[x] rim: .location.role[classCode=SDLOC]
name	S Σ	1..1	string	Element id HealthcareService.name Short description Description of service as presented to a consumer while searching Definition Further description of the service as it would be presented to a consumer while searching. Comments Bedeutung: Informeller Name der Behandlungseinheit Hinweis: Es wird im Rahmen dieser Spezifikation davon ausgegangen, dass für einen HealthcareService keine natürlichen Identifier vorliegen, die in einem realen Kontext vergeben werden. Somit kann durch den Namen ein informeller, jedoch identifizierender Bezeichner vergeben werden. Begründung Kardinalität: Eine Behandlungseinheit muss mindestens einen Namen haben, um eine Wiedererkennbarkeit im Rahmen der Terminplanung zu gewährleisten. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .name
comment	Σ	0..1	string	There are no (further) constraints on this element Element id HealthcareService.comment Short description Additional description and/or any specific issues not covered elsewhere Definition Any additional description of the service and/or any specific issues not covered by the other attributes, which can be displayed as further detail under the serviceName. Comments Would expect that a user would not see this information on a search results, and it would only be available when viewing the complete details of the service. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .location.role[classCode=SDLOC].desc
extraDetails		0..1	markdown	There are no (further) constraints on this element Element id HealthcareService.extraDetails Short description Extra details about the service that can't be placed in the other fields Definition Extra details about the service that can't be placed in the other fields. Data type markdown Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .actrelationship[typeCode=COMP.act[classCode=ACT][moodCode=DEF].text
photo	Σ	0..1	Attachment	There are no (further) constraints on this element Element id HealthcareService.photo Short description Facilitates quick identification of the service Definition If there is a photo/symbol associated with this HealthcareService, it may be included here to facilitate quick identification of the service in a list. Data type Attachment Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .actrelationship[typeCode=SBJ].observation.value
telecom		0..*	ContactPoint	There are no (further) constraints on this element Element id HealthcareService.telecom Short description Contacts related to the healthcare service Definition List of contacts related to this specific healthcare service. Comments If this is empty, then refer to the location's contacts. Data type ContactPoint Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .telecom
coverageArea		0..*	Reference(Location)	There are no (further) constraints on this element Element id HealthcareService.coverageArea Short description Location(s) service is intended for/available to Definition The location(s) that this service is available to (not where the service is provided). Comments The locations referenced by the coverage area can include both specific locations, including areas, and also conceptual domains too (mode = kind), such as a physical area (tri-state area) and some other attribute (covered by Example Care Organization). These types of Locations are often not managed by any specific organization. This could also include generic locations such as "in-home". Data type Reference(Location) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .location.role[classCode=SDLOC].subjectOf.A_SpatialCoordinate
serviceProvisionCode		0..*	CodeableConcept	There are no (further) constraints on this element Element id HealthcareService.serviceProvisionCode Short description Conditions under which service is available/offered Definition The code(s) that detail the conditions under which the healthcare service is available/offered. Comments The provision means being commissioned by, contractually obliged or financially sourced. Types of costings that may apply to this healthcare service, such if the service may be available for free, some discounts available, or fees apply. Data type CodeableConcept Binding The code(s) that detail the conditions under which the healthcare service is available/offered. ServiceProvisionConditions (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .actrelationship[typeCode=PRCN].observation[moodCode=EVN.CRT]
eligibility		0..*	BackboneElement	There are no (further) constraints on this element Element id HealthcareService.eligibility Short description Specific eligibility requirements required to use the service Definition Does this service have specific eligibility requirements that need to be met in order to use the service? Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id HealthcareService.eligibility.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id HealthcareService.eligibility.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 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
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id HealthcareService.eligibility.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 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
code		0..1	CodeableConcept	There are no (further) constraints on this element Element id HealthcareService.eligibility.code Short description Coded value for the eligibility Definition Coded value for the eligibility. Data type CodeableConcept Binding Coded values underwhich a specific service is made available. (unbound) (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .actrelationship[typeCode=PRCN].observation[moodCode=EVN.CRT]
comment		0..1	markdown	There are no (further) constraints on this element Element id HealthcareService.eligibility.comment Short description Describes the eligibility conditions for the service Definition Describes the eligibility conditions for the service. Comments The description of service eligibility should, in general, not exceed one or two paragraphs. It should be sufficient for a prospective consumer to determine if they are likely to be eligible or not. Where eligibility requirements and conditions are complex, it may simply be noted that an eligibility assessment is required. Where eligibility is determined by an outside source, such as an Act of Parliament, this should be noted, preferably with a reference to a commonly available copy of the source document such as a web page. Data type markdown Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .actrelationship[typeCode=PRCN].observation[moodCode=EVN.CRT].text
program		0..*	CodeableConcept	There are no (further) constraints on this element Element id HealthcareService.program Short description Programs that this service is applicable to Definition Programs that this service is applicable to. Comments Programs are often defined externally to an Organization, commonly by governments; e.g. Home and Community Care Programs, Homeless Program, …. Data type CodeableConcept Binding Government or local programs that this service applies to. Program (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .actrelationship[typeCode=PERT].observation
