{
  "resourceType": "StructureDefinition",
  "id": "zib-Stoma",
  "url": "http://nictiz.nl/fhir/StructureDefinition/zib-Stoma",
  "version": "1.1.3",
  "name": "Zib Stoma",
  "title": "HCIM Stoma",
  "status": "active",
  "publisher": "Nictiz",
  "contact": [
    {
      "name": "Nictiz",
      "telecom": [
        {
          "system": "url",
          "value": "https://www.nictiz.nl",
          "use": "work"
        }
      ]
    }
  ],
  "description": "Stoma is defined by the Dutch Health and Care Information models (Dutch: Zorginformatiebouwsteen or ZIB) version 3.2, release 2017.\r\n\r\nA stoma is an unnatural, surgically created opening connecting a body cavity with the outside world. A stoma is created e.g. as an exit opening for feces or urine in the event that they cannot leave the body naturally. In the case of a tracheostomy, the stoma is intended to facilitate breathing if that is no longer possible via the oral, nasal and throat cavity.",
  "purpose": "Information on present stomas is recorded to inform other health professionals. This information is of importance in determining the care required for the patient. In a transfer situation, the information offers the option to realize continuity of care by organizing specific expertise and materials in advance, for example.",
  "copyright": "CC0",
  "fhirVersion": "3.0.2",
  "mapping": [
    {
      "identity": "hcim-stoma-v3.2-2017EN",
      "uri": "https://zibs.nl/wiki/Stoma-v3.2(2017EN)",
      "name": "HCIM Stoma-v3.2(2017EN)"
    },
    {
      "identity": "hcim-basicelements-v1.0-2017EN",
      "uri": "https://zibs.nl/wiki/BasicElements-v1.0(2017EN)",
      "name": "HCIM BasicElements-v1.0(2017EN)"
    }
  ],
  "kind": "resource",
  "abstract": false,
  "type": "Observation",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Observation",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "Observation",
        "path": "Observation",
        "short": "Stoma",
        "alias": [
          "Stoma"
        ],
        "mapping": [
          {
            "identity": "hcim-stoma-v3.2-2017EN",
            "map": "NL-CM:5.2.1",
            "comment": "Stoma"
          }
        ]
      },
      {
        "id": "Observation.identifier",
        "path": "Observation.identifier",
        "mapping": [
          {
            "identity": "hcim-basicelements-v1.0-2017EN",
            "map": "NL-CM:0.0.6",
            "comment": "IdentificationNumber"
          }
        ]
      },
      {
        "id": "Observation.code.coding",
        "path": "Observation.code.coding",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "system"
            },
            {
              "type": "value",
              "path": "code"
            }
          ],
          "rules": "open"
        },
        "min": 1
      },
      {
        "id": "Observation.code.coding:stomaCode",
        "path": "Observation.code.coding",
        "sliceName": "stomaCode",
        "min": 1,
        "max": "1"
      },
      {
        "id": "Observation.code.coding:stomaCode.system",
        "path": "Observation.code.coding.system",
        "min": 1,
        "fixedUri": "http://snomed.info/sct"
      },
      {
        "id": "Observation.code.coding:stomaCode.code",
        "path": "Observation.code.coding.code",
        "min": 1,
        "fixedCode": "245857005"
      },
      {
        "id": "Observation.code.coding:stomaCode.display",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          }
        ],
        "path": "Observation.code.coding.display",
        "defaultValueString": "Stoma (morphologic abnormality)"
      },
      {
        "id": "Observation.subject",
        "path": "Observation.subject",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://fhir.nl/fhir/StructureDefinition/nl-core-patient"
          }
        ],
        "mapping": [
          {
            "identity": "hcim-basicelements-v1.0-2017EN",
            "map": "NL-CM:0.0.11",
            "comment": "Subject"
          }
        ]
      },
      {
        "id": "Observation.effective[x]:effectiveDateTime",
        "path": "Observation.effectiveDateTime",
        "sliceName": "effectiveDateTime",
        "short": "CreationDate",
        "definition": "The date on which the stoma was created in the patient. A vague date, such as only the year, is permitted.",
        "alias": [
          "AanlegDatum"
        ],
        "type": [
          {
            "code": "dateTime"
          }
        ],
        "mapping": [
          {
            "identity": "hcim-stoma-v3.2-2017EN",
            "map": "NL-CM:5.2.5",
            "comment": "CreationDate"
          },
          {
            "identity": "hcim-basicelements-v1.0-2017EN",
            "map": "NL-CM:0.0.14",
            "comment": "DateTime"
          }
        ]
      },
      {
        "id": "Observation.performer",
        "path": "Observation.performer",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://fhir.nl/fhir/StructureDefinition/nl-core-organization"
          },
          {
