MII IG Kerndatensatz-Modul Molekulares Tumorboard
2027.0.0-ballot.1 - Germany

This page is part of the MII Implementation Guide Molecular Tumor Board (v2027.0.0-ballot.1: Release) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Resource Profile: MII PR MTB Clinical Impresssion

Official URL: https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-follow-up-clinicalimpression Version: 2027.0.0-ballot.1
Active as of 2026-09-15 Computable Name: MII_PR_MTB_Follow_Up_ClinicalImpression

Follow-Up als Prozess des Einholens von Informationen über durchgeführte Therapien & Kostenuebernahmen

Content

This profile describes information about the administrative process "Follow-Up" and the information collected in the course of it. As part of this Follow-Up process, the therapies carried out (MII_PR_MTB_Systemische_Therapie) are documented, including the subsequent therapy response and, where applicable, their cost coverage (MII_PR_MTB_Antrag_Kostenuebernahme & MII_PR_MTB_Antwort_Kostenuebernahme). In addition, the status of the Therapieplan (therapy plan) ClinicalImpression.investigation and a justification in case of non-implementation ClinicalImpression.statusReason are contained here.

The Follow-Up ClinicalImpressions all reference the Behandlungsepisode (treatment episode) under ClinicalImpression.previous

Content

Mapping dataset to FHIR

Search parameters

The following search parameters are relevant for the MTB module, also in combination:

  1. The search parameter "_id" MUST be supported:

    Examples:

    GET [base]/ClinicalImpression?_id=12345

    Usage notes: Further information on searching for "_id" can be found in the FHIR base specification - section "Parameters for all resources".

  2. The search parameter "_profile" MUST be supported:

    Examples:

    GET [base]/ClinicalImpression?_profile=https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-follow-up-clinicalimpression

    Usage notes: Further information on searching for "_profile" can be found in the FHIR base specification - section "Parameters for all resources".

  3. The search parameter "status" MUST be supported:

    Examples:

    GET [base]/ClinicalImpression?status=completed

    Usage notes: Further information on searching for "ClinicalImpression.status" can be found in the FHIR base specification - section "token".

  4. The search parameter "statusReason" MUST be supported:

    Examples:

    GET [base]/ClinicalImpression?statusReson=https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-systemische-therapie-status-grund|payment-refused

    Usage notes: Further information on searching for "ClinicalImpression.statusReason" can be found in the FHIR base specification - section "token".

  5. The search parameter "subject" MUST be supported:

    Examples:

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

    Usage notes: Further information on searching for "ClinicalImpression.subject" can be found in the FHIR base specification - section "reference".

  6. The search parameter "investigation" MUST be supported:

    Examples:

    GET [base]/ClinicalImpression?investigation=https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-follow-up-status|ongoing

    Usage notes: Further information on searching for "ClinicalImpression.investigation" can be found in the FHIR base specification - section "token".

  7. The search parameter "supporting-info" MUST be supported:

    Examples:

    GET [base]/ClinicalImpression?supporting-info=MII_PR_MTB_Systemische_Therapie/example

    Usage notes: Further information on searching for "ClinicalImpression.supportingInfo" can be found in the FHIR base specification - section "reference".

Examples

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots, and their representations.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ClinicalImpression 0..* ClinicalImpression A clinical assessment performed when planning treatments and management strategies for a patient
... meta SΣ 0..1 Meta Metadata about the resource
.... profile SΣ 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... statusReason S 0..1 CodeableConcept Reason for Non-Implementation
Binding Description: (example): Codes identifying the reason for the current state of a clinical impression.
.... coding Σ 1..1 Coding Code defined by a terminology system
..... system Σ 0..1 uri Identity of the terminology system
Required Pattern: https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-systemische-therapie-status-grund
..... code SΣ 1..1 code Symbol in syntax defined by the system
Binding: MII VS Follow-Up Grund Nicht-Umsetzung (required)
... code SΣ 1..1 CodeableConcept Follow-Up
Binding Description: (example): Identifies categories of clinical impressions. This is a place-holder only. It may be removed.
.... coding Σ 0..* Coding Code defined by a terminology system