characteristic		0..*	CodeableConcept	There are no (further) constraints on this element Element id HealthcareService.characteristic Short description Collection of characteristics (attributes) Definition Collection of characteristics (attributes). Comments These could be such things as is wheelchair accessible. Data type CodeableConcept Binding A custom attribute that could be provided at a service (e.g. Wheelchair accessibiliy). (unbound) (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .actrelationship[typeCode=PERT].observation
communication		0..*	CodeableConceptBinding	There are no (further) constraints on this element Element id HealthcareService.communication Short description The language that this service is offered in Definition Some services are specifically made available in multiple languages, this property permits a directory to declare the languages this is offered in. Typically this is only provided where a service operates in communities with mixed languages used. Comments When using this property it indicates that the service is available with this language, it is not derived from the practitioners, and not all are required to use this language, just that this language is available while scheduling. Data type CodeableConcept Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
referralMethod		0..*	CodeableConcept	There are no (further) constraints on this element Element id HealthcareService.referralMethod Short description Ways that the service accepts referrals Definition Ways that the service accepts referrals, if this is not provided then it is implied that no referral is required. Data type CodeableConcept Binding The methods of referral can be used when referring to a specific HealthCareService resource. ReferralMethod (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .actrelationship[typeCode=PERT].observation
appointmentRequired		0..1	boolean	There are no (further) constraints on this element Element id HealthcareService.appointmentRequired Short description If an appointment is required for access to this service Definition Indicates whether or not a prospective consumer will require an appointment for a particular service at a site to be provided by the Organization. Indicates if an appointment is required for access to this service. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .actrelationship[typeCode=PERT].observation
availableTime		0..*	BackboneElement	There are no (further) constraints on this element Element id HealthcareService.availableTime Short description Times the Service Site is available Definition A collection of times that the Service Site is available. Comments More detailed availability information may be provided in associated Schedule/Slot resources. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .effectiveTime
id		0..1	string	There are no (further) constraints on this element Element id HealthcareService.availableTime.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id HealthcareService.availableTime.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 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
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id HealthcareService.availableTime.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 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
daysOfWeek		0..*	codeBinding	There are no (further) constraints on this element Element id HealthcareService.availableTime.daysOfWeek Short description mon \| tue \| wed \| thu \| fri \| sat \| sun Definition Indicates which days of the week are available between the start and end Times. Data type code Binding The days of the week. DaysOfWeek (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .effectiveTime
allDay		0..1	boolean	There are no (further) constraints on this element Element id HealthcareService.availableTime.allDay Short description Always available? e.g. 24 hour service Definition Is this always available? (hence times are irrelevant) e.g. 24 hour service. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .effectiveTime
availableStartTime		0..1	time	There are no (further) constraints on this element Element id HealthcareService.availableTime.availableStartTime Short description Opening time of day (ignored if allDay = true) Definition The opening time of day. Note: If the AllDay flag is set, then this time is ignored. Comments The time zone is expected to be for where this HealthcareService is provided at. Data type time Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .effectiveTime
availableEndTime		0..1	time	There are no (further) constraints on this element Element id HealthcareService.availableTime.availableEndTime Short description Closing time of day (ignored if allDay = true) Definition The closing time of day. Note: If the AllDay flag is set, then this time is ignored. Comments The time zone is expected to be for where this HealthcareService is provided at. Data type time Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .effectiveTime
notAvailable		0..*	BackboneElement	There are no (further) constraints on this element Element id HealthcareService.notAvailable Short description Not available during this time due to provided reason Definition The HealthcareService is not available during this period of time due to the provided reason. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .effectiveTime
id		0..1	string	There are no (further) constraints on this element Element id HealthcareService.notAvailable.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id HealthcareService.notAvailable.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 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
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id HealthcareService.notAvailable.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 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
description		1..1	string	There are no (further) constraints on this element Element id HealthcareService.notAvailable.description Short description Reason presented to the user explaining why time not available Definition The reason that can be presented to the user as to why this time is not available. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
during		0..1	Period	There are no (further) constraints on this element Element id HealthcareService.notAvailable.during Short description Service not available from this date Definition Service is not available (seasonally or for a public holiday) from this date. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .effectiveTime
availabilityExceptions		0..1	string	There are no (further) constraints on this element Element id HealthcareService.availabilityExceptions Short description Description of availability exceptions Definition A description of site availability exceptions, e.g. public holiday availability. Succinctly describing all possible exceptions to normal site availability as details in the available Times and not available Times. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .effectiveTime
endpoint		0..*	Reference(Endpoint)	There are no (further) constraints on this element Element id HealthcareService.endpoint Short description Technical endpoints providing access to electronic services operated for the healthcare service Definition Technical endpoints providing access to services operated for the specific healthcare services defined at this resource. Data type Reference(Endpoint) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a

