MII IG Onkologie DE v2024

Tumorkonferenz: CarePlan

Dieses Profil beschreibt die Tumorkonferenz und die Therapieempfehlungen. Die Datenfelder sind seit der Version 2021 Teil des oBDS und werden in zwei verschiedenen Modulen erfasst. Da alle beteiligten Felder sehr gut über die FHIR CarePlan-Ressource abbildbar sind, wurden alle die Tumorkonferenz- und Therapieemfpehlungsfelder im Tumorkonferenz-Profil zusammengefasst.

Das Tumorkonferenz-Profil umfasst daher

die Referenz auf Patient über subject
die Referenz auf die Primärdiagnose über addresses.
die Kategorie des Plans nach oBDS über category
das Datum über created
einzelne Empfehlungen (activity)mit jeweils den folgenden Elementen:
- die oBDS-Kodierung der vorgeschlagenen Therapiemaßnahmecode
- Der Status der einzelnen Aktivitäten unterstatus gemäß den HL7 FHIR status codes
- Bei Abbruch: Die Angabe, ob therapiespezifisch auf Wunsch des Patienten abgebrochen wurde, unter statusReason

Die CarePlan-Ressource sieht eine verpflichtende Angabe des status-Elements einer activity vor. Diese Informationen sind in dieser Form nicht im oBDS enthalten. Die tatsächlich erfolgten Therapien werden jedoch in den Krebsregisterdaten erfasst und SOLLEN über Procedure.basedOn(Reference(CarePlan)) auf die Tumorkonferenz-Ressource verweisen.

Die Statusangaben geben den tatsächlichen Stand der Therapieempfehlung wieder. Für alle Statusangaben gilt das offizielle FHIR CarePlanActivityStatus-CodeSet.
https://www.hl7.org/fhir/R4/valueset-care-plan-activity-status.html
Es SOLLTEN folgende Status-Codes verwendet werden:

completed bei abgeschlossener Therapie,
on-hold bei Therapieunterbrechung für noch nicht gestartete Therapie
stopped bei Therapieunterbrechung für bereits gestarteter Therapie
unknown für unbekannt, soweit keine Informationen über den Status vorliegen.

Bei den Statusangaben on-hold und stopped SOLL das Feld statusReason mit den Angaben aus dem oBDS-Feld 'Therapieabweichung auf Wunsch des Patienten' befüllt werden.

Jede Tumorkonferenz mit Therapieempfehlung SOLL als einzelne Ressource gespeichert und über CarePlan.addresses(Reference(Condition)) auf die Primärdiagnose referenzieren.

Name	Status	Version	Canonical	Basis
MII_PR_Onko_Tumorkonferenz	draft	2024.0.0-ballot	https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-tumorkonferenz	http://hl7.org/fhir/StructureDefinition/CarePlan

