<status value="active" /> <publisher value="HL7 Netherlands" /> <contact> <name value="Nictiz" /> <telecom> <system value="url" /> <value value="https://www.nictiz.nl" /> <use value="work" /> </telecom> </contact> <description value="An nl-core base CarePlan profile, that references to all relating Dutch Health and Care Information models or HCIM (Dutch: Zorginformatiebouwsteen or ZIB) profiles. This profile is not based on an HCIM, because no HCIM exists for the CarePlan concept." /> <purpose value="Multiple HCIMs are better interpreted in a coherent set than by themselves. These are the HCIMs NursingIntervention, TreatmentObjective and TreatmentOutcome. They constitute a CarePlan, hence the reason to create a CarePlan profile." /> <copyright value="CC0" /> <fhirVersion value="3.0.2" /> <mapping> <identity value="hcim-nursingintervention-v3.2-2018EN" /> <uri value="https://zibs.nl/wiki/NursingIntervention-v3.2(2018EN)" /> <name value="HCIM NursingIntervention-v3.2(2018EN)" /> <comment value="HCIM release 2018 is because it does not have the redundant container 'NursingProcedure'." /> </mapping> <mapping> <identity value="hcim-outcomeofcare-v3.1-2017EN" /> <uri value="https://zibs.nl/wiki/OutcomeOfCare-v3.1(2017EN)" /> <name value="HCIM OutcomeOfCare-v3.1 (2017EN)" /> </mapping> <mapping> <identity value="hcim-basicelements-v1.0-2017EN" /> <uri value="https://zibs.nl/wiki/BasicElements-v1.0(2017EN)" /> <name value="HCIM BasicElements-v1.0(2017EN)" /> </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"> <path value="CarePlan" /> <definition value="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. The CarePlan structure bears relationship to a number of HCIMs including TreatmentObjective and NursingIntervention. Not all systems currently capture care plans this way. For this reason this profile explicitly allows for fallback to an unstructured description, leveraging `CarePlan.text`. The CarePlan SHALL be either: * fully structured with clinically relevant text as xhtml in `CarePlan.text` with `.text.status` = *extensions*, or * fully unstructured with clinically relevant text as xhtml in `CarePlan.text` with `.text.status` = *additional* * Required other elements are `CarePlan.status`, `CarePlan.intent`, `CarePlan.subject` * Additional elements MAY be populated The `CarePlan.text` (`Resource.text`) is explained in more detail in the [FHIR DomainResource](https://hl7.org/fhir/STU3/domainresource.html). The status *additional* generically signals receivers that the contents of the narrative may contain additional information not found in the structured data, which means the `CarePlan.text` SHALL NOT be ignored. In an unstructured care plan the `CarePlan.text` is expected to be meaningful to the human receiver without further inspection of any structured data that may or may not be present in the care plan as well." /> </element> <element id="CarePlan.text"> <path value="CarePlan.text" /> <comment value="Note: see the documentation on the root element for guidance on using this element to communicate the care plan in an unstructured way." /> </element> <element id="CarePlan.identifier"> <path value="CarePlan.identifier" /> <mapping> <identity value="hcim-basicelements-v1.0-2017EN" /> <map value="NL-CM:0.0.6" /> <comment value="IdentificationNumber" /> </mapping> </element> <element id="CarePlan.subject"> <path value="CarePlan.subject" /> <type> <code value="Reference" /> <targetProfile value="http://fhir.nl/fhir/StructureDefinition/nl-core-patient" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group" /> </type> <mapping> <identity value="hcim-basicelements-v1.0-2017EN" /> <map value="NL-CM:0.0.11" /> <comment value="Subject" /> </mapping> </element> <element id="CarePlan.context"> <path value="CarePlan.context" /> <type> <code value="Reference" /> <targetProfile value="http://nictiz.nl/fhir/StructureDefinition/zib-Encounter" /> </type> <type> <code value="Reference" /> <targetProfile value="http://fhir.nl/fhir/StructureDefinition/nl-core-episodeofcare" /> </type> </element> <element id="CarePlan.period"> <path value="CarePlan.period" /> <mapping> <identity value="hcim-basicelements-v1.0-2017EN" /> <map value="NL-CM:0.0.14" /> <comment value="DateTime" /> </mapping> </element> <element id="CarePlan.author"> <path value="CarePlan.author" /> <type> <code value="Reference" /> <targetProfile value="http://fhir.nl/fhir/StructureDefinition/nl-core-patient" /> </type> <type> <code value="Reference" /> <targetProfile value="http://fhir.nl/fhir/StructureDefinition/nl-core-practitioner" /> </type> <type> <code value="Reference" /> <targetProfile value="http://fhir.nl/fhir/StructureDefinition/nl-core-relatedperson" /> </type> <type> <code value="Reference" /> <targetProfile value="http://fhir.nl/fhir/StructureDefinition/nl-core-organization" /> </type> <type> <code value="Reference" /> <targetProfile value="http://fhir.nl/fhir/StructureDefinition/nl-core-careteam" /> </type> </element> <element id="CarePlan.author.extension"> <path value="CarePlan.author.