Required Pattern: At least the following
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 390906007
..... display 1..1 string Representation defined by the system
Fixed Value: Follow-up encounter (procedure)
..... userSelected 0..1 boolean If this coding was chosen directly by the user
... subject SΣ 1..1 Reference(Patient | Group) Patient or group assessed
... effective[x] SΣ 0..1 dateTime Recording Date
... previous S 1..1 Reference(MII PR MTB Behandlungsepisode) MTB Treatment Episode
... investigation S 0..* BackboneElement Follow-Up Status
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code 1..1 CodeableConcept A name/code for the set
Binding: InvestigationType (example): A name/code for a set of investigations.
... Slices for supportingInfo S 0..* Reference(Resource) Information supporting the clinical impression
Slice: Unordered, Open by type:$this.resolve()
.... supportingInfo:UmgesetzteTherapien S 0..* Reference(Procedure) Implemented Therapies
.... supportingInfo:AntraegeKostenuebernahme S 0..* Reference(Claim) Cost Coverage Applications
.... supportingInfo:AntwortenKostenuebernahme 0..* Reference(ClaimResponse) Cost Coverage Responses

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
ClinicalImpression.status Base required Clinical Impression Status 📍4.0.1 FHIR Std.
ClinicalImpression.statusReason Base example Not State Unknown
ClinicalImpression.statusReason.​coding.code Base required MII VS Follow-Up Grund Nicht-Umsetzung 📦2027.0.0-ballot.1 This IG
ClinicalImpression.code Base example Not State Unknown
ClinicalImpression.investigation.​code Base example Investigation Type 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error ClinicalImpression If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error ClinicalImpression If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error ClinicalImpression If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error ClinicalImpression If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice ClinicalImpression A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ClinicalImpression 0..* ClinicalImpression A clinical assessment performed when planning treatments and management strategies for a patient
... meta S 0..1 Meta Metadata about the resource
.... profile S 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
... status S 1..1 code in-progress | completed | entered-in-error
... statusReason S 0..1 CodeableConcept Reason for Non-Implementation
.... coding 1..1 Coding Code defined by a terminology system
..... system 0..1 uri Identity of the terminology system
Required Pattern: https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-systemische-therapie-status-grund
..... code S 1..1 code Symbol in syntax defined by the system
Binding: MII VS Follow-Up Grund Nicht-Umsetzung (required)
.... coding 0..* Coding Code defined by a terminology system
Required Pattern: At least the following
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 390906007
..... display 1..1 string Representation defined by the system
Fixed Value: Follow-up encounter (procedure)
... subject S 1..1 Reference(Patient | Group) Patient or group assessed
... effective[x] S 0..1 dateTime Recording Date
... previous S 1..1 Reference(MII PR MTB Behandlungsepisode) MTB Treatment Episode
... investigation S 0..* BackboneElement Follow-Up Status
.... code
..... coding
...... system 0..1 uri Identity of the terminology system
Required Pattern: https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-follow-up-status
...... code 0..1 code Symbol in syntax defined by the system
Binding: MII VS Follow-Up Status (required)
... Slices for supportingInfo S 0..* Reference(Resource) Information supporting the clinical impression
Slice: Unordered, Open by type:$this.resolve()
.... supportingInfo:UmgesetzteTherapien S 0..* Reference(Procedure) Implemented Therapies
.... supportingInfo:AntraegeKostenuebernahme S 0..* Reference(Claim) Cost Coverage Applications
.... supportingInfo:AntwortenKostenuebernahme 0..* Reference(ClaimResponse) Cost Coverage Responses