Inhalt

MII_PR_Onko_Tumorkonferenz (CarePlan)	I		CarePlan	There are no (further) constraints on this element Element id CarePlan Short description Healthcare plan for patient or group Alternate names Care Team Definition Describes the intention of how one or more practitioners intend to deliver care for a particular patient, group or community for a period of time, possibly limited to care for a specific condition or set of conditions. Data type CarePlan 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()` Mappings rim: Entity. Role, or Act workflow: Request rim: Act[classCode=PCPR, moodCode=INT]
id	Σ	0..1	string	There are no (further) constraints on this element Element id CarePlan.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 CarePlan.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())` Mappings rim: n/a rim: N/A
id		0..1	string	There are no (further) constraints on this element Element id CarePlan.meta.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 CarePlan.meta.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 rim: N/A
versionId	Σ	0..1	id	There are no (further) constraints on this element Element id CarePlan.meta.versionId Short description Version specific identifier Definition The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. Comments The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes. Data type id Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
lastUpdated	Σ	0..1	instant	There are no (further) constraints on this element Element id CarePlan.meta.lastUpdated Short description When the resource version last changed Definition When the resource last changed - e.g. when the version changed. Comments This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction. Data type instant Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
source	Σ	0..1	uri	There are no (further) constraints on this element Element id CarePlan.meta.source Short description Identifies where the resource comes from Definition A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc. Comments In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL. 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
profile	S Σ	0..*	canonical(StructureDefinition)	There are no (further) constraints on this element Element id CarePlan.meta.profile Short description Profiles this resource claims to conform to Definition A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. Comments It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set. Data type canonical(StructureDefinition) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
security	Σ	0..*	CodingBinding	There are no (further) constraints on this element Element id CarePlan.meta.security Short description Security Labels applied to this resource Definition Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. Comments The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored. 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
tag	Σ	0..*	Coding	There are no (further) constraints on this element Element id CarePlan.meta.tag Short description Tags applied to this resource Definition Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. Comments The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored. Data type Coding Binding Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". CommonTags (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 subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id CarePlan.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())` Mappings rim: n/a
language		0..1	codeBinding	There are no (further) constraints on this element Element id CarePlan.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())` Mappings rim: n/a
text		0..1	Narrative	There are no (further) constraints on this element Element id CarePlan.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: n/a rim: N/A rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id CarePlan.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: Entity. Role, or Act rim: N/A
extension	I	0..*	Extension	There are no (further) constraints on this element Element id CarePlan.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) 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 rim: N/A
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id CarePlan.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) 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 rim: N/A
identifier	S Σ	0..*	Identifier	There are no (further) constraints on this element Element id CarePlan.identifier Short description External Ids for this plan Definition Business identifiers assigned to this care plan by the performer or other systems which remain constant as the resource is updated and propagates from server to server. Requirements Allows identification of the care plan as it is known by various participating systems and in a way that remains consistent across servers. Comments This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` 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: Request.identifier w5: FiveWs.identifier v2: PTH-3 rim: .id
instantiatesCanonical	Σ	0..*	canonical(PlanDefinition \| Questionnaire \| Measure \| ActivityDefinition \| OperationDefinition)	There are no (further) constraints on this element Element id CarePlan.instantiatesCanonical Short description Instantiates FHIR protocol or definition Definition The URL pointing to a FHIR-defined protocol, guideline, questionnaire or other definition that is adhered to in whole or in part by this CarePlan. Comments see Canonical References Data type canonical(PlanDefinition \| Questionnaire \| Measure \| ActivityDefinition \| OperationDefinition) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Request.instantiatesCanonical rim: .outboundRelationship[typeCode=DEFN].target
instantiatesUri	Σ	0..*	uri	There are no (further) constraints on this element Element id CarePlan.instantiatesUri Short description Instantiates external protocol or definition Definition The URL pointing to an externally maintained protocol, guideline, questionnaire or other definition that is adhered to in whole or in part by this CarePlan. Comments This might be an HTML page, PDF, etc. or could just be a non-resolvable URI 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 workflow: Request.instantiatesUri rim: .outboundRelationship[typeCode=DEFN].target
basedOn	Σ I	0..*	Reference(CarePlan)	There are no (further) constraints on this element Element id CarePlan.basedOn Short description Fulfills CarePlan Alternate names fulfills Definition A care plan that is fulfilled in whole or in part by this care plan. Requirements Allows tracing of the care plan and tracking whether proposals/recommendations were acted upon. 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(CarePlan) 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: Request.basedOn
replaces	Σ I	0..*	Reference(CarePlan)	There are no (further) constraints on this element Element id CarePlan.replaces Short description CarePlan replaced by this CarePlan Alternate names supersedes Definition Completed or terminated care plan whose function is taken by this new care plan. Requirements Allows tracing the continuation of a therapy or administrative process instantiated through multiple care plans. Comments The replacement could be because the initial care plan was immediately rejected (due to an issue) or because the previous care plan was completed, but the need for the action described by the care plan remains ongoing. Data type Reference(CarePlan) 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: Request.replaces
partOf	Σ I	0..*	Reference(CarePlan)	There are no (further) constraints on this element Element id CarePlan.partOf Short description Part of referenced CarePlan Definition A larger care plan of which this particular care plan is a component or step. Comments Each care plan is an independent request, such that having a care plan be part of another care plan can cause issues with cascading statuses. As such, this element is still being discussed. Data type Reference(CarePlan) 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)
status	S Σ ?!	1..1	codeBinding	There are no (further) constraints on this element Element id CarePlan.status Short description draft \| active \| on-hold \| revoked \| completed \| entered-in-error \| unknown Definition Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record. Requirements Allows clinicians to determine whether the plan is actionable or not. Comments The unknown code is not to be used to convey other statuses. The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the care plan. This element is labeled as a modifier because the status contains the code entered-in-error that marks the plan as not currently valid. Data type code Binding Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record. RequestStatus (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Request.status {uses different ValueSet} w5: FiveWs.status v2: PTH-5 rim: .statusCode planned = new active = active completed = completed
intent	S Σ ?!	1..1	codeBinding	There are no (further) constraints on this element Element id CarePlan.intent Short description proposal \| plan \| order \| option Definition Indicates the level of authority/intentionality associated with the care plan and where the care plan fits into the workflow chain. Requirements Proposals/recommendations, plans and orders all use the same structure and can exist in the same fulfillment chain. Comments This element is labeled as a modifier because the intent alters when and how the resource is actually applicable. Data type code Binding Codes indicating the degree of authority/intentionality associated with a care plan. CarePlanIntent (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Request.intent
category	S Σ	1..1	CodeableConcept	There are no (further) constraints on this element Element id CarePlan.category Short description Type of plan Definition Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", "wellness plan", etc. Requirements Used for filtering what plan(s) are retrieved and displayed to different types of users. Comments There may be multiple axes of categorization and one plan may serve multiple purposes. In some cases, this may be redundant with references to CarePlan.concern. Data type CodeableConcept Binding Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc. CarePlanCategory (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 w5: FiveWs.class
id		0..1	string	There are no (further) constraints on this element Element id CarePlan.category.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 CarePlan.category.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 rim: N/A