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <rules value="open" /> </slicing> </element> <element id="CarePlan.author.extension:practitionerRole"> <path value="CarePlan.author.extension" /> <sliceName value="practitionerRole" /> <max value="1" /> <type> <code value="Extension" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference" /> </type> </element> <element id="CarePlan.goal"> <path value="CarePlan.goal" /> <type> <code value="Reference" /> <targetProfile value="http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentObjective" /> </type> <mapping> <identity value="hcim-nursingintervention-v3.2-2018EN" /> <map value="NL-CM:14.2.14" /> <comment value="TreatmentObjective" /> </mapping> </element> <element id="CarePlan.activity"> <path value="CarePlan.activity" /> <slicing> <discriminator> <type value="pattern" /> <path value="detail.category" /> </discriminator> <rules value="open" /> </slicing> </element> <element id="CarePlan.activity:nursingIntervention"> <path value="CarePlan.activity" /> <sliceName value="nursingIntervention" /> <constraint> <key value="hicm-outcomeofcare-1" /> <severity value="error" /> <human value="Provide a HealthcareResult text or a reference, not both" /> <expression value="outcomeCodeableConcept.empty() or outcomeReference.empty()" /> </constraint> <mapping> <identity value="hcim-outcomeofcare-v3.2-2018EN" /> <map value="NL-CM:13.4.4" /> <comment value="Intervention" /> </mapping> <mapping> <identity value="hcim-nursingintervention-v3.2-2018EN" /> <map value="NL-CM:14.2.1" /> <comment value="NursingIntervention" /> </mapping> </element> <element id="CarePlan.activity:nursingIntervention.extension"> <path value="CarePlan.activity.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <rules value="open" /> </slicing> </element> <element id="CarePlan.activity:nursingIntervention.extension:comment"> <path value="CarePlan.activity.extension" /> <sliceName value="comment" /> <definition value="Comment on the nursing intervention." /> <max value="1" /> <type> <code value="Extension" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/Comment" /> </type> </element> <element id="CarePlan.activity:nursingIntervention.extension:comment.valueString:valueString"> <path value="CarePlan.activity.extension.valueString" /> <sliceName value="valueString" /> <mapping> <identity value="hcim-nursingintervention-v3.2-2018EN" /> <map value="NL-CM:14.2.5" /> </mapping> </element> <element id="CarePlan.activity:nursingIntervention.outcomeCodeableConcept"> <path value="CarePlan.activity.outcomeCodeableConcept" /> <max value="1" /> </element> <element id="CarePlan.activity:nursingIntervention.outcomeCodeableConcept.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true" /> </extension> <path value="CarePlan.activity.outcomeCodeableConcept.text" /> <short value="HealthcareResult" /> <definition value="The textual account of the healthcare result. If HealthcareResult cannot be entered as a measurement value or functional/mental status, it can be described as free text in the healthcare result." /> <alias value="Zorgresultaat" /> <mapping> <identity value="hcim-outcomeofcare-v3.1-2017EN" /> <map value="NL-CM:13.4.5" /> <comment value="HealthcareResult" /> </mapping> </element> <element id="CarePlan.activity:nursingIntervention.outcomeReference"> <path value="CarePlan.activity.outcomeReference" /> <short value="MeasurementValue / HealthCondition" /> <definition value="Measurements in which an observation, carried out with a (measuring) tool if possible, is translated to a relevant unit or a description of the patient’s health condition in the form of a functional and/or mental status." /> <alias value="Meetwaarde" /> <alias value="Gezondheidstoestand" /> <max value="1" /> <type> <code value="Reference" /> <targetProfile value="http://nictiz.nl/fhir/StructureDefinition/zib-GeneralMeasurement" /> </type> <type> <code value="Reference" /> <targetProfile value="http://nictiz.nl/fhir/StructureDefinition/zib-FunctionalOrMentalStatus" /> </type> <mapping> <identity