MII IG Kerndatensatz-Modul Onkologie
2027.0.0-ballot.1 -
Germany
MII IG Kerndatensatz-Modul Onkologie
2027.0.0-ballot.1 -
Germany
This page is part of the MII IG Kerndatensatz-Modul Onkologie (v2027.0.0-ballot.1: Release) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions
<Bundle xmlns="http://hl7.org/fhir">
<id value="mii-exa-onko-folfox-workflow-bundle"/>
<language value="de"/>
<type value="collection"/>
<timestamp value="2024-03-15T10:00:00Z"/>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/Patient/mii-exa-onko-folfox-patient"/>
<resource>
<Patient>
<id value="mii-exa-onko-folfox-patient"/>
<language value="de"/>
<text>
<status value="generated"/>
</text>
<identifier>
<system
value="https://www.medizininformatik-initiative.de/fhir/sid/patienten"/>
<value value="FOLFOX-2024-001"/>
</identifier>
<name>
<family value="Schmidt"/>
<given value="Hans"/>
</name>
<gender value="male"/>
<birthDate value="1959-03-15"/>
</Patient>
</resource>
</entry>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/Encounter/mii-exa-onko-folfox-encounter-diagnosis"/>
<resource>
<Encounter>
<id value="mii-exa-onko-folfox-encounter-diagnosis"/>
<language value="de"/>
<text>
<status value="generated"/>
</text>
<status value="finished"/>
<class>
<system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
<code value="AMB"/>
<display value="ambulatory"/>
</class>
<subject>🔗
<reference value="Patient/mii-exa-onko-folfox-patient"/>
</subject>
</Encounter>
</resource>
</entry>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/Encounter/mii-exa-onko-folfox-encounter-surgery"/>
<resource>
<Encounter>
<id value="mii-exa-onko-folfox-encounter-surgery"/>
<language value="de"/>
<text>
<status value="generated"/>
</text>
<status value="finished"/>
<class>
<system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
<code value="IMP"/>
<display value="inpatient encounter"/>
</class>
<subject>🔗
<reference value="Patient/mii-exa-onko-folfox-patient"/>
</subject>
</Encounter>
</resource>
</entry>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/Encounter/mii-exa-onko-folfox-encounter-chemo"/>
<resource>
<Encounter>
<id value="mii-exa-onko-folfox-encounter-chemo"/>
<language value="de"/>
<text>
<status value="generated"/>
</text>
<status value="finished"/>
<class>
<system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
<code value="AMB"/>
<display value="ambulatory"/>
</class>
<subject>🔗
<reference value="Patient/mii-exa-onko-folfox-patient"/>
</subject>
</Encounter>
</resource>
</entry>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/Condition/mii-exa-onko-colorectal-cancer-diagnosis"/>
<resource>
<Condition>
<id value="mii-exa-onko-colorectal-cancer-diagnosis"/>
<meta>
<profile
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-diagnose-primaertumor"/>
</meta>
<language value="de"/>
<text>
<status value="extensions"/>
</text>
<extension
url="http://hl7.org/fhir/StructureDefinition/condition-assertedDate">
<valueDateTime value="2024-01-15"/>
</extension>
<clinicalStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
<code value="active"/>
</coding>
</clinicalStatus>
<verificationStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
<code value="confirmed"/>
</coding>
</verificationStatus>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/condition-category"/>
<code value="encounter-diagnosis"/>
<display value="Encounter Diagnosis"/>
</coding>
</category>
<category>
<coding>
<system value="http://snomed.info/sct"/>
<code value="55342001"/>
<display value="Neoplastic disease"/>
</coding>
</category>
<code>
<coding>
<system value="http://fhir.de/CodeSystem/bfarm/icd-10-gm"/>
<version value="2024"/>
<code value="C18.7"/>
<display value="Bösartige Neubildung: Colon sigmoideum"/>
</coding>
</code>
<subject>🔗
<reference value="Patient/mii-exa-onko-folfox-patient"/>
</subject>