coding	S Σ	1..*	CodingBinding	Element id CarePlan.category.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 Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Binding MII_VS_Onko_Therapieplanung_Typ (required) 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 v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	string	There are no (further) constraints on this element Element id CarePlan.category.coding.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 CarePlan.category.coding.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 rim: N/A
system	S Σ	1..1	uriPattern	Element id CarePlan.category.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapieplanung-typ Mappings rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id CarePlan.category.coding.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. 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 v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	S Σ	1..1	code	Element id CarePlan.category.coding.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code oBDS: 18.2
display	Σ	0..1	string	There are no (further) constraints on this element Element id CarePlan.category.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size 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 v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id CarePlan.category.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. 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 v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
text	Σ	0..1	string	There are no (further) constraints on this element Element id CarePlan.category.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 rim: n/a 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
title	Σ	0..1	string	There are no (further) constraints on this element Element id CarePlan.title Short description Human-friendly name for the care plan Definition Human-friendly name for the care plan. Comments Note that FHIR strings SHALL NOT exceed 1MB in size 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
description	Σ	0..1	string	There are no (further) constraints on this element Element id CarePlan.description Short description Summary of nature of plan Definition A description of the scope and nature of the plan. Requirements Provides more detail than conveyed by category. Comments Note that FHIR strings SHALL NOT exceed 1MB in size 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 w5: FiveWs.what[x]
subject	S Σ I	1..1	Reference(Patient)	Element id CarePlan.subject Short description Who the care plan is for Alternate names patient Definition Identifies the patient or group whose intended care is described by the plan. 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) 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: Request.subject w5: FiveWs.subject[x] v2: PID-3 rim: .participation[typeCode=PAT].role[classCode=PAT] w5: FiveWs.subject
encounter	S Σ I	0..1	Reference(Encounter)	There are no (further) constraints on this element Element id CarePlan.encounter Short description Encounter created as part of Definition The Encounter during which this CarePlan was created or to which the creation of this record is tightly associated. Comments This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. CarePlan activities conducted as a result of the care plan may well occur as part of other encounters. Data type Reference(Encounter) 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: Request.context w5: FiveWs.context v2: Associated PV1 rim: .
period	Σ I	0..1	Period	There are no (further) constraints on this element Element id CarePlan.period Short description Time period plan covers Alternate names timing Definition Indicates when the plan did (or is intended to) come into effect and end. Requirements Allows tracking what plan(s) are in effect at a particular time. Comments Any activities scheduled as part of the plan should be constrained to the specified period regardless of whether the activities are planned within a single encounter/episode or across multiple encounters/episodes (e.g. the longitudinal management of a chronic condition). 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"] workflow: Request.occurrence[x] w5: FiveWs.planned v2: GOL-7 / GOL-8 rim: .effectiveTime
created	S Σ	1..1	dateTime	Element id CarePlan.created Short description Date record was first recorded Alternate names authoredOn Definition Represents when this particular CarePlan record was created in the system, which is often a system-generated date. 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: Request.authoredOn w5: FiveWs.recorded rim: .participation[typeCode=AUT].time oBDS: 18.1
author	Σ I	0..1	Reference(Patient \| Practitioner \| PractitionerRole \| Device \| RelatedPerson \| Organization \| CareTeam)	There are no (further) constraints on this element Element id CarePlan.author Short description Who is the designated responsible party Definition When populated, the author is responsible for the care plan. The care plan is attributed to the author. Comments The author may also be a contributor. For example, an organization can be an author, but not listed as a contributor. Data type Reference(Patient \| Practitioner \| PractitionerRole \| Device \| RelatedPerson \| Organization \| CareTeam) 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: Request.requester w5: FiveWs.author
contributor	I	0..*	Reference(Patient \| Practitioner \| PractitionerRole \| Device \| RelatedPerson \| Organization \| CareTeam)	There are no (further) constraints on this element Element id CarePlan.contributor Short description Who provided the content of the care plan Definition Identifies the individual(s) or organization who provided the contents of the care plan. Comments Collaborative care plans may have multiple contributors. Data type Reference(Patient \| Practitioner \| PractitionerRole \| Device \| RelatedPerson \| Organization \| CareTeam) 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)
careTeam	I	0..*	Reference(CareTeam)	There are no (further) constraints on this element Element id CarePlan.careTeam Short description Who's involved in plan? Definition Identifies all people and organizations who are expected to be involved in the care envisioned by this plan. Requirements Allows representation of care teams, helps scope care plan. In some cases may be a determiner of access permissions. 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(CareTeam) 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: Request.performer {similar but does not entail CareTeam} w5: FiveWs.actor
addresses	S Σ I	0..*	Reference(Condition)	There are no (further) constraints on this element Element id CarePlan.addresses Short description Health issues this plan addresses Definition Identifies the conditions/problems/concerns/diagnoses/etc. whose management and/or mitigation are handled by this plan. Requirements Links plan to the conditions it manages. The element can identify risks addressed by the plan as well as active conditions. (The Condition resource can include things like "at risk for hypertension" or "fall risk".) Also scopes plans - multiple plans may exist addressing different concerns. Comments When the diagnosis is related to an allergy or intolerance, the Condition and AllergyIntolerance resources can both be used. However, to be actionable for decision support, using Condition alone is not sufficient as the allergy or intolerance condition needs to be represented as an AllergyIntolerance. Data type Reference(Condition) 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: Request.reasonReference w5: FiveWs.why[x] v2: PRB-4 rim: .actRelationship[typeCode=SUBJ].target[classCode=CONC, moodCode=EVN]
supportingInfo	S I	0..*	Reference(Resource)	There are no (further) constraints on this element Element id CarePlan.supportingInfo Short description Information considered as part of plan Definition Identifies portions of the patient's record that specifically influenced the formation of the plan. These might include comorbidities, recent procedures, limitations, recent assessments, etc. Requirements Identifies barriers and other considerations associated with the care plan. Comments Use "concern" to identify specific conditions addressed by the care plan. 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) workflow: Request.supportingInfo
goal	I	0..*	Reference(Goal)	There are no (further) constraints on this element Element id CarePlan.goal Short description Desired outcome of plan Definition Describes the intended objective(s) of carrying out the care plan. Requirements Provides context for plan. Allows plan effectiveness to be evaluated by clinicians. Comments Goal can be achieving a particular change or merely maintaining a current state or even slowing a decline. Data type Reference(Goal) 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) v2: GOL.1 rim: .outboundRelationship[typeCode<=OBJ].
activity	S I	0..*	BackboneElement	There are no (further) constraints on this element Element id CarePlan.activity Short description Action to occur as part of plan Definition Identifies a planned action to occur as part of the plan. For example, a medication to be used, lab tests to perform, self-monitoring, education, etc. Requirements Allows systems to prompt for performance of planned activities, and validate plans against best practice. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` cpl-3: Provide a reference or detail, not both `detail.empty() or reference.empty()` Mappings rim: n/a workflow: {no mapping NOTE: This is a list of contained Request-Event tuples!} rim: .outboundRelationship[typeCode=COMP].target
id		0..1	string	There are no (further) constraints on this element Element id CarePlan.activity.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 CarePlan.activity.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 rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id CarePlan.activity.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 rim: N/A
outcomeCodeableConcept		0..*	CodeableConcept	There are no (further) constraints on this element Element id CarePlan.activity.outcomeCodeableConcept Short description Results of the activity Definition Identifies the outcome at the point when the status of the activity is assessed. For example, the outcome of an education activity could be patient understands (or not). Comments Note that this should not duplicate the activity status (e.g. completed or in progress). Data type CodeableConcept Binding Identifies the results of the activity. CarePlanActivityOutcome (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