<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="ISiKMedizinischeBehandlungseinheit" />
    <url value="https://gematik.de/fhir/isik/StructureDefinition/ISiKMedizinischeBehandlungseinheit" />
    <version value="5.0.0-rc" />
    <name value="ISiKMedizinischeBehandlungseinheit" />
    <status value="active" />
    <experimental value="false" />
    <date value="2025-04-09" />
    <publisher value="gematik GmbH" />
    <description value="Unter einer medizinischen Behandlungseinheit wird hier im weiteren Sinne eine Dienstleistung (diagnostisch, therapeutisch, im weiten Sinne gesundheitsf&#246;rdernd etc.) zum Zweck einer Terminbuchung verstanden. Hierf&#252;r k&#246;nnen von der Fachabteilung (Organization) unabh&#228;ngige Kalender gepflegt werden. Im Kontext der Terminplanung k&#246;nnen somit angebotene Leistungen (z.B. CT/MRT-Untersuchungen, chirurgische Eingriffe, Beratungsstunden zur Geburt etc.) abgebildet werden.\n\nDer Kontext zu diesem Profil wird mit folgender User Story veranschaulicht: \n\n**User Story**: Ein Patient erh&#228;lt von seiner Haus&#228;rztin einen &#220;berweisungsschein f&#252;r eine weitere diagnostische Untersuchung in Form einer Kapselendoskopie der Speiser&#246;hre. Der Patient nutzt ein Patientenportal, um unter Angabe der ben&#246;tigten diagnostische Leistung nach einem verf&#252;gbaren Termin zu suchen und findet einen passenden Termin bei der Fachabteilung f&#252;r Gastroenterologie eines &#246;rtlichen Krankenhauses.\n\nHintergrund: Die Suche nach verf&#252;gbaren Terminenbl&#246;cken (Slot) unter Einbeziehung der Dienstleistung entspricht der Angabe des &#220;berweisungsscheins, erm&#246;glicht hier zugleich eine pr&#228;zisere Suche und vergr&#246;&#223;ert dar&#252;ber hinaus den Raum m&#246;glicher Termine &#252;ber verschiedene Abteilungen (und Institutionen im Patientenportal) hinweg." />
    <fhirVersion value="4.0.1" />
    <kind value="resource" />
    <abstract value="false" />
    <type value="HealthcareService" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/HealthcareService" />
    <derivation value="constraint" />
    <differential>
        <element id="HealthcareService.active">
            <path value="HealthcareService.active" />
            <comment value="Bedeutung: Ist der HealthcareService in aktiver Verwendung.\n  \n  Hinweis: Historische HealthcareServices k&#246;nnen ebenfalls &#252;ber die ISiK-Schnittstelle ausgetauscht werden. F&#252;r diese d&#252;rfen jedoch keine Termine vereinbart werden. Das terminf&#252;hrende System MUSS dies bei der Buchung &#252;berpr&#252;fen.\n  \n  Begr&#252;ndung Kardinalit&#228;t und Must-Support-Flag (MS): Die Kardinalit&#228;t 1..1 und das Must-Support-Flag (MS) f&#252;r das &#39;active&#39;-Element stellen sicher, dass jede Behandlungseinheit eindeutig als aktiv oder inaktiv gekennzeichnet ist. Dies ist entscheidend f&#252;r die Ressourcenplanung und Verf&#252;gbarkeit von Behandlungseinheiten." />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="HealthcareService.type">
            <path value="HealthcareService.type" />
            <comment value="**Bedeutung:** Klassifikation der Behandlungsleistung welche durch den HealthcareService erbracht wird\n\n**Hinweis:** Diese Klassifikation SOLL stets auch in Appointment.serviceType und Schedule.serviceType angegeben werden. Seitens der aktuellen Spezifikation werden keine Vorgaben bez&#252;glich der zu verwendenden Terminologie gemacht. Entsprechend verwendete Kataloge m&#252;ssen als CodeSystem- und ValueSet-Ressourcen exponiert werden. Siehe [Suchparameter &#39;context-type-value&#39; in ISiK Basis - Datenobjekt ValueSet](https://simplifier.net/resolve?&amp;scope=isik-basis-v4@current&amp;canonical=https://gematik.de/fhir/isik/StructureDefinition/ISiKValueSet).\n\n**Begr&#252;ndung Kardinalit&#228;t:** Eine Behandlungseinheit muss mindestens einen Typ haben, sodass im Rahmen der Terminplanung ermittelt werden kann, welcher Akteur f&#252;r die Durchf&#252;hrung eines Termins zur Verf&#252;gung steht." />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="HealthcareService.specialty">