value="hcim-outcomeofcare-v3.1-2017EN" /> <map value="NL-CM:13.4.2" /> <comment value="MeasurementValue" /> </mapping> <mapping> <identity value="hcim-outcomeofcare-v3.1-2017EN" /> <map value="NL-CM:13.4.3" /> <comment value="HealthCondition" /> </mapping> </element> <element id="CarePlan.activity:nursingIntervention.reference"> <path value="CarePlan.activity.reference" /> <definition value="The details of the proposed activity represented in a specific resource. Used for example to provide the details of the health professional who requested the nursing intervention. If desired, only the requester’s specialty can be entered." /> <comment value="Requester information should be captured and exchanged in the resource ProcedureRequest referenced by `activity.reference`. Requester is the healthcare provider and/or organization where or by whom the NursingInterverntion was requested. There are a few required elements in ProcedureRequest: * `ProcedureRequest.status` (use fixed value _active_, unless you know what the actual value is) * `ProcedureRequest.intent` (use fixed value _order_, unless you know what the actual value is) * `ProcedureRequest.code` (use extension http://hl7.org/fhir/STU3/extension-iso21090-nullflavor.html with `valueCode` _UNK_, unless you know what the actual value is) * `ProcedureRequest.subject` (equal to `Observation.subject`) * `ProcedureRequest.requester.agent` (contains the requesting HealthProfessional)" /> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Appointment" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/CommunicationRequest" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/DeviceRequest" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationRequest" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/NutritionOrder" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Task" /> </type> <type> <code value="Reference" /> <targetProfile value="http://nictiz.nl/fhir/StructureDefinition/zib-ProcedureRequest" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ReferralRequest" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/VisionPrescription" /> </type> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/RequestGroup" /> </type> <mapping> <identity value="hcim-nursingintervention-v3.2-2018EN" /> <map value="NL-CM:14.2.8" /> <comment value="Requester" /> </mapping> </element> <element id="CarePlan.activity:nursingIntervention.detail.extension"> <path value="CarePlan.activity.detail.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <rules value="open" /> </slicing> </element> <element id="CarePlan.activity:nursingIntervention.detail.extension:medicalDevice"> <path value="CarePlan.activity.detail.extension" /> <sliceName value="medicalDevice" /> <short value="MedicalDevice" /> <definition value="Description of the materials used for the nursing procedure, such as bandages." /> <alias value="MedischHulpmiddel" /> <type> <code value="Extension" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/extension-medicaldevice" /> </type> </element> <element id="CarePlan.activity:nursingIntervention.detail.extension:medicalDevice.valueReference:valueReference"> <path value="CarePlan.activity.detail.extension.valueReference" /> <sliceName value="valueReference" /> <mapping> <identity value="hcim-nursingintervention-v3.2-2018EN" /> <map value="NL-CM:14.2.13" /> <comment value="MedicalDevice" /> </mapping> </element> <element id="CarePlan.activity:nursingIntervention.detail.category"> <path value="CarePlan.activity.detail.category" /> <short value="Nursing procedure" /> <definition value="High-level categorization of the type of activity in a care plan. This slice defines a nursing procedure conform the HCIM NursingIntervention." /> <min value="1" /> <patternCodeableConcept> <coding> <system value="http://snomed.info/sct" /> <code value="9632001" /> </coding> </patternCodeableConcept> </element> <element id="CarePlan.activity:nursingIntervention.detail.code"> <path value="CarePlan.activity.detail.code" /> <short value="Intervention" /> <definition value="A nursing intervention is a treatment carried out by a nurse based on an expert opinion and clinical knowledge for the benefit of the person requesting healthcare. The intervention is targeted towards a certain problem (diagnosis) and has a predetermined healthcare result." /> <alias value="Interventie" /> <min value="1" /> <mapping> <identity value="hcim-nursingintervention-v3.2-2018EN" /> <map value="NL-CM:14.2.2" /> <comment value="Intervention" /> </mapping> </element> <element