outcomeReference	I	0..*	Reference(Resource)	There are no (further) constraints on this element Element id CarePlan.activity.outcomeReference Short description Appointment, Encounter, Procedure, etc. Definition Details of the outcome or action resulting from the activity. The reference to an "event" resource, such as Procedure or Encounter or Observation, is the result/outcome of the activity itself. The activity can be conveyed using CarePlan.activity.detail OR using the CarePlan.activity.reference (a reference to a “request” resource). Requirements Links plan to resulting actions. Comments The activity outcome is independent of the outcome of the related goal(s). For example, if the goal is to achieve a target body weight of 150 lbs and an activity is defined to diet, then the activity outcome could be calories consumed whereas the goal outcome is an observation for the actual body weight measured. 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) workflow: {Event that is outcome of Request in activity.reference} rim: .inboundRelationship[typeCode=FLFS].source
progress		0..*	Annotation	There are no (further) constraints on this element Element id CarePlan.activity.progress Short description Comments about the activity status/progress Definition Notes about the adherence/status/progress of the activity. Requirements Can be used to capture information about adherence, progress, concerns, etc. Comments This element should NOT be used to describe the activity to be performed - that occurs either within the resource pointed to by activity.detail.reference or in activity.detail.description. Data type Annotation Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: N/A rim: Act v2: NTE? rim: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="annotation"].value
reference	I	0..1	Reference(Appointment \| CommunicationRequest \| DeviceRequest \| MedicationRequest \| NutritionOrder \| Task \| ServiceRequest \| VisionPrescription \| RequestGroup)	There are no (further) constraints on this element Element id CarePlan.activity.reference Short description Activity details defined in specific resource Definition The details of the proposed activity represented in a specific resource. Requirements Details in a form consistent with other applications and contexts of use. Comments Standard extension exists (resource-pertainsToGoal) that allows goals to be referenced from any of the referenced resources in CarePlan.activity.reference. The goal should be visible when the resource referenced by CarePlan.activity.reference is viewed independently from the CarePlan. Requests that are pointed to by a CarePlan using this element should not point to this CarePlan using the "basedOn" element. i.e. Requests that are part of a CarePlan are not "based on" the CarePlan. Data type Reference(Appointment \| CommunicationRequest \| DeviceRequest \| MedicationRequest \| NutritionOrder \| Task \| ServiceRequest \| VisionPrescription \| RequestGroup) 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: {Request that resulted in Event in activity.actionResulting} rim: .outboundRelationship[typeCode=COMP].target
detail	S I	1..1	BackboneElement	There are no (further) constraints on this element Element id CarePlan.activity.detail Short description In-line definition of activity Definition A simple summary of a planned activity suitable for a general care plan system (e.g. form driven) that doesn't know about specific resources such as procedure etc. Requirements Details in a simple form for generic care plan systems. 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: .outboundRelationship[typeCode=COMP, subsetCode=SUMM].target
id		0..1	string	There are no (further) constraints on this element Element id CarePlan.activity.detail.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 CarePlan.activity.detail.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 rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id CarePlan.activity.detail.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 rim: N/A
kind		0..1	codeBinding	There are no (further) constraints on this element Element id CarePlan.activity.detail.kind Short description Appointment \| CommunicationRequest \| DeviceRequest \| MedicationRequest \| NutritionOrder \| Task \| ServiceRequest \| VisionPrescription Definition A description of the kind of resource the in-line definition of a care plan activity is representing. The CarePlan.activity.detail is an in-line definition when a resource is not referenced using CarePlan.activity.reference. For example, a MedicationRequest, a ServiceRequest, or a CommunicationRequest. Requirements May determine what types of extensions are permitted. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Binding Resource types defined as part of FHIR that can be represented as in-line definitions of a care plan activity. CarePlanActivityKind (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: .inboundRelationship[typeCode=COMP].source[classCode=LIST].code
instantiatesCanonical		0..*	canonical(PlanDefinition \| ActivityDefinition \| Questionnaire \| Measure \| OperationDefinition)	There are no (further) constraints on this element Element id CarePlan.activity.detail.instantiatesCanonical Short description Instantiates FHIR protocol or definition Definition The URL pointing to a FHIR-defined protocol, guideline, questionnaire or other definition that is adhered to in whole or in part by this CarePlan activity. Requirements Allows Questionnaires that the patient (or practitioner) should fill in to fulfill the care plan activity. Comments see Canonical References Data type canonical(PlanDefinition \| ActivityDefinition \| Questionnaire \| Measure \| OperationDefinition) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Request.instantiatesCanonical rim: .outboundRelationship[typeCode=DEFN].target
instantiatesUri		0..*	uri	There are no (further) constraints on this element Element id CarePlan.activity.detail.instantiatesUri Short description Instantiates external protocol or definition Definition The URL pointing to an externally maintained protocol, guideline, questionnaire or other definition that is adhered to in whole or in part by this CarePlan activity. Requirements Allows Questionnaires that the patient (or practitioner) should fill in to fulfill the care plan activity. Comments This might be an HTML page, PDF, etc. or could just be a non-resolvable URI 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 workflow: Request.instantiatesUri rim: .outboundRelationship[typeCode=DEFN].target
code	S	1..1	CodeableConceptBinding	Element id CarePlan.activity.detail.code Short description Detail type of activity Definition Detailed description of the type of planned activity; e.g. what lab test, what procedure, what kind of encounter. Requirements Allows matching performed to planned as well as validation against protocols. Comments Tends to be less relevant for activities involving particular products. Codes should not convey negation - use "prohibited" instead. Data type CodeableConcept Binding Detailed description of the type of activity; e.g. What lab test, what procedure, what kind of encounter. MII_VS_Onko_Therapieempfehlung_Typ (required) 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 workflow: Request.code v2: OBR-4 / RXE-2 / RXO-1 / RXD-2 rim: .code
id		0..1	string	There are no (further) constraints on this element Element id CarePlan.activity.detail.code.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 CarePlan.activity.detail.code.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 rim: N/A
coding	Σ	0..*	Coding	There are no (further) constraints on this element Element id CarePlan.activity.detail.code.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 Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding 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 v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	string	There are no (further) constraints on this element Element id CarePlan.activity.detail.code.coding.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 CarePlan.activity.detail.code.coding.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 rim: N/A
system	S Σ	1..1	uriPattern	Element id CarePlan.activity.detail.code.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapie-typ Mappings rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id CarePlan.activity.detail.code.coding.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. 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 v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	S Σ	1..1	code	Element id CarePlan.activity.detail.code.coding.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code oBDS: 19.1
display	Σ	0..1	string	There are no (further) constraints on this element Element id CarePlan.activity.detail.code.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size 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 v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id CarePlan.activity.detail.code.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. 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 v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
text	Σ	0..1	string	There are no (further) constraints on this element Element id CarePlan.activity.detail.code.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 rim: n/a 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
reasonCode		0..*	CodeableConcept	There are no (further) constraints on this element Element id CarePlan.activity.detail.reasonCode Short description Why activity should be done or why activity was prohibited Definition Provides the rationale that drove the inclusion of this particular activity as part of the plan or the reason why the activity was prohibited. Comments This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonCondition instead. Data type CodeableConcept Binding Identifies why a care plan activity is needed. Can include any health condition codes as well as such concepts as "general wellness", prophylaxis, surgical preparation, etc. SNOMEDCTClinicalFindings (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 workflow: Request.reasonCode
reasonReference	I	0..*	Reference(Condition \| Observation \| DiagnosticReport \| DocumentReference)	There are no (further) constraints on this element Element id CarePlan.activity.detail.reasonReference Short description Why activity is needed Definition Indicates another resource, such as the health condition(s), whose existence justifies this request and drove the inclusion of this particular activity as part of the plan. Comments Conditions can be identified at the activity level that are not identified as reasons for the overall plan. Data type Reference(Condition \| Observation \| DiagnosticReport \| DocumentReference) 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: Request.reasonReference