            <path value="HealthcareService.specialty" />
            <comment value="**Bedeutung:** Fachrichtung der Behandlungsleistung welche durch den HealthcareService erbracht wird\n\n**Hinweis:** Diese Fachrichtung SOLL stets auch in Appointment.specialty und Schedule.specialty angegeben werden.\n  \n**Begr&#252;ndung Kardinalit&#228;t:** Eine Behandlungseinheit kann multiprofessionell sein und mehere Fachbereiche abdecken. Sie muss jedoch mindestens einem Fachbereich zugeordnet sein, sodass die Behandlungseinheit w&#228;hrend der Terminplanung als Akteur f&#252;r passende Termine miteinbezogen wird." />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="HealthcareService.specialty.coding">
            <path value="HealthcareService.specialty.coding" />
            <slicing>
                <discriminator>
                    <type value="pattern" />
                    <path value="$this" />
                </discriminator>
                <rules value="open" />
            </slicing>
            <comment value="**Begr&#252;ndung Kardinalit&#228;t Fachrichtung:** Die Kardinalit&#228;t der Fachrichtung-Eigenschaft wird auf 1..1 festgelegt, um sicherzustellen, dass genau eine Fachrichtung per IHE-XDS-Kodierung vorhanden ist. Dies ist notwendig, um die Spezialisierung der Behandlungseinheit eindeutig zu definieren und eine korrekte Zuordnung zu gew&#228;hrleisten.\n  \n  **Begr&#252;ndung Kardinalit&#228;t ErweiterterFachabteilungsschluessel:** Die Kardinalit&#228;t der ErweiterterFachabteilungsschluessel-Eigenschaft wird auf 0..1 festgelegt, um sicherzustellen, dass optional ein erweiterter Fachabteilungsschl&#252;ssel vorhanden sein kann." />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="HealthcareService.specialty.coding:Fachrichtung">
            <path value="HealthcareService.specialty.coding" />
            <sliceName value="Fachrichtung" />
            <comment value="Die Wahl des hinterlegten ValueSets (http://ihe-d.de/ValueSets/IHEXDSpracticeSettingCode) wurde mit einem Mitglied der IHE Deutschland Arbeitsgruppe XDS ValueSets (https://www.ihe-d.de/projekte/xds-value-sets-fuer-deutschland/) sowie mit der KBV abgestimmt (Stand:13.6.2024)." />
            <min value="1" />
            <max value="1" />
            <mustSupport value="true" />
            <binding>
                <strength value="required" />
                <valueSet value="http://ihe-d.de/ValueSets/IHEXDSpracticeSettingCode" />
            </binding>
        </element>
        <element id="HealthcareService.specialty.coding:ErweiterterFachabteilungsschluessel">
            <path value="HealthcareService.specialty.coding" />
            <sliceName value="ErweiterterFachabteilungsschluessel" />
            <comment value="Dieses ValueSet KANN &#252;ber ein Mapping (siehe Abschnitt https://wiki.hl7.de/index.php?title=IG:Value_Sets_f%C3%BCr_XDS#DocumentEntry.practiceSettingCode) mit dem ValueSet der Fachrichtung verkn&#252;pft werden und dar&#252;ber ggf. die Integration von Systemen erleichtern." />
            <min value="0" />
            <max value="1" />
            <binding>
                <strength value="required" />
                <valueSet value="http://fhir.de/ValueSet/dkgev/Fachabteilungsschluessel-erweitert" />
            </binding>
        </element>
        <element id="HealthcareService.name">
            <path value="HealthcareService.name" />
            <comment value="**Bedeutung:** Informeller Name der Behandlungseinheit\n\n**Hinweis:** Es wird im Rahmen dieser Spezifikation davon ausgegangen, dass f&#252;r einen HealthcareService keine nat&#252;rlichen Identifier vorliegen, die in einem realen Kontext vergeben werden. Somit kann durch den Namen ein informeller, jedoch identifizierender Bezeichner vergeben werden.\n\n**Begr&#252;ndung Kardinalit&#228;t:** Eine Behandlungseinheit muss mindestens einen Namen haben, um eine Wiedererkennbarkeit im Rahmen der Terminplanung zu gew&#228;hrleisten." />
            <min value="1" />
            <mustSupport value="true" />
        </element>
    </differential>
</StructureDefinition>