id="CarePlan.activity:nursingIntervention.detail.code.coding"> <path value="CarePlan.activity.detail.code.coding" /> <slicing> <discriminator> <type value="value" /> <path value="$this" /> </discriminator> <rules value="open" /> </slicing> </element> <element id="CarePlan.activity:nursingIntervention.detail.code.coding:interventionNICCodelist"> <path value="CarePlan.activity.detail.code.coding" /> <sliceName value="interventionNICCodelist" /> <short value="interventionNICCodelist" /> <max value="1" /> <binding> <strength value="required" /> <description value="NIC - All Values" /> <valueSetReference> <reference value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.14.2.2--20171231000000" /> </valueSetReference> </binding> </element> <element id="CarePlan.activity:nursingIntervention.detail.code.coding:interventionNICCodelist.system"> <path value="CarePlan.activity.detail.code.coding.system" /> <min value="1" /> </element> <element id="CarePlan.activity:nursingIntervention.detail.code.coding:interventionNICCodelist.code"> <path value="CarePlan.activity.detail.code.coding.code" /> <min value="1" /> </element> <element id="CarePlan.activity:nursingIntervention.detail.code.coding:interventionSnomedCodelist"> <path value="CarePlan.activity.detail.code.coding" /> <sliceName value="interventionSnomedCodelist" /> <short value="interventionSnomedCodelist" /> <max value="1" /> <binding> <strength value="required" /> <description value="SNOMED CT - SNOMED CT: &lt;&lt;71388002 | procedure |" /> <valueSetReference> <reference value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.14.2.4--20171231000000" /> </valueSetReference> </binding> </element> <element id="CarePlan.activity:nursingIntervention.detail.code.coding:interventionSnomedCodelist.system"> <path value="CarePlan.activity.detail.code.coding.system" /> <min value="1" /> </element> <element id="CarePlan.activity:nursingIntervention.detail.code.coding:interventionSnomedCodelist.code"> <path value="CarePlan.activity.detail.code.coding.code" /> <min value="1" /> </element> <element id="CarePlan.activity:nursingIntervention.detail.reasonReference"> <path value="CarePlan.activity.detail.reasonReference" /> <short value="Indication" /> <definition value="The nursing-related problem (indication) providing cause for the intervention." /> <alias value="Indicatie" /> <max value="1" /> <type> <code value="Reference" /> <targetProfile value="http://nictiz.nl/fhir/StructureDefinition/zib-Problem" /> </type> <mapping> <identity value="hcim-nursingintervention-v3.2-2018EN" /> <map value="NL-CM:14.2.6" /> <comment value="Indication" /> </mapping> </element> <element id="CarePlan.activity:nursingIntervention.detail.goal"> <path value="CarePlan.activity.detail.goal" /> <short value="TreatmentObjective" /> <definition value="The description of the treatment goal that the intervention decision is based on." /> <alias value="Behandeldoel" /> <max value="1" /> <type> <code value="Reference" /> <targetProfile value="http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentObjective" /> </type> <mapping> <identity value="hcim-nursingintervention-v3.2-2018EN" /> <map value="NL-CM:14.2.14" /> <comment value="TreatmentObjective" /> </mapping> </element> <element id="CarePlan.activity:nursingIntervention.detail.scheduled[x]:scheduledTiming"> <path value="CarePlan.activity.detail.scheduledTiming" /> <sliceName value="scheduledTiming" /> <type> <code value="Timing" /> </type> </element> <element id="CarePlan.activity:nursingIntervention.detail.scheduled[x]:scheduledTiming.repeat.bounds[x]:boundsPeriod"> <path value="CarePlan.activity.detail.scheduledTiming.repeat.boundsPeriod" /> <sliceName value="boundsPeriod" /> <type> <code value="Period" /> </type> </element> <element id="CarePlan.activity:nursingIntervention.detail.scheduled[x]:scheduledTiming.repeat.bounds[x]:boundsPeriod.start"> <path value="CarePlan.activity.detail.scheduledTiming.repeat.boundsPeriod.start" /> <short value="ProcedureStartDateTime" /> <definition value="The start date (and if possible start time) of the procedure. The concept offers the option to indicate the start of the period of a series of repeating procedures." /> <alias value="ActieStartDatumTijd" /> <mapping> <identity value="hcim-nursingintervention-v3.2-2018EN" /> <map value="NL-CM:14.2.11" /> <comment value="ProcedureStartDateTime" /> </mapping> </element> <element id="CarePlan.activity:nursingIntervention.detail.scheduled[x]:scheduledTiming.repeat.bounds[x]:boundsPeriod.end"> <path value="CarePlan.activity.detail.scheduledTiming.repeat.boundsPeriod.end" /> <short