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
ClinicalImpression.statusReason.​coding.code Base required MII VS Follow-Up Grund Nicht-Umsetzung 📦2027.0.0-ballot.1 This IG
ClinicalImpression.investigation.​code.coding.code Base required MII VS Follow-Up Status 📦2027.0.0-ballot.1 This IG
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ClinicalImpression 0..* ClinicalImpression A clinical assessment performed when planning treatments and management strategies for a patient
... id Σ 0..1 id Logical id of this artifact
... meta SΣ 0..1 Meta Metadata about the resource
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId Σ 0..1 id Version specific identifier
.... lastUpdated Σ 0..1 instant When the resource version last changed
.... source Σ 0..1 uri Identifies where the resource comes from
.... profile SΣ 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
.... security Σ 0..* Coding Security Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
.... tag Σ 0..* Coding Tags applied to this resource
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Business identifier
... status ?!SΣ 1..1 code in-progress | completed | entered-in-error
Binding: ClinicalImpressionStatus (required): The workflow state of a clinical impression.
... statusReason S 0..1 CodeableConcept Reason for Non-Implementation
Binding Description: (example): Codes identifying the reason for the current state of a clinical impression.
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... coding Σ 1..1 Coding Code defined by a terminology system
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... system Σ 0..1 uri Identity of the terminology system
Required Pattern: https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-systemische-therapie-status-grund
..... version Σ 0..1 string Version of the system - if relevant
..... code SΣ 1..1 code Symbol in syntax defined by the system
Binding: MII VS Follow-Up Grund Nicht-Umsetzung (required)
..... display Σ 0..1 string Representation defined by the system
..... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... code SΣ 1..1 CodeableConcept Follow-Up
Binding Description: (example): Identifies categories of clinical impressions. This is a place-holder only. It may be removed.
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... coding Σ 0..* Coding Code defined by a terminology system

Required Pattern: At least the following
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 390906007
..... display 1..1 string Representation defined by the system
Fixed Value: Follow-up encounter (procedure)
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... description Σ 0..1 string Why/how the assessment was performed
... subject SΣ 1..1 Reference(Patient | Group) Patient or group assessed
... encounter Σ 0..1 Reference(Encounter) Encounter created as part of
... effective[x] SΣ 0..1 dateTime Recording Date
... date Σ 0..1 dateTime When the assessment was documented
... assessor Σ 0..1 Reference(Practitioner | PractitionerRole) The clinician performing the assessment
... previous S 1..1 Reference(MII PR MTB Behandlungsepisode) MTB Treatment Episode
... problem Σ 0..* Reference(Condition | AllergyIntolerance) Relevant impressions of patient state
... investigation S 0..* BackboneElement Follow-Up Status
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code 1..1 CodeableConcept A name/code for the set
Binding: InvestigationType (example): A name/code for a set of investigations.
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... coding Σ 0..* Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 0..1 uri Identity of the terminology system
Required Pattern: https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-follow-up-status
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 0..1 code Symbol in syntax defined by the system
Binding: MII VS Follow-Up Status (required)
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text Σ 0..1 string Plain text representation of the concept
.... item 0..* Reference(Observation | QuestionnaireResponse | FamilyMemberHistory | DiagnosticReport | RiskAssessment | ImagingStudy | Media) Record of a specific investigation
... protocol 0..* uri Clinical Protocol followed
... summary 0..1 string Summary of the assessment
... finding 0..* BackboneElement Possible or likely findings and diagnoses
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... itemCodeableConcept 0..1 CodeableConcept What was found
Binding: Condition/Problem/DiagnosisCodes (example): Identification of the Condition or diagnosis.
.... itemReference 0..1 Reference(Condition | Observation | Media) What was found
.... basis 0..1 string Which investigations support finding
... prognosisCodeableConcept 0..* CodeableConcept Estimate of likely outcome
Binding: ClinicalImpressionPrognosis (example): Prognosis or outlook findings.
... prognosisReference 0..* Reference(RiskAssessment) RiskAssessment expressing likely outcome
... Slices for supportingInfo S 0..* Reference(Resource) Information supporting the clinical impression
Slice: Unordered, Open by type:$this.resolve()
.... supportingInfo:UmgesetzteTherapien S 0..* Reference(Procedure) Implemented Therapies
.... supportingInfo:AntraegeKostenuebernahme S 0..* Reference(Claim) Cost Coverage Applications
.... supportingInfo:AntwortenKostenuebernahme 0..* Reference(ClaimResponse) Cost Coverage Responses
... note 0..* Annotation Comments made about the ClinicalImpression