{
    "resourceType": "StructureDefinition",
    "id": "ISiKMedizinischeBehandlungseinheit",
    "url": "https://gematik.de/fhir/isik/StructureDefinition/ISiKMedizinischeBehandlungseinheit",
    "version": "5.0.0-rc",
    "name": "ISiKMedizinischeBehandlungseinheit",
    "status": "active",
    "experimental": false,
    "date": "2025-04-09",
    "publisher": "gematik GmbH",
    "description": "Unter einer medizinischen Behandlungseinheit wird hier im weiteren Sinne eine Dienstleistung (diagnostisch, therapeutisch, im weiten Sinne gesundheitsfördernd etc.) zum Zweck einer Terminbuchung verstanden. Hierfür können von der Fachabteilung (Organization) unabhängige Kalender gepflegt werden. Im Kontext der Terminplanung können somit angebotene Leistungen (z.B. CT/MRT-Untersuchungen, chirurgische Eingriffe, Beratungsstunden zur Geburt etc.) abgebildet werden.\n\nDer Kontext zu diesem Profil wird mit folgender User Story veranschaulicht: \n\n**User Story**: Ein Patient erhält von seiner Hausärztin einen Überweisungsschein für eine weitere diagnostische Untersuchung in Form einer Kapselendoskopie der Speiseröhre. Der Patient nutzt ein Patientenportal, um unter Angabe der benötigten diagnostische Leistung nach einem verfügbaren Termin zu suchen und findet einen passenden Termin bei der Fachabteilung für Gastroenterologie eines örtlichen Krankenhauses.\n\nHintergrund: Die Suche nach verfügbaren Terminenblöcken (Slot) unter Einbeziehung der Dienstleistung entspricht der Angabe des Überweisungsscheins, ermöglicht hier zugleich eine präzisere Suche und vergrößert darüber hinaus den Raum möglicher Termine über verschiedene Abteilungen (und Institutionen im Patientenportal) hinweg.",
    "fhirVersion": "4.0.1",
    "kind": "resource",
    "abstract": false,
    "type": "HealthcareService",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/HealthcareService",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "HealthcareService.active",
                "path": "HealthcareService.active",
                "comment": "Bedeutung: Ist der HealthcareService in aktiver Verwendung.\n  \n  Hinweis: Historische HealthcareServices können ebenfalls über die ISiK-Schnittstelle ausgetauscht werden. Für diese dürfen jedoch keine Termine vereinbart werden. Das terminführende System MUSS dies bei der Buchung überprüfen.\n  \n  Begründung Kardinalität und Must-Support-Flag (MS): Die Kardinalität 1..1 und das Must-Support-Flag (MS) für das 'active'-Element stellen sicher, dass jede Behandlungseinheit eindeutig als aktiv oder inaktiv gekennzeichnet ist. Dies ist entscheidend für die Ressourcenplanung und Verfügbarkeit von Behandlungseinheiten.",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "HealthcareService.type",
                "path": "HealthcareService.type",
                "comment": "**Bedeutung:** Klassifikation der Behandlungsleistung welche durch den HealthcareService erbracht wird\n\n**Hinweis:** Diese Klassifikation SOLL stets auch in Appointment.serviceType und Schedule.serviceType angegeben werden. Seitens der aktuellen Spezifikation werden keine Vorgaben bezüglich der zu verwendenden Terminologie gemacht. Entsprechend verwendete Kataloge müssen als CodeSystem- und ValueSet-Ressourcen exponiert werden. Siehe [Suchparameter 'context-type-value' in ISiK Basis - Datenobjekt ValueSet](https://simplifier.net/resolve?&scope=isik-basis-v4@current&canonical=https://gematik.de/fhir/isik/StructureDefinition/ISiKValueSet).\n\n**Begründung Kardinalität:** Eine Behandlungseinheit muss mindestens einen Typ haben, sodass im Rahmen der Terminplanung ermittelt werden kann, welcher Akteur für die Durchführung eines Termins zur Verfügung steht.",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "HealthcareService.specialty",
                "path": "HealthcareService.specialty",