<encounter>🔗
<reference
value="Encounter/mii-exa-onko-folfox-encounter-diagnosis"/>
</encounter>
<onsetDateTime value="2024-01-15"/>
<recordedDate value="2024-01-15"/>
<note>
<text
value="Adenokarzinom des Colon sigmoideum, Stadium III (T3N1M0)"/>
</note>
</Condition>
</resource>
</entry>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/Observation/mii-exa-onko-colorectal-tnm-t"/>
<resource>
<Observation>
<id value="mii-exa-onko-colorectal-tnm-t"/>
<meta>
<profile
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</meta>
<language value="de"/>
<text>
<status value="generated"/>
</text>
<status value="final"/>
<code>
<extension
url="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-ex-onko-tnm-cp-praefix">
<valueCodeableConcept>
<coding>
<system value="https://www.uicc.org/resources/tnm"/>
<code value="p"/>
</coding>
</valueCodeableConcept>
</extension>
<coding>
<system value="http://snomed.info/sct"/>
<code value="384625004"/>
<display value="pT category (observable entity)"/>
</coding>
</code>
<subject>🔗
<reference value="Patient/mii-exa-onko-folfox-patient"/>
</subject>
<focus>🔗
<reference
value="Condition/mii-exa-onko-colorectal-cancer-diagnosis"/>
</focus>
<effectiveDateTime value="2024-02-20"/>
<valueCodeableConcept>
<coding>
<system value="https://www.uicc.org/resources/tnm"/>
<code value="T3"/>
</coding>
</valueCodeableConcept>
<method>
<coding>
<system
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-tnm-version"/>
<code value="8"/>
</coding>
</method>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/Observation/mii-exa-onko-colorectal-tnm-n"/>
<resource>
<Observation>
<id value="mii-exa-onko-colorectal-tnm-n"/>
<meta>
<profile
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</meta>
<language value="de"/>
<text>
<status value="generated"/>
</text>
<status value="final"/>
<code>
<extension
url="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-ex-onko-tnm-cp-praefix">
<valueCodeableConcept>
<coding>
<system value="https://www.uicc.org/resources/tnm"/>
<code value="p"/>
</coding>
</valueCodeableConcept>
</extension>
<coding>
<system value="http://snomed.info/sct"/>
<code value="371494008"/>
<display value="pN category (observable entity)"/>
</coding>
</code>
<subject>🔗
<reference value="Patient/mii-exa-onko-folfox-patient"/>
</subject>
<focus>🔗
<reference
value="Condition/mii-exa-onko-colorectal-cancer-diagnosis"/>
</focus>
<effectiveDateTime value="2024-02-20"/>
<valueCodeableConcept>
<coding>
<system value="https://www.uicc.org/resources/tnm"/>
<code value="N1"/>
</coding>
</valueCodeableConcept>
<method>
<coding>
<system
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-tnm-version"/>
<code value="8"/>
</coding>
</method>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/Observation/mii-exa-onko-colorectal-tnm-m"/>
<resource>
<Observation>
<id value="mii-exa-onko-colorectal-tnm-m"/>
<meta>
<profile
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-tnm-m-kategorie|2027.0.0-ballot.1"/>
</meta>
<language value="de"/>
<text>
<status value="generated"/>
</text>
<status value="final"/>
<code>
<extension
url="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-ex-onko-tnm-cp-praefix">
<valueCodeableConcept>
<coding>
<system value="https://www.uicc.org/resources/tnm"/>
<code value="c"/>
</coding>
</valueCodeableConcept>
</extension>
<coding>
<system value="http://snomed.info/sct"/>
<code value="399387003"/>
<display value="cM category (observable entity)"/>
</coding>
</code>
<subject>🔗
<reference value="Patient/mii-exa-onko-folfox-patient"/>
</subject>
<focus>🔗
<reference
value="Condition/mii-exa-onko-colorectal-cancer-diagnosis"/>
</focus>
<effectiveDateTime value="2024-02-20"/>
<valueCodeableConcept>
<coding>
<system value="https://www.uicc.org/resources/tnm"/>
<code value="M0"/>
</coding>
</valueCodeableConcept>
<method>
<coding>