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
ClinicalImpression.meta.​security Base extensible SecurityLabels 📍4.0.1 FHIR Std.
ClinicalImpression.meta.​tag Base example Common Tags 📍4.0.1 FHIR Std.
ClinicalImpression.language Base preferred Common Languages 📍4.0.1 FHIR Std.
ClinicalImpression.status Base required Clinical Impression Status 📍4.0.1 FHIR Std.
ClinicalImpression.statusReason Base example Not State Unknown
ClinicalImpression.statusReason.​coding.code Base required MII VS Follow-Up Grund Nicht-Umsetzung 📦2027.0.0-ballot.1 This IG
ClinicalImpression.code Base example Not State Unknown
ClinicalImpression.investigation.​code Base example Investigation Type 📍4.0.1 FHIR Std.
ClinicalImpression.investigation.​code.coding.code Base required MII VS Follow-Up Status 📦2027.0.0-ballot.1 This IG
ClinicalImpression.finding.​itemCodeableConcept Base example Condition/Problem/Diagnosis Codes 📍4.0.1 FHIR Std.
ClinicalImpression.prognosisCodeableConcept Base example Clinical Impression Prognosis 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error ClinicalImpression If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error ClinicalImpression If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error ClinicalImpression If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error ClinicalImpression If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice ClinicalImpression A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

Summary

Mandatory: 2 elements(2 nested mandatory elements)
Must-Support: 13 elements

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of ClinicalImpression.supportingInfo

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ClinicalImpression 0..* ClinicalImpression A clinical assessment performed when planning treatments and management strategies for a patient
... meta SΣ 0..1 Meta Metadata about the resource
.... profile SΣ 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... statusReason S 0..1 CodeableConcept Reason for Non-Implementation
Binding Description: (example): Codes identifying the reason for the current state of a clinical impression.
.... coding Σ 1..1 Coding Code defined by a terminology system
..... system Σ 0..1 uri Identity of the terminology system
Required Pattern: https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-systemische-therapie-status-grund
..... code SΣ 1..1 code Symbol in syntax defined by the system
Binding: MII VS Follow-Up Grund Nicht-Umsetzung (required)
... code SΣ 1..1 CodeableConcept Follow-Up
Binding Description: (example): Identifies categories of clinical impressions. This is a place-holder only. It may be removed.
.... coding Σ 0..* Coding Code defined by a terminology system

Required Pattern: At least the following
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 390906007
..... display 1..1 string Representation defined by the system
Fixed Value: Follow-up encounter (procedure)
..... userSelected 0..1 boolean If this coding was chosen directly by the user
... subject SΣ 1..1 Reference(Patient | Group) Patient or group assessed
... effective[x] SΣ 0..1 dateTime Recording Date
... previous S 1..1 Reference(MII PR MTB Behandlungsepisode) MTB Treatment Episode
... investigation S 0..* BackboneElement Follow-Up Status
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code 1..1 CodeableConcept A name/code for the set
Binding: InvestigationType (example): A name/code for a set of investigations.
... Slices for supportingInfo S 0..* Reference(Resource) Information supporting the clinical impression
Slice: Unordered, Open by type:$this.resolve()
.... supportingInfo:UmgesetzteTherapien S 0..* Reference(Procedure) Implemented Therapies
.... supportingInfo:AntraegeKostenuebernahme S 0..* Reference(Claim) Cost Coverage Applications
.... supportingInfo:AntwortenKostenuebernahme 0..* Reference(ClaimResponse) Cost Coverage Responses

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
ClinicalImpression.status Base required Clinical Impression Status 📍4.0.1 FHIR Std.
ClinicalImpression.statusReason Base example Not State Unknown
ClinicalImpression.statusReason.​coding.code Base required MII VS Follow-Up Grund Nicht-Umsetzung 📦2027.0.0-ballot.1 This IG
ClinicalImpression.code Base example Not State Unknown
ClinicalImpression.investigation.​code Base example Investigation Type 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error ClinicalImpression If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error ClinicalImpression If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error ClinicalImpression If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error ClinicalImpression If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice ClinicalImpression A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