                "comment": "**Bedeutung:** Fachrichtung der Behandlungsleistung welche durch den HealthcareService erbracht wird\n\n**Hinweis:** Diese Fachrichtung SOLL stets auch in Appointment.specialty und Schedule.specialty angegeben werden.\n  \n**Begründung Kardinalität:** Eine Behandlungseinheit kann multiprofessionell sein und mehere Fachbereiche abdecken. Sie muss jedoch mindestens einem Fachbereich zugeordnet sein, sodass die Behandlungseinheit während der Terminplanung als Akteur für passende Termine miteinbezogen wird.",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "HealthcareService.specialty.coding",
                "path": "HealthcareService.specialty.coding",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "pattern",
                            "path": "$this"
                        }
                    ],
                    "rules": "open"
                },
                "comment": "**Begründung Kardinalität Fachrichtung:** Die Kardinalität der Fachrichtung-Eigenschaft wird auf 1..1 festgelegt, um sicherzustellen, dass genau eine Fachrichtung per IHE-XDS-Kodierung vorhanden ist. Dies ist notwendig, um die Spezialisierung der Behandlungseinheit eindeutig zu definieren und eine korrekte Zuordnung zu gewährleisten.\n  \n  **Begründung Kardinalität ErweiterterFachabteilungsschluessel:** Die Kardinalität der ErweiterterFachabteilungsschluessel-Eigenschaft wird auf 0..1 festgelegt, um sicherzustellen, dass optional ein erweiterter Fachabteilungsschlüssel vorhanden sein kann.",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "HealthcareService.specialty.coding:Fachrichtung",
                "path": "HealthcareService.specialty.coding",
                "sliceName": "Fachrichtung",
                "comment": "Die Wahl des hinterlegten ValueSets (http://ihe-d.de/ValueSets/IHEXDSpracticeSettingCode) wurde mit einem Mitglied der IHE Deutschland Arbeitsgruppe XDS ValueSets (https://www.ihe-d.de/projekte/xds-value-sets-fuer-deutschland/) sowie mit der KBV abgestimmt (Stand:13.6.2024).",
                "min": 1,
                "max": "1",
                "mustSupport": true,
                "binding": {
                    "strength": "required",
                    "valueSet": "http://ihe-d.de/ValueSets/IHEXDSpracticeSettingCode"
                }
            },
            {
                "id": "HealthcareService.specialty.coding:ErweiterterFachabteilungsschluessel",
                "path": "HealthcareService.specialty.coding",
                "sliceName": "ErweiterterFachabteilungsschluessel",
                "comment": "Dieses ValueSet KANN über ein Mapping (siehe Abschnitt https://wiki.hl7.de/index.php?title=IG:Value_Sets_f%C3%BCr_XDS#DocumentEntry.practiceSettingCode) mit dem ValueSet der Fachrichtung verknüpft werden und darüber ggf. die Integration von Systemen erleichtern.",
                "min": 0,
                "max": "1",
                "binding": {
                    "strength": "required",
                    "valueSet": "http://fhir.de/ValueSet/dkgev/Fachabteilungsschluessel-erweitert"
                }
            },
            {
                "id": "HealthcareService.name",
                "path": "HealthcareService.name",
                "comment": "**Bedeutung:** Informeller Name der Behandlungseinheit\n\n**Hinweis:** Es wird im Rahmen dieser Spezifikation davon ausgegangen, dass für einen HealthcareService keine natürlichen Identifier vorliegen, die in einem realen Kontext vergeben werden. Somit kann durch den Namen ein informeller, jedoch identifizierender Bezeichner vergeben werden.\n\n**Begründung Kardinalität:** Eine Behandlungseinheit muss mindestens einen Namen haben, um eine Wiedererkennbarkeit im Rahmen der Terminplanung zu gewährleisten.",
                "min": 1,
                "mustSupport": true
            }
        ]
    }
}