<system
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-tnm-version"/>
<code value="8"/>
</coding>
</method>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/Observation/mii-exa-onko-colorectal-tnm"/>
<resource>
<Observation>
<id value="mii-exa-onko-colorectal-tnm"/>
<meta>
<profile
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-tnm-klassifikation"/>
</meta>
<language value="de"/>
<text>
<status value="generated"/>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="399588009"/>
<display value="Pathologic TNM stage grouping"/>
</coding>
</code>
<subject>🔗
<reference value="Patient/mii-exa-onko-folfox-patient"/>
</subject>
<focus>🔗
<reference
value="Condition/mii-exa-onko-colorectal-cancer-diagnosis"/>
</focus>
<effectiveDateTime value="2024-02-20"/>
<valueCodeableConcept>
<coding>
<system value="https://www.uicc.org/resources/tnm"/>
<code value="IIIB"/>
</coding>
</valueCodeableConcept>
<method>
<coding>
<system
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-tnm-version"/>
<code value="8"/>
</coding>
</method>
<hasMember>🔗
<reference value="Observation/mii-exa-onko-colorectal-tnm-t"/>
</hasMember>
<hasMember>🔗
<reference value="Observation/mii-exa-onko-colorectal-tnm-n"/>
</hasMember>
<hasMember>🔗
<reference value="Observation/mii-exa-onko-colorectal-tnm-m"/>
</hasMember>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CarePlan/mii-exa-onko-tumorkonferenz-folfox"/>
<resource>
<CarePlan>
<id value="mii-exa-onko-tumorkonferenz-folfox"/>
<meta>
<profile
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-tumorkonferenz|2027.0.0-ballot.1"/>
</meta>
<language value="de"/>
<text>
<status value="generated"/>
</text>
<identifier>
<value value="Tumorkonferenz_FOLFOX_001"/>
</identifier>
<status value="active"/>
<intent value="plan"/>
<category>
<coding>
<system
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapieplanung-typ"/>
<code value="praeth"/>
<display
value="prätherapeutische Tumorkonferenz (Festlegung der Therapiestrategie)"/>
</coding>
</category>
<subject>🔗
<reference value="Patient/mii-exa-onko-folfox-patient"/>
</subject>
<created value="2024-03-10"/>
<addresses>🔗
<reference
value="Condition/mii-exa-onko-colorectal-cancer-diagnosis"/>
</addresses>
<activity>
<progress>
<text
value="Tumor board recommends FOLFOX chemotherapy protocol for stage III colon cancer, adjuvant setting"/>
</progress>
<reference>🔗
<reference value="RequestGroup/mii-exa-onko-folfox-requestgroup"/>
</reference>
</activity>
</CarePlan>
</resource>
</entry>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/RequestGroup/mii-exa-onko-folfox-requestgroup"/>
<resource>
<RequestGroup>
<id value="mii-exa-onko-folfox-requestgroup"/>
<meta>
<profile
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-therapieempfehlung-kombinationstherapie|2027.0.0-ballot.1"/>
</meta>
<language value="de"/>
<text>
<status value="generated"/>
</text>
<status value="active"/>
<intent value="proposal"/>
<code>
<coding>
<system
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapie-typ"/>
<code value="CH"/>
<display value="Chemotherapie"/>
</coding>
<text value="Chemotherapie"/>
</code>
<subject>🔗
<reference value="Patient/mii-exa-onko-folfox-patient"/>
</subject>
<authoredOn value="2024-03-10"/>
<reasonReference>🔗
<reference
value="Condition/mii-exa-onko-colorectal-cancer-diagnosis"/>
</reasonReference>
<action>
<title value="FOLFOX4 Protocol"/>
<description
value="FOLFOX4 chemotherapy protocol: Fluorouracil + Folinsäure + Oxaliplatin"/>
<code>
<coding>
<system
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-systemische-therapie-protokolle"/>
<code value="FOLFOX4"/>
<display value="FOLFOX4"/>
</coding>
</code>
<action>
<title value="Fluorouracil (5-FU)"/>
<description
value="5-Fluorouracil - pyrimidine analog, antineoplastic"/>
<resource>🔗
<reference