Differential View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ClinicalImpression 0..* ClinicalImpression A clinical assessment performed when planning treatments and management strategies for a patient
... meta S 0..1 Meta Metadata about the resource
.... profile S 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
... status S 1..1 code in-progress | completed | entered-in-error
... statusReason S 0..1 CodeableConcept Reason for Non-Implementation
.... coding 1..1 Coding Code defined by a terminology system
..... system 0..1 uri Identity of the terminology system
Required Pattern: https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-systemische-therapie-status-grund
..... code S 1..1 code Symbol in syntax defined by the system
Binding: MII VS Follow-Up Grund Nicht-Umsetzung (required)
.... coding 0..* Coding Code defined by a terminology system
Required Pattern: At least the following
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 390906007
..... display 1..1 string Representation defined by the system
Fixed Value: Follow-up encounter (procedure)
... subject S 1..1 Reference(Patient | Group) Patient or group assessed
... effective[x] S 0..1 dateTime Recording Date
... previous S 1..1 Reference(MII PR MTB Behandlungsepisode) MTB Treatment Episode
... investigation S 0..* BackboneElement Follow-Up Status
.... code
..... coding
...... system 0..1 uri Identity of the terminology system
Required Pattern: https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-follow-up-status
...... code 0..1 code Symbol in syntax defined by the system
Binding: MII VS Follow-Up Status (required)
... Slices for supportingInfo S 0..* Reference(Resource) Information supporting the clinical impression
Slice: Unordered, Open by type:$this.resolve()
.... supportingInfo:UmgesetzteTherapien S 0..* Reference(Procedure) Implemented Therapies
.... supportingInfo:AntraegeKostenuebernahme S 0..* Reference(Claim) Cost Coverage Applications
.... supportingInfo:AntwortenKostenuebernahme 0..* Reference(ClaimResponse) Cost Coverage Responses

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
ClinicalImpression.statusReason.​coding.code Base required MII VS Follow-Up Grund Nicht-Umsetzung 📦2027.0.0-ballot.1 This IG
ClinicalImpression.investigation.​code.coding.code Base required MII VS Follow-Up Status 📦2027.0.0-ballot.1 This IG

Snapshot ViewView

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ClinicalImpression 0..* ClinicalImpression A clinical assessment performed when planning treatments and management strategies for a patient
... id Σ 0..1 id Logical id of this artifact
... meta SΣ 0..1 Meta Metadata about the resource
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId Σ 0..1 id Version specific identifier
.... lastUpdated Σ 0..1 instant When the resource version last changed
.... source Σ 0..1 uri Identifies where the resource comes from
.... profile SΣ 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
.... security Σ 0..* Coding Security Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
.... tag Σ 0..* Coding Tags applied to this resource
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Business identifier
... status ?!SΣ 1..1 code in-progress | completed | entered-in-error
Binding: ClinicalImpressionStatus (required): The workflow state of a clinical impression.
... statusReason S 0..1 CodeableConcept Reason for Non-Implementation
Binding Description: (example): Codes identifying the reason for the current state of a clinical impression.
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... coding Σ 1..1 Coding Code defined by a terminology system
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... system Σ 0..1 uri Identity of the terminology system
Required Pattern: https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-systemische-therapie-status-grund
..... version Σ 0..1 string Version of the system - if relevant
..... code SΣ 1..1 code Symbol in syntax defined by the system
Binding: MII VS Follow-Up Grund Nicht-Umsetzung (required)
..... display Σ 0..1 string Representation defined by the system
..... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... code SΣ 1..1 CodeableConcept Follow-Up
Binding Description: (example): Identifies categories of clinical impressions. This is a place-holder only. It may be removed.
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... coding Σ 0..* Coding Code defined by a terminology system