ISiKMedizinischeBehandlungseinheit

Constraints/Invarianten

Terminology-Bindings

Element	Staerke	ValueSet
HealthcareService.specialty.coding:Fachrichtung	required	http://ihe-d.de/ValueSets/IHEXDSpracticeSettingCode
HealthcareService.specialty.coding:ErweiterterFachabteilungsschluessel	required	http://fhir.de/ValueSet/dkgev/Fachabteilungsschluessel-erweitert

Anmerkungen zu Must-Support-Feldern

Feldname	Hinweise
HealthcareService.active	Bedeutung: Ist der HealthcareService in aktiver Verwendung. Hinweis: Historische HealthcareServices können ebenfalls über die ISiK-Schnittstelle ausgetauscht werden. Für diese dürfen jedoch keine Termine vereinbart werden. Das terminführende System MUSS dies bei der Buchung überprüfen. Begründung Kardinalität und Must-Support-Flag (MS): Die Kardinalität 1..1 und das Must-Support-Flag (MS) für das 'active'-Element stellen sicher, dass jede Behandlungseinheit eindeutig als aktiv oder inaktiv gekennzeichnet ist. Dies ist entscheidend für die Ressourcenplanung und Verfügbarkeit von Behandlungseinheiten.
HealthcareService.type	Bedeutung: Klassifikation der Behandlungsleistung welche durch den HealthcareService erbracht wird Hinweis: Diese Klassifikation SOLL stets auch in Appointment.serviceType und Schedule.serviceType angegeben werden. Seitens der aktuellen Spezifikation werden keine Vorgaben bezüglich der zu verwendenden Terminologie gemacht. Entsprechend verwendete Kataloge müssen als CodeSystem- und ValueSet-Ressourcen exponiert werden. Siehe Suchparameter 'context-type-value' in ISiK Basis - Datenobjekt ValueSet. Begründung Kardinalität: Eine Behandlungseinheit muss mindestens einen Typ haben, sodass im Rahmen der Terminplanung ermittelt werden kann, welcher Akteur für die Durchführung eines Termins zur Verfügung steht.
HealthcareService.specialty	Bedeutung: Fachrichtung der Behandlungsleistung welche durch den HealthcareService erbracht wird Hinweis: Diese Fachrichtung SOLL stets auch in Appointment.specialty und Schedule.specialty angegeben werden. Begründung Kardinalität: Eine Behandlungseinheit kann multiprofessionell sein und mehere Fachbereiche abdecken. Sie muss jedoch mindestens einem Fachbereich zugeordnet sein, sodass die Behandlungseinheit während der Terminplanung als Akteur für passende Termine miteinbezogen wird.
HealthcareService.specialty.coding	Begründung Kardinalität Fachrichtung: Die Kardinalität der Fachrichtung-Eigenschaft wird auf 1..1 festgelegt, um sicherzustellen, dass genau eine Fachrichtung per IHE-XDS-Kodierung vorhanden ist. Dies ist notwendig, um die Spezialisierung der Behandlungseinheit eindeutig zu definieren und eine korrekte Zuordnung zu gewährleisten. Begründung Kardinalität ErweiterterFachabteilungsschluessel: Die Kardinalität der ErweiterterFachabteilungsschluessel-Eigenschaft wird auf 0..1 festgelegt, um sicherzustellen, dass optional ein erweiterter Fachabteilungsschlüssel vorhanden sein kann.
HealthcareService.specialty.coding:Fachrichtung	Die Wahl des hinterlegten ValueSets (http://ihe-d.de/ValueSets/IHEXDSpracticeSettingCode) wurde mit einem Mitglied der IHE Deutschland Arbeitsgruppe XDS ValueSets (https://www.ihe-d.de/projekte/xds-value-sets-fuer-deutschland/) sowie mit der KBV abgestimmt (Stand:13.6.2024).
HealthcareService.name	Bedeutung: Informeller Name der Behandlungseinheit Hinweis: Es wird im Rahmen dieser Spezifikation davon ausgegangen, dass für einen HealthcareService keine natürlichen Identifier vorliegen, die in einem realen Kontext vergeben werden. Somit kann durch den Namen ein informeller, jedoch identifizierender Bezeichner vergeben werden. Begründung Kardinalität: Eine Behandlungseinheit muss mindestens einen Namen haben, um eine Wiedererkennbarkeit im Rahmen der Terminplanung zu gewährleisten.

Anmerkungen zu Must-Support-Feldern

`HealthcareService.active`

Bedeutung: Ist der HealthcareService in aktiver Verwendung.

Hinweis: Historische HealthcareServices können ebenfalls über die ISiK-Schnittstelle ausgetauscht werden. Für diese dürfen jedoch keine Termine vereinbart werden. Das terminführende System MUSS dies bei der Buchung überprüfen.

`HealthcareService.type`

Bedeutung: Klassifikation der Behandlungsleistung welche durch den HealthcareService erbracht wird

Hinweis: Diese Klassifikation SOLL stets auch in Appointment.serviceType und Schedule.serviceType angegeben werden. Seitens der aktuellen Spezifikation werden keine Vorgaben bezüglich der zu verwendenden Terminologie gemacht. Entsprechend verwendete Kataloge müssen als CodeSystem- und ValueSet-Ressourcen exponiert werden.

`HealthcareService.specialty`

Bedeutung: Fachrichtung der Behandlungsleistung welche durch den HealthcareService erbracht wird

Hinweis: Diese Fachrichtung SOLL stets auch in Appointment.specialty und Schedule.specialty angegeben werden.

`HealthcareService.name`

Bedeutung: Informeller Name der Behandlungseinheit

Hinweis: Es wird im Rahmen dieser Spezifikation davon ausgegangen, dass für einen HealthcareService keine natürlichen Identifier vorliegen, die in einem realen Kontext vergeben werden. Somit kann durch den Namen ein informeller, jedoch identifizierender Bezeichner vergeben werden.