value="MedicationRequest/mii-exa-onko-folfox-5fu-request"/>
</resource>
</action>
<action>
<title value="Folinsäure (Leucovorin)"/>
<description value="Folinic acid - enhances 5-FU efficacy"/>
<resource>🔗
<reference
value="MedicationRequest/mii-exa-onko-folfox-leucovorin-request"/>
</resource>
</action>
<action>
<title value="Oxaliplatin"/>
<description value="Platinum-based chemotherapy agent"/>
<resource>🔗
<reference
value="MedicationRequest/mii-exa-onko-folfox-oxaliplatin-request"/>
</resource>
</action>
</action>
</RequestGroup>
</resource>
</entry>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/MedicationRequest/mii-exa-onko-folfox-5fu-request"/>
<resource>
<MedicationRequest>
<id value="mii-exa-onko-folfox-5fu-request"/>
<meta>
<profile
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-therapieempfehlung-medikation|2027.0.0-ballot.1"/>
</meta>
<language value="de"/>
<text>
<status value="generated"/>
</text>
<status value="active"/>
<intent value="proposal"/>
<medicationCodeableConcept>
<coding>
<system value="http://fhir.de/CodeSystem/bfarm/atc"/>
<code value="L01BC02"/>
<display value="Fluorouracil"/>
</coding>
<text value="5-Fluorouracil (5-FU)"/>
</medicationCodeableConcept>
<subject>🔗
<reference value="Patient/mii-exa-onko-folfox-patient"/>
</subject>
<authoredOn value="2024-03-10"/>
<reasonReference>🔗
<reference
value="Condition/mii-exa-onko-colorectal-cancer-diagnosis"/>
</reasonReference>
</MedicationRequest>
</resource>
</entry>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/MedicationRequest/mii-exa-onko-folfox-leucovorin-request"/>
<resource>
<MedicationRequest>
<id value="mii-exa-onko-folfox-leucovorin-request"/>
<meta>
<profile
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</meta>
<language value="de"/>
<text>
<status value="generated"/>
</text>
<status value="active"/>
<intent value="proposal"/>
<medicationCodeableConcept>
<coding>
<system value="http://fhir.de/CodeSystem/bfarm/atc"/>
<code value="V03AF03"/>
<display value="Calciumfolinat"/>
</coding>
<text value="Leucovorin (Folinsäure)"/>
</medicationCodeableConcept>
<subject>🔗
<reference value="Patient/mii-exa-onko-folfox-patient"/>
</subject>
<authoredOn value="2024-03-10"/>
<reasonReference>🔗
<reference
value="Condition/mii-exa-onko-colorectal-cancer-diagnosis"/>
</reasonReference>
</MedicationRequest>
</resource>
</entry>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/MedicationRequest/mii-exa-onko-folfox-oxaliplatin-request"/>
<resource>
<MedicationRequest>
<id value="mii-exa-onko-folfox-oxaliplatin-request"/>
<meta>
<profile
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</meta>
<language value="de"/>
<text>
<status value="generated"/>
</text>
<status value="active"/>
<intent value="proposal"/>
<medicationCodeableConcept>
<coding>
<system value="http://fhir.de/CodeSystem/bfarm/atc"/>
<code value="L01XA03"/>
<display value="Oxaliplatin"/>
</coding>
<text value="Oxaliplatin"/>
</medicationCodeableConcept>
<subject>🔗
<reference value="Patient/mii-exa-onko-folfox-patient"/>
</subject>
<authoredOn value="2024-03-10"/>
<reasonReference>🔗
<reference
value="Condition/mii-exa-onko-colorectal-cancer-diagnosis"/>
</reasonReference>
</MedicationRequest>
</resource>
</entry>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/Procedure/mii-exa-onko-sigmoid-resection"/>
<resource>
<Procedure>
<id value="mii-exa-onko-sigmoid-resection"/>
<meta>
<profile
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-operation"/>
</meta>
<language value="de"/>
<text>
<status value="extensions"/>
</text>
<extension
url="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-ex-onko-operation-intention">
<valueCodeableConcept>
<coding>
<system
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-intention"/>
<code value="K"/>
<display value="Kurativ"/>
</coding>
</valueCodeableConcept>
</extension>
<status value="completed"/>