            "code": "Reference",
            "targetProfile": "http://fhir.nl/fhir/StructureDefinition/nl-core-patient"
          },
          {
            "code": "Reference",
            "targetProfile": "http://fhir.nl/fhir/StructureDefinition/nl-core-practitioner"
          },
          {
            "code": "Reference",
            "targetProfile": "http://fhir.nl/fhir/StructureDefinition/nl-core-relatedperson"
          }
        ],
        "mapping": [
          {
            "identity": "hcim-basicelements-v1.0-2017EN",
            "map": "NL-CM:0.0.7",
            "comment": "Author"
          }
        ]
      },
      {
        "id": "Observation.performer.extension",
        "path": "Observation.performer.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        }
      },
      {
        "id": "Observation.performer.extension:practitionerRole",
        "path": "Observation.performer.extension",
        "sliceName": "practitionerRole",
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": "http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference"
          }
        ]
      },
      {
        "id": "Observation.value[x]:valueCodeableConcept",
        "path": "Observation.valueCodeableConcept",
        "sliceName": "valueCodeableConcept",
        "short": "Stoma type",
        "definition": "Stoma type indicates which body cavity the stoma is in and the kind of stoma used.",
        "alias": [
          "StomaType"
        ],
        "min": 1,
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "example": [
          {
            "label": "Zib example of double-barrelled colostomy",
            "valueCodeableConcept": {
              "coding": [
                {
                  "system": "http://snomed.info/sct",
                  "code": "261072008",
                  "display": "double-barrelled colostomy"
                }
              ]
            }
          }
        ],
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "ObservationCode"
            }
          ],
          "strength": "extensible",
          "description": "Stoma type code list",
          "valueSetReference": {
            "reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.2.1--20171231000000",
            "display": "StomaTypeCodelijst"
          }
        },
        "mapping": [
          {
            "identity": "hcim-stoma-v3.2-2017EN",
            "map": "NL-CM:5.2.2",
            "comment": "StomaType"
          }
        ]
      },
      {
        "id": "Observation.comment",
        "path": "Observation.comment",
        "short": "Comment",
        "definition": "A comment on the stoma.",
        "alias": [
          "Toelichting"
        ],
        "mapping": [
          {
            "identity": "hcim-stoma-v3.2-2017EN",
            "map": "NL-CM:5.2.7",
            "comment": "Comment"
          }
        ]
      },
      {
        "id": "Observation.bodySite",
        "path": "Observation.bodySite",
        "short": "AnatomicalLocation",
        "definition": "Anatomical location of the stoma on the patient.",
        "alias": [
          "AnatomischeLocatie"
        ],
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "BodySite"
            }
          ],
          "strength": "extensible",
          "description": "Codes describing anatomical locations for a stoma",
          "valueSetReference": {
            "reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.2.2--20171231000000",
            "display": "StomaAnatomischeLocatieCodelijst"
          }
        },
        "mapping": [
          {
            "identity": "hcim-stoma-v3.2-2017EN",
            "map": "NL-CM:5.2.4",
            "comment": "AnatomicalLocation"
          }
        ]
      },
      {
        "id": "Observation.bodySite.extension",
        "path": "Observation.bodySite.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        }
      },
      {
        "id": "Observation.bodySite.extension:Laterality",
        "path": "Observation.bodySite.extension",
        "sliceName": "Laterality",
        "short": "Laterality",
        "alias": [
          "Lateraliteit"
        ],
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": "http://nictiz.nl/fhir/StructureDefinition/BodySite-Qualifier"
          }
        ],
        "mapping": [
          {
            "identity": "hcim-stoma-v3.2-2017EN",
            "map": "NL-CM:5.2.8",
            "comment": "Laterality"
          }
        ]
      },
      {
        "id": "Observation.bodySite.extension:Laterality.valueCodeableConcept:valueCodeableConcept",
        "path": "Observation.bodySite.extension.valueCodeableConcept",
        "sliceName": "valueCodeableConcept",
        "binding": {
          "strength": "extensible",
          "description": "StomaLateralityCodelist",
          "valueSetReference": {
            "reference": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.5.2.3--20171231000000",
            "display": "StomaLateralityCodelist"
          }
        }
      }
    ]
  }
}