goal	I	0..*	Reference(Goal)	There are no (further) constraints on this element Element id CarePlan.activity.detail.goal Short description Goals this activity relates to Definition Internal reference that identifies the goals that this activity is intended to contribute towards meeting. Requirements So that participants know the link explicitly. 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(Goal) 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) rim: .outboundRelationship[typeCode<=OBJ].
status	S ?!	1..1	codeBinding	Element id CarePlan.activity.detail.status Short description not-started \| scheduled \| in-progress \| on-hold \| completed \| cancelled \| stopped \| unknown \| entered-in-error Definition Identifies what progress is being made for the specific activity. Requirements Indicates progress against the plan, whether the activity is still relevant for the plan. Comments Some aspects of status can be inferred based on the resources linked in actionTaken. Note that "status" is only as current as the plan was most recently updated. The unknown code is not to be used to convey other statuses. The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the activity. Data type code Binding Codes that reflect the current state of a care plan activity within its overall life cycle. CarePlanActivityStatus (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Request.status v2: ORC-5? rim: .statusCode not-started = new scheduled = not-started (and fulfillment relationship to appointent) in-progress = active on-hold = suspended completed = completed cancelled = aborted oBDS: 19.2
statusReason	S	0..1	CodeableConceptBinding	Element id CarePlan.activity.detail.statusReason Short description Reason for current status Definition Provides reason why the activity isn't yet started, is on hold, was cancelled, etc. Comments Will generally not be present if status is "complete". Be sure to prompt to update this (or at least remove the existing value) if the status is changed. Data type CodeableConcept Binding MII_VS_Onko_Therapieabweichung (required) 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 workflow: Request.statusReason
id		0..1	string	There are no (further) constraints on this element Element id CarePlan.activity.detail.statusReason.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 CarePlan.activity.detail.statusReason.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 rim: N/A
coding	S Σ	0..*	Coding	Element id CarePlan.activity.detail.statusReason.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 Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding 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 v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding oBDS: 19.2
id		0..1	string	There are no (further) constraints on this element Element id CarePlan.activity.detail.statusReason.coding.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 CarePlan.activity.detail.statusReason.coding.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 rim: N/A
system	Σ	0..1	uriPattern	Element id CarePlan.activity.detail.statusReason.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapieabweichung Mappings rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id CarePlan.activity.detail.statusReason.coding.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. 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 v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	S Σ	0..1	code	There are no (further) constraints on this element Element id CarePlan.activity.detail.statusReason.coding.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	0..1	string	There are no (further) constraints on this element Element id CarePlan.activity.detail.statusReason.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size 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 v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id CarePlan.activity.detail.statusReason.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. 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 v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
text	Σ	0..1	string	There are no (further) constraints on this element Element id CarePlan.activity.detail.statusReason.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 rim: n/a 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
doNotPerform	?!	0..1	boolean	There are no (further) constraints on this element Element id CarePlan.activity.detail.doNotPerform Short description If true, activity is prohibiting action Definition If true, indicates that the described activity is one that must NOT be engaged in when following the plan. If false, or missing, indicates that the described activity is one that should be engaged in when following the plan. Requirements Captures intention to not do something that may have been previously typical. Comments This element is labeled as a modifier because it marks an activity as an activity that is not to be performed. Meaning when missing If missing indicates that the described activity is one that should be engaged in when following the plan. 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 workflow: Request.doNotPerform rim: actionNegationInd
scheduled[x]		0..1		There are no (further) constraints on this element Element id CarePlan.activity.detail.scheduled[x] Short description When activity is to occur Definition The period, timing or frequency upon which the described activity is to occur. Requirements Allows prompting for activities and detection of missed planned activities. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Request.occurrence[x] v2: TQ1 rim: .effectiveTime
scheduledTiming			Timing	There are no (further) constraints on this element Data type Timing
scheduledPeriod			Period	There are no (further) constraints on this element Data type Period
scheduledString			string	There are no (further) constraints on this element Data type string
location	I	0..1	Reference(Location)	There are no (further) constraints on this element Element id CarePlan.activity.detail.location Short description Where it should happen Definition Identifies the facility where the activity will occur; e.g. home, hospital, specific clinic, etc. Requirements Helps in planning of activity. Comments May reference a specific clinical location or may identify a type of location. Data type Reference(Location) 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) v2: OBR-24(???!!) rim: .participation[typeCode=LOC].role
performer	I	0..*	Reference(Practitioner \| PractitionerRole \| Organization \| RelatedPerson \| Patient \| CareTeam \| HealthcareService \| Device)	There are no (further) constraints on this element Element id CarePlan.activity.detail.performer Short description Who will be responsible? Definition Identifies who's expected to be involved in the activity. Requirements Helps in planning of activity. Comments A performer MAY also be a participant in the care plan. Data type Reference(Practitioner \| PractitionerRole \| Organization \| RelatedPerson \| Patient \| CareTeam \| HealthcareService \| Device) 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: Request.performer v2: PRT-5 : ( PRV-4 = (provider participations)); PRT-5 : ( PRV-4 = (non-provider person participations )) ; PRT-5 : ( PRV-4 = (patient non-subject of care) ) ; PRT-8 rim: .participation[typeCode=PFM]
product[x]		0..1		There are no (further) constraints on this element Element id CarePlan.activity.detail.product[x] Short description What is to be administered/supplied Definition Identifies the food, drug or other product to be consumed or supplied in the activity. Binding A product supplied or administered as part of a care plan activity. SNOMEDCTMedicationCodes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: RXE-2 / RXO-1 / RXD-2 rim: .participation[typeCode=PRD].role
productCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data type CodeableConcept
productReference			Reference(Medication \| Substance)	There are no (further) constraints on this element Data type Reference(Medication \| Substance)
dailyAmount	I	0..1	SimpleQuantity	There are no (further) constraints on this element Element id CarePlan.activity.detail.dailyAmount Short description How to consume/day? Alternate names daily dose Definition Identifies the quantity expected to be consumed in a given day. Requirements Allows rough dose checking. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data type SimpleQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values v2: RXO-23 / RXE-19 / RXD-12 rim: .outboundRelationship[typeCode=COMP][classCode=SBADM].doseQuantity
quantity	I	0..1	SimpleQuantity	There are no (further) constraints on this element Element id CarePlan.activity.detail.quantity Short description How much to administer/supply/consume Definition Identifies the quantity expected to be supplied, administered or consumed by the subject. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data type SimpleQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values v2: RXO-11 / RXE-10 / RXD-4 / RXG-5 / RXA-6 / TQ1-2.1 and RXO-12 / RXE-11 / RXD-5 / RXG-7 / RXA-7 / TQ1-2.2 rim: .outboundRelationship[typeCode=COMP][classCode=SPLY].quantity
description		0..1	string	There are no (further) constraints on this element Element id CarePlan.activity.detail.description Short description Extra info describing activity to perform Definition This provides a textual description of constraints on the intended activity occurrence, including relation to other activities. It may also include objectives, pre-conditions and end-conditions. Finally, it may convey specifics about the activity such as body site, method, route, etc. Comments Note that FHIR strings SHALL NOT exceed 1MB in size 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 v2: NTE? rim: .text
note		0..*	Annotation	There are no (further) constraints on this element Element id CarePlan.note Short description Comments about the plan Definition General notes about the care plan not covered elsewhere. Requirements Used to capture information that applies to the plan as a whole that doesn't fit into discrete elements. Comments For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible). Data type Annotation Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: N/A rim: Act workflow: Request.note v2: NTE? rim: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="annotation"].value