Interaktionen

Interaktion	Verbindlichkeit
read	SHALL
search-type	SHALL

Parameter	Typ	Verbindlichkeit	Hinweise
_id	token	SHALL	Beispiel: `GET [base]/[Resourcetype]?_id=103270` Anwendungshinweis: Der Parameter `_id` wird selten alleinstehend verwendet, da sich zum Abruf einer Ressource anhand der `id` die `READ`-Interaktion besser anbietet. Der Parameter kann jedoch verwendet werden, um den Abruf einer Ressource bspw. mit einem `_include` weiterer Ressourcen zu verbinden, z.B. zum Abruf eines Encounters in Verbindung mit dem zugehörigen Patienten: `GET [base]/Encounter?_id=103270&_include=Encounter:patient` Weitere Details siehe FHIR-Kernspezifikation, Abschnitt Parameters for all resources. Dieser Suchparameter ist für die Umsetzung des IHE PDQm Profils verpflichtend.
_tag	token	SHALL	Beispiel: `GET [base]/[Resourcetype]?_tag=https://example.org/codes\|needs-review` Anwendungshinweis: Weitere Details siehe FHIR-Kernspezifikation, Abschnitt Parameters for all resources sowie Abschnitt Tags.
_count	number	SHALL	Beispiel: `GET [base]/[Resourcetype]?_count=100` Anwendungshinweis: Weitere Details siehe FHIR-Kernspezifikation, Abschnitt Page Count.
_has	string	MAY	Beispiel: Suche nach allen Patienten, die eine Observation mit dem Code '1234-5' haben `GET [base]/Patient?_has:Observation:patient:code=1234-5` Beispiel: Suche nach allen Encountern, bei denen die Diagnose 'A12.3' gestellt wurde `GET [base]/Encounter?_has:Condition:encounter:code=A12.3` Anwendungshinweis: Weitere Details siehe FHIR-Kernspezifikation, Abschnitt Reverse Chaining.
active	token	SHALL	Beispiel: `GET [base]/HealthcareService?active=true` Anwendungshinweis: Weitere Details siehe FHIR-Kernspezifikation.
service-type	token	SHALL	Beispiel: `GET [base]/HealthcareService?service-type=http://example.org/fhir/CodeSystem/ScheduleServiceType\|CT` Anwendungshinweis: Weitere Details siehe FHIR-Kernspezifikation.
specialty	token	SHALL	Beispiel: `GET [base]/HealthcareService?specialty=urn:oid:1.2.276.0.76.5.114\|535` Anwendungshinweis: Weitere Details siehe FHIR-Kernspezifikation.
name	string	SHALL	Beispiel: `GET [base]/HealthcareService?name=Medizinische Behandlungseinheit Des Fachbereichs 0100` Anwendungshinweis: Weitere Details siehe FHIR-Kernspezifikation.

(Reverse-)Include

Include
Schedule:actor; Appointment:actor

Command 'pagelink' could not render: Page not found.

Beispiele

HealthcareService

id : ISiKMedizinischeBehandlungseinheitExample

meta

profile : https://gematik.de/fhir/isik/StructureDefinition/ISiKMedizinischeBehandlungseinheit

active : True

type

coding

system : http://terminology.hl7.org/CodeSystem/service-type

code : 124

specialty

coding

system : http://ihe-d.de/CodeSystems/AerztlicheFachrichtungen

code : ALLG

name : Allgemeine Beratungsstelle der Fachabteilung 0100

<HealthcareService xmlns="http://hl7.org/fhir">
    <id value="ISiKMedizinischeBehandlungseinheitExample" />
    <meta>
        <profile value="https://gematik.de/fhir/isik/StructureDefinition/ISiKMedizinischeBehandlungseinheit" />
    </meta>
    <active value="true" />
    <type>
        <coding>
            <system value="http://terminology.hl7.org/CodeSystem/service-type" />
            <code value="124" />
        </coding>
    </type>
    <specialty>
        <coding>
            <system value="http://ihe-d.de/CodeSystems/AerztlicheFachrichtungen" />
            <code value="ALLG" />
        </coding>
    </specialty>
    <name value="Allgemeine Beratungsstelle der Fachabteilung 0100" />
</HealthcareService>

{
    "resourceType": "HealthcareService",
    "id": "ISiKMedizinischeBehandlungseinheitExample",
    "meta": {
        "profile":  [
            "https://gematik.de/fhir/isik/StructureDefinition/ISiKMedizinischeBehandlungseinheit"
        ]
    },
    "active": true,
    "type":  [
        {
            "coding":  [
                {
                    "code": "124",
                    "system": "http://terminology.hl7.org/CodeSystem/service-type"
                }
            ]
        }
    ],
    "specialty":  [
        {
            "coding":  [
                {
                    "code": "ALLG",
                    "system": "http://ihe-d.de/CodeSystems/AerztlicheFachrichtungen"
                }
            ]
        }
    ],
    "name": "Allgemeine Beratungsstelle der Fachabteilung 0100"
}

Allgemeine Beratungsstelle der Fachabteilung 0100