value="ProcedureEndDateTime" /> <definition value="The end date (and if possible end time) of the procedure. The concept offers the option to indicate the end of the period of a series of repeating procedures." /> <alias value="ActieEindDatumTijd" /> <mapping> <identity value="hcim-nursingintervention-v3.2-2018EN" /> <map value="NL-CM:14.2.12" /> <comment value="ProcedureEndDateTime" /> </mapping> </element> <element id="CarePlan.activity:nursingIntervention.detail.scheduled[x]:scheduledTiming.repeat.frequency"> <path value="CarePlan.activity.detail.scheduledTiming.repeat.frequency" /> <short value="Frequency" /> <definition value="The frequency describes how often and in which period certain procedures are carried out, e.g. 3x a day." /> <alias value="Frequentie" /> <mapping> <identity value="hcim-nursingintervention-v3.2-2018EN" /> <map value="NL-CM:14.2.4" /> <comment value="Frequency" /> </mapping> </element> <element id="CarePlan.activity:nursingIntervention.detail.scheduled[x]:scheduledTiming.repeat.period"> <path value="CarePlan.activity.detail.scheduledTiming.repeat.period" /> <short value="Interval" /> <definition value=""Interval indicates the time between planned procedures. When entering an interval, the focus is on the time between the consecutive procedures, such as in the treatment of a wound, for example. The exact times are of lesser importance."" /> <alias value="Interval" /> <mapping> <identity value="hcim-nursingintervention-v3.2-2018EN" /> <map value="NL-CM:14.2.3" /> <comment value="Interval" /> </mapping> </element> <element id="CarePlan.activity:nursingIntervention.detail.location"> <path value="CarePlan.activity.detail.location" /> <type> <code value="Reference" /> <targetProfile value="http://fhir.nl/fhir/StructureDefinition/nl-core-location" /> </type> </element> <element id="CarePlan.activity:nursingIntervention.detail.performer"> <path value="CarePlan.activity.detail.performer" /> <short value="Performer" /> <definition value="The person carrying out the nursing procedure. Can be the health professional, caregiver or the patient." /> <alias value="Uitvoerder" /> <alias value="Zorgverlener" /> <alias value="Verzorger" /> <alias value="Patient" /> <type> <code value="Reference" /> <targetProfile value="http://fhir.nl/fhir/StructureDefinition/nl-core-practitioner" /> </type> <type> <code value="Reference" /> <targetProfile value="http://fhir.nl/fhir/StructureDefinition/nl-core-organization" /> </type> <type> <code value="Reference" /> <targetProfile value="http://fhir.nl/fhir/StructureDefinition/nl-core-relatedperson" /> </type> <type> <code value="Reference" /> <targetProfile value="http://fhir.nl/fhir/StructureDefinition/nl-core-patient" /> </type> <type> <code value="Reference" /> <targetProfile value="http://fhir.nl/fhir/StructureDefinition/nl-core-careteam" /> </type> <mapping> <identity value="hcim-nursingintervention-v3.2-2018EN" /> <map value="NL-CM:14.2.15" /> <comment value="Performer" /> </mapping> <mapping> <identity value="hcim-nursingintervention-v3.2-2018EN" /> <map value="NL-CM:14.2.7" /> <comment value="HealthcareProvider" /> </mapping> <mapping> <identity value="hcim-nursingintervention-v3.2-2018EN" /> <map value="NL-CM:14.2.16" /> <comment value="Caregiver" /> </mapping> <mapping> <identity value="hcim-nursingintervention-v3.2-2018EN" /> <map value="NL-CM:14.2.17" /> <comment value="Patient" /> </mapping> </element> <element id="CarePlan.activity:nursingIntervention.detail.performer.extension"> <path value="CarePlan.activity.detail.performer.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <rules value="open" /> </slicing> </element> <element id="CarePlan.activity:nursingIntervention.detail.performer.extension:practitionerRole"> <path value="CarePlan.activity.detail.performer.extension" /> <sliceName value="practitionerRole" /> <max value="1" /> <type> <code value="Extension" /> <profile value="http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference" /> </type> </element> <element id="CarePlan.activity:nursingIntervention.detail.description"> <path value="CarePlan.activity.detail.description" /> <short value="Instruction" /> <definition value="Instructions for performing the nursing action. This is particularly at issue when the action is performed by the patient himself or by a caregiver." /> <mapping> <identity value="hcim-nursingintervention-v3.2-2018EN" /> <map value="NL-CM:14.2.18" /> <comment value="Instruction" /> </mapping> </element> </differential> </StructureDefinition>