Dieses Profil beschreibt die Tumorkonferenz und die Therapieempfehlungen

Feldname
CarePlan.meta.profile
CarePlan.identifier
CarePlan.status
CarePlan.intent
CarePlan.category
CarePlan.category.coding
CarePlan.category.coding.system
CarePlan.category.coding.code
CarePlan.subject
CarePlan.encounter
CarePlan.created
CarePlan.addresses
CarePlan.supportingInfo
CarePlan.activity
CarePlan.activity.detail
CarePlan.activity.detail.code
CarePlan.activity.detail.code.coding.system
CarePlan.activity.detail.code.coding.code
CarePlan.activity.detail.status
CarePlan.activity.detail.statusReason
CarePlan.activity.detail.statusReason.coding
CarePlan.activity.detail.statusReason.coding.code

<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="mii-pr-onko-tumorkonferenz" />
    <url value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-tumorkonferenz" />
    <version value="2024.0.0-ballot" />
    <name value="MII_PR_Onko_Tumorkonferenz" />
    <title value="MII PR Onkologie Tumorkonferenz" />
    <status value="draft" />
    <publisher value="Medizininformatik Initiative" />
    <contact>
        <telecom>
            <system value="url" />
            <value value="https://www.medizininformatik-initiative.de" />
        </telecom>
    </contact>
    <description value="Dieses Profil beschreibt die Tumorkonferenz und die Therapieempfehlungen" />
    <fhirVersion value="4.0.1" />
    <mapping>
        <identity value="oBDS" />
        <name value="Mapping FHIR zu oBDS" />
    </mapping>
    <kind value="resource" />
    <abstract value="false" />
    <type value="CarePlan" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/CarePlan" />
    <derivation value="constraint" />
    <differential>
        <element id="CarePlan.meta.profile">
            <path value="CarePlan.meta.profile" />
            <mustSupport value="true" />
        </element>
        <element id="CarePlan.identifier">
            <path value="CarePlan.identifier" />
            <mustSupport value="true" />
        </element>
        <element id="CarePlan.status">
            <path value="CarePlan.status" />
            <mustSupport value="true" />
        </element>
        <element id="CarePlan.intent">
            <path value="CarePlan.intent" />
            <mustSupport value="true" />
        </element>
        <element id="CarePlan.category">
            <path value="CarePlan.category" />
            <min value="1" />
            <max value="1" />
            <mustSupport value="true" />
        </element>
        <element id="CarePlan.category.coding">
            <path value="CarePlan.category.coding" />
            <min value="1" />
            <mustSupport value="true" />
            <binding>
                <strength value="required" />
                <valueSet value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/ValueSet/mii-vs-onko-therapieplanung-typ" />
            </binding>
        </element>
        <element id="CarePlan.category.coding.system">
            <path value="CarePlan.category.coding.system" />
            <min value="1" />
            <patternUri value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapieplanung-typ" />
            <mustSupport value="true" />
        </element>
        <element id="CarePlan.category.coding.code">
            <path value="CarePlan.category.coding.code" />
            <min value="1" />
            <mustSupport value="true" />
            <mapping>
                <identity value="oBDS" />
                <map value="18.2" />
                <comment value="Tumorkonferenz Therapieplanung Typ" />
            </mapping>
        </element>
        <element id="CarePlan.subject">
            <path value="CarePlan.subject" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="CarePlan.encounter">
            <path value="CarePlan.encounter" />
            <mustSupport value="true" />
        </element>
        <element id="CarePlan.created">
            <path value="CarePlan.created" />
            <min value="1" />
            <mustSupport value="true" />
            <mapping>
                <identity value="oBDS" />
                <map value="18.1" />
                <comment value="Tumorkonferenz Therapieplanung Datum" />
            </mapping>
        </element>
        <element id="CarePlan.addresses">
            <path value="CarePlan.addresses" />
            <mustSupport value="true" />
        </element>
        <element id="CarePlan.supportingInfo">
            <path value="CarePlan.supportingInfo" />
            <mustSupport value="true" />
        </element>
        <element id="CarePlan.activity">
            <path value="CarePlan.activity" />
            <mustSupport value="true" />
        </element>
        <element id="CarePlan.activity.detail">
            <path value="CarePlan.activity.detail" />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="CarePlan.activity.detail.code">
            <path value="CarePlan.activity.detail.code" />
            <min value="1" />
            <mustSupport value="true" />
            <binding>
                <strength value="required" />
                <valueSet value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/ValueSet/mii-vs-onko-therapieempfehlung-typ" />
            </binding>
        </element>
        <element id="CarePlan.activity.detail.code.coding.system">
            <path value="CarePlan.activity.detail.code.coding.system" />
            <min value="1" />
            <patternUri value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapie-typ" />
            <mustSupport value="true" />
        </element>
        <element id="CarePlan.activity.detail.code.coding.code">
            <path value="CarePlan.activity.detail.code.coding.code" />
            <min value="1" />
            <mustSupport value="true" />
            <mapping>
                <identity value="oBDS" />
                <map value="19.1" />
                <comment value="Tumorkonferenz Therapieempfehlung Typ" />
            </mapping>
        </element>
        <element id="CarePlan.activity.detail.status">
            <path value="CarePlan.activity.detail.status" />
            <mustSupport value="true" />
            <mapping>
                <identity value="oBDS" />
                <map value="19.2" />
                <comment value="Tumorkonferenz/Therapieempfehlung Therapieabweichung auf Wunsch des Patienten" />
            </mapping>
        </element>
        <element id="CarePlan.activity.detail.statusReason">
            <path value="CarePlan.activity.detail.statusReason" />
            <mustSupport value="true" />
            <binding>
                <strength value="required" />
                <valueSet value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/ValueSet/mii-vs-onko-therapieabweichung" />
            </binding>
        </element>
        <element id="CarePlan.activity.detail.statusReason.coding">
            <path value="CarePlan.activity.detail.statusReason.coding" />
            <mustSupport value="true" />
            <mapping>
                <identity value="oBDS" />
                <map value="19.2" />
                <comment value="Tumorkonferenz/Therapieempfehlung Therapieabweichung auf Wunsch des Patienten" />
            </mapping>
        </element>
        <element id="CarePlan.activity.detail.statusReason.coding.system">
            <path value="CarePlan.activity.detail.statusReason.coding.system" />
            <patternUri value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapieabweichung" />
        </element>
        <element id="CarePlan.activity.detail.statusReason.coding.code">
            <path value="CarePlan.activity.detail.statusReason.coding.code" />
            <mustSupport value="true" />
        </element>
    </differential>
</StructureDefinition>