Required Pattern: At least the following
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 390906007
..... display 1..1 string Representation defined by the system
Fixed Value: Follow-up encounter (procedure)
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... description Σ 0..1 string Why/how the assessment was performed
... subject SΣ 1..1 Reference(Patient | Group) Patient or group assessed
... encounter Σ 0..1 Reference(Encounter) Encounter created as part of
... effective[x] SΣ 0..1 dateTime Recording Date
... date Σ 0..1 dateTime When the assessment was documented
... assessor Σ 0..1 Reference(Practitioner | PractitionerRole) The clinician performing the assessment
... previous S 1..1 Reference(MII PR MTB Behandlungsepisode) MTB Treatment Episode
... problem Σ 0..* Reference(Condition | AllergyIntolerance) Relevant impressions of patient state
... investigation S 0..* BackboneElement Follow-Up Status
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code 1..1 CodeableConcept A name/code for the set
Binding: InvestigationType (example): A name/code for a set of investigations.
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... coding Σ 0..* Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ 0..1 uri Identity of the terminology system
Required Pattern: https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-follow-up-status
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 0..1 code Symbol in syntax defined by the system
Binding: MII VS Follow-Up Status (required)
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text Σ 0..1 string Plain text representation of the concept
.... item 0..* Reference(Observation | QuestionnaireResponse | FamilyMemberHistory | DiagnosticReport | RiskAssessment | ImagingStudy | Media) Record of a specific investigation
... protocol 0..* uri Clinical Protocol followed
... summary 0..1 string Summary of the assessment
... finding 0..* BackboneElement Possible or likely findings and diagnoses
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... itemCodeableConcept 0..1 CodeableConcept What was found
Binding: Condition/Problem/DiagnosisCodes (example): Identification of the Condition or diagnosis.
.... itemReference 0..1 Reference(Condition | Observation | Media) What was found
.... basis 0..1 string Which investigations support finding
... prognosisCodeableConcept 0..* CodeableConcept Estimate of likely outcome
Binding: ClinicalImpressionPrognosis (example): Prognosis or outlook findings.
... prognosisReference 0..* Reference(RiskAssessment) RiskAssessment expressing likely outcome
... Slices for supportingInfo S 0..* Reference(Resource) Information supporting the clinical impression
Slice: Unordered, Open by type:$this.resolve()
.... supportingInfo:UmgesetzteTherapien S 0..* Reference(Procedure) Implemented Therapies
.... supportingInfo:AntraegeKostenuebernahme S 0..* Reference(Claim) Cost Coverage Applications
.... supportingInfo:AntwortenKostenuebernahme 0..* Reference(ClaimResponse) Cost Coverage Responses
... note 0..* Annotation Comments made about the ClinicalImpression

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
ClinicalImpression.meta.​security Base extensible SecurityLabels 📍4.0.1 FHIR Std.
ClinicalImpression.meta.​tag Base example Common Tags 📍4.0.1 FHIR Std.
ClinicalImpression.language Base preferred Common Languages 📍4.0.1 FHIR Std.
ClinicalImpression.status Base required Clinical Impression Status 📍4.0.1 FHIR Std.
ClinicalImpression.statusReason Base example Not State Unknown
ClinicalImpression.statusReason.​coding.code Base required MII VS Follow-Up Grund Nicht-Umsetzung 📦2027.0.0-ballot.1 This IG
ClinicalImpression.code Base example Not State Unknown
ClinicalImpression.investigation.​code Base example Investigation Type 📍4.0.1 FHIR Std.
ClinicalImpression.investigation.​code.coding.code Base required MII VS Follow-Up Status 📦2027.0.0-ballot.1 This IG
ClinicalImpression.finding.​itemCodeableConcept Base example Condition/Problem/Diagnosis Codes 📍4.0.1 FHIR Std.
ClinicalImpression.prognosisCodeableConcept Base example Clinical Impression Prognosis 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error ClinicalImpression If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error ClinicalImpression If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error ClinicalImpression If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error ClinicalImpression If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice ClinicalImpression A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

Summary

Mandatory: 2 elements(2 nested mandatory elements)
Must-Support: 13 elements

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of ClinicalImpression.supportingInfo

 

Other representations of profile: CSV, Excel, Schematron