{
    "resourceType": "StructureDefinition",
    "id": "mii-pr-onko-tumorkonferenz",
    "url": "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-tumorkonferenz",
    "version": "2024.0.0-ballot",
    "name": "MII_PR_Onko_Tumorkonferenz",
    "title": "MII PR Onkologie Tumorkonferenz",
    "status": "draft",
    "publisher": "Medizininformatik Initiative",
    "contact":  [
        {
            "telecom":  [
                {
                    "system": "url",
                    "value": "https://www.medizininformatik-initiative.de"
                }
            ]
        }
    ],
    "description": "Dieses Profil beschreibt die Tumorkonferenz und die Therapieempfehlungen",
    "fhirVersion": "4.0.1",
    "mapping":  [
        {
            "identity": "oBDS",
            "name": "Mapping FHIR zu oBDS"
        }
    ],
    "kind": "resource",
    "abstract": false,
    "type": "CarePlan",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/CarePlan",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "CarePlan.meta.profile",
                "path": "CarePlan.meta.profile",
                "mustSupport": true
            },
            {
                "id": "CarePlan.identifier",
                "path": "CarePlan.identifier",
                "mustSupport": true
            },
            {
                "id": "CarePlan.status",
                "path": "CarePlan.status",
                "mustSupport": true
            },
            {
                "id": "CarePlan.intent",
                "path": "CarePlan.intent",
                "mustSupport": true
            },
            {
                "id": "CarePlan.category",
                "path": "CarePlan.category",
                "min": 1,
                "max": "1",
                "mustSupport": true
            },
            {
                "id": "CarePlan.category.coding",
                "path": "CarePlan.category.coding",
                "min": 1,
                "mustSupport": true,
                "binding": {
                    "strength": "required",
                    "valueSet": "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/ValueSet/mii-vs-onko-therapieplanung-typ"
                }
            },
            {
                "id": "CarePlan.category.coding.system",
                "path": "CarePlan.category.coding.system",
                "min": 1,
                "patternUri": "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapieplanung-typ",
                "mustSupport": true
            },
            {
                "id": "CarePlan.category.coding.code",
                "path": "CarePlan.category.coding.code",
                "min": 1,
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "oBDS",
                        "map": "18.2",
                        "comment": "Tumorkonferenz Therapieplanung Typ"
                    }
                ]
            },
            {
                "id": "CarePlan.subject",
                "path": "CarePlan.subject",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Patient"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "CarePlan.encounter",
                "path": "CarePlan.encounter",
                "mustSupport": true
            },
            {
                "id": "CarePlan.created",
                "path": "CarePlan.created",
                "min": 1,
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "oBDS",
                        "map": "18.1",
                        "comment": "Tumorkonferenz Therapieplanung Datum"
                    }
                ]
            },
            {
                "id": "CarePlan.addresses",
                "path": "CarePlan.addresses",
                "mustSupport": true
            },
            {
                "id": "CarePlan.supportingInfo",
                "path": "CarePlan.supportingInfo",
                "mustSupport": true
            },
            {
                "id": "CarePlan.activity",
                "path": "CarePlan.activity",
                "mustSupport": true
            },
            {
                "id": "CarePlan.activity.detail",
                "path": "CarePlan.activity.detail",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "CarePlan.activity.detail.code",
                "path": "CarePlan.activity.detail.code",
                "min": 1,
                "mustSupport": true,
                "binding": {
                    "strength": "required",
                    "valueSet": "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/ValueSet/mii-vs-onko-therapieempfehlung-typ"
                }
            },
            {
                "id": "CarePlan.activity.detail.code.coding.system",
                "path": "CarePlan.activity.detail.code.coding.system",
                "min": 1,
                "patternUri": "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapie-typ",
                "mustSupport": true
            },
            {
                "id": "CarePlan.activity.detail.code.coding.code",
                "path": "CarePlan.activity.detail.code.coding.code",
                "min": 1,
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "oBDS",
                        "map": "19.1",
                        "comment": "Tumorkonferenz Therapieempfehlung Typ"
                    }
                ]
            },
            {
                "id": "CarePlan.activity.detail.status",
                "path": "CarePlan.activity.detail.status",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "oBDS",
                        "map": "19.2",
                        "comment": "Tumorkonferenz/Therapieempfehlung Therapieabweichung auf Wunsch des Patienten"
                    }
                ]
            },
            {
                "id": "CarePlan.activity.detail.statusReason",
                "path": "CarePlan.activity.detail.statusReason",
                "mustSupport": true,
                "binding": {
                    "strength": "required",
                    "valueSet": "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/ValueSet/mii-vs-onko-therapieabweichung"
                }
            },
            {
                "id": "CarePlan.activity.detail.statusReason.coding",
                "path": "CarePlan.activity.detail.statusReason.coding",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "oBDS",
                        "map": "19.2",
                        "comment": "Tumorkonferenz/Therapieempfehlung Therapieabweichung auf Wunsch des Patienten"
                    }
                ]
            },
            {
                "id": "CarePlan.activity.detail.statusReason.coding.system",
                "path": "CarePlan.activity.detail.statusReason.coding.system",
                "patternUri": "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapieabweichung"
            },
            {
                "id": "CarePlan.activity.detail.statusReason.coding.code",
                "path": "CarePlan.activity.detail.statusReason.coding.code",
                "mustSupport": true
            }
        ]
    }
}

MII PR Onkologie Tumorkonferenz

Mapping Datensatz zu FHIR

Datensatz	Erklaerung	FHIR
Tumorkonferenz und Therapieempfehlung	Tumorkonferenz und Therapieempfehlung
Tumorkonferenz Therapieplanung Datum	Datum der Durchführung der Tumorkonferenz bzw. der sonstigen Therapieplanung.	CarePlan.created
Tumorkonferenz Therapieplanung Typ	Typ der Tumorkonferenz bzw. der sonstigen Therapieplanung.	CarePlan.category
Tumorkonferenz Therapieempfehlung Typ	Typ der Therapieempfehlung der Tumorkonferenz.	CarePlan.activity.detail.code
Tumorkonferenz/Therapieempfehlung Therapieabweichung auf Wunsch des Patienten	Abweichung auf Wunsch des Patienten.	CarePlan.activity.detail.status & statusReason

Mapping Einheitlicher onkologischer Basisdatensatz (oBDS) zu FHIR

oBDS	Definition	FHIR
18.2	Tumorkonferenz Therapieplanung Typ	CarePlan.category.coding.code
18.1	Tumorkonferenz Therapieplanung Datum	CarePlan.created
19.1	Tumorkonferenz Therapieempfehlung Typ	CarePlan.activity.detail.code.coding.code
19.2	Tumorkonferenz/Therapieempfehlung Therapieabweichung auf Wunsch des Patienten	CarePlan.activity.detail.status
19.2	Tumorkonferenz/Therapieempfehlung Therapieabweichung auf Wunsch des Patienten	CarePlan.activity.detail.statusReason.coding

Suchparameter

Folgende Suchparameter sind für das Modul Onkologie relevant, auch in Kombination:

Der Suchparameter _id MUSS unterstützt werden:

Beispiele:

GET [base]/CarePlan?_id=1234

Anwendungshinweise: Weitere Informationen zur Suche nach "_id" finden sich in der FHIR-Basisspezifikation - Abschnitt "Parameters for all resources".
Der Suchparameter _profile MUSS unterstützt werden:

Beispiele:

GET [base]/CarePlan?_profile=https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-tumorkonferenz

Anwendungshinweise: Weitere Informationen zur Suche nach "_profile" finden sich in der FHIR-Basisspezifikation - Abschnitt "token".
Der Suchparameter identifier MUSS unterstützt werden:

Beispiele:

GET [base]/CarePlan?identifier=Tumorkonferenz_1

Anwendungshinweise: Weitere Informationen zur Suche nach "_profile" finden sich in der [FHIR-Basisspezifikation - Abschnitt "token"].
Der Suchparameter category MUSS unterstützt werden: Beispiele:

GET [base]/CarePlan?category=http://snomed.info/sct|734163000

Anwendungshinweise: Weitere Informationen zur Suche nach "_profile" finden sich in der [FHIR-Basisspezifikation - Abschnitt "token"].
Der Suchparameter subject MUSS unterstützt werden: Beispiele:

GET [base]/CarePlan?subject=Patient/example

Anwendungshinweise: Weitere Informationen zur Suche nach "_profile" finden sich in der [FHIR-Basisspezifikation - Abschnitt "identifier" oder Abschnitt "[type]"].
Der Suchparameter period MUSS unterstützt werden: Beispiele:

GET [base]/CarePlan?date=eq2022-01-01

Anwendungshinweise: Weitere Informationen zur Suche nach "_profile" finden sich in der [FHIR-Basisspezifikation - Abschnitt "date"].
Der Suchparameter contributor MUSS unterstützt werden: Beispiele:

GET [base]/CarePlan?contributor=Practitioner/example

Anwendungshinweise: Weitere Informationen zur Suche nach "_profile" finden sich in der [FHIR-Basisspezifikation - Abschnitt "identifier" oder Abschnitt "[type]"].
Der Suchparameter addresses MUSS unterstützt werden: Beispiele:

GET [base]/CarePlan?addresses=Condition/example

Anwendungshinweise: Weitere Informationen zur Suche nach "_profile" finden sich in der [FHIR-Basisspezifikation - Abschnitt "identifier" oder Abschnitt "[type]"].
Der Suchparameter activity-code MUSS unterstützt werden: Beispiele:

GET [base]/CarePlan?activity-code=https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-therapieempfehlung-typ|OP

Anwendungshinweise: Weitere Informationen zur Suche nach "_profile" finden sich in der [FHIR-Basisspezifikation - Abschnitt "token"].

Beispiele

{
    "resourceType": "CarePlan",
    "id": "mii-exa-onko-tumorkonferenz-01",
    "meta": {
        "profile":  [
            "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-tumorkonferenz"
        ]
    },
    "category":  [
        {
            "coding":  [
                {
                    "system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapieplanung-typ",
                    "code": "postop"
                }
            ]
        }
    ],
    "activity":  [
        {
            "detail": {
                "code": {
                    "coding":  [
                        {
                            "system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapie-typ",
                            "code": "OP"
                        }
                    ]
                },
                "status": "scheduled",
                "statusReason": {
                    "coding":  [
                        {
                            "code": "N",
                            "system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapieabweichung",
                            "display": "nein"
                        }
                    ]
                }
            }
        }
    ],
    "identifier":  [
        {
            "value": "Tumorkonferenz_1"
        }
    ],
    "status": "active",
    "intent": "plan",
    "subject": {
        "reference": "Patient/example"
    },
    "created": "2024-01-11"
}