<category>
<coding>
<system value="http://snomed.info/sct"/>
<code value="387713003"/>
<display value="Surgical procedure"/>
</coding>
</category>
<code>
<coding>
<system value="http://fhir.de/CodeSystem/bfarm/ops"/>
<version value="2024"/>
<code value="5-484.5"/>
<display
value="Rektumresektion unter Sphinktererhaltung: Tiefe anteriore Resektion"/>
</coding>
<text
value="Laparoskopische Sigmaresektion mit TME und Lymphknotendissektion"/>
</code>
<subject>🔗
<reference value="Patient/mii-exa-onko-folfox-patient"/>
</subject>
<encounter>🔗
<reference value="Encounter/mii-exa-onko-folfox-encounter-surgery"/>
</encounter>
<performedDateTime value="2024-02-15"/>
<reasonReference>🔗
<reference
value="Condition/mii-exa-onko-colorectal-cancer-diagnosis"/>
</reasonReference>
<outcome>
<coding>
<system
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-residualstatus"/>
<code value="R0"/>
<display value="Kein Residualtumor"/>
</coding>
</outcome>
<note>
<text
value="Laparoscopic sigmoid resection with TME and lymphadenectomy. No intraoperative complications. Tumor completely resected with clear margins (R0). 18 lymph nodes removed, 3 positive. Surgery performed in 3 components: resection, anastomosis, and lymph node dissection."/>
</note>
</Procedure>
</resource>
</entry>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/Procedure/mii-exa-onko-sigmoid-resection-part1"/>
<resource>
<Procedure>
<id value="mii-exa-onko-sigmoid-resection-part1"/>
<meta>
<profile
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</meta>
<language value="de"/>
<text>
<status value="extensions"/>
</text>
<extension
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<valueCodeableConcept>
<coding>
<system
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-intention"/>
<code value="K"/>
<display value="Kurativ"/>
</coding>
</valueCodeableConcept>
</extension>
<partOf>🔗
<reference value="Procedure/mii-exa-onko-sigmoid-resection"/>
</partOf>
<status value="completed"/>
<category>
<coding>
<system value="http://snomed.info/sct"/>
<code value="387713003"/>
<display value="Surgical procedure"/>
</coding>
</category>
<code>
<coding>
<system value="http://fhir.de/CodeSystem/bfarm/ops"/>
<version value="2024"/>
<code value="5-484.5"/>
<display
value="Rektumresektion unter Sphinktererhaltung: Tiefe anteriore Resektion"/>
</coding>
</code>
<subject>🔗
<reference value="Patient/mii-exa-onko-folfox-patient"/>
</subject>
<encounter>🔗
<reference value="Encounter/mii-exa-onko-folfox-encounter-surgery"/>
</encounter>
<performedDateTime value="2024-02-15"/>
<reasonReference>🔗
<reference
value="Condition/mii-exa-onko-colorectal-cancer-diagnosis"/>
</reasonReference>
<note>
<text
value="Sigmoid colon resected including tumor. End-to-end anastomosis created."/>
</note>
</Procedure>
</resource>
</entry>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/Procedure/mii-exa-onko-sigmoid-resection-part2"/>
<resource>
<Procedure>
<id value="mii-exa-onko-sigmoid-resection-part2"/>
<meta>
<profile
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-operation"/>
</meta>
<language value="de"/>
<text>
<status value="extensions"/>
</text>
<extension
url="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-ex-onko-operation-intention">
<valueCodeableConcept>
<coding>
<system
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-intention"/>
<code value="K"/>
<display value="Kurativ"/>
</coding>
</valueCodeableConcept>
</extension>
<partOf>🔗
<reference value="Procedure/mii-exa-onko-sigmoid-resection"/>
</partOf>
<status value="completed"/>
<category>
<coding>
<system value="http://snomed.info/sct"/>
<code value="387713003"/>
<display value="Surgical procedure"/>
</coding>
</category>
<code>
<coding>
<system value="http://fhir.de/CodeSystem/bfarm/ops"/>
<version value="2024"/>
<code value="5-407.0"/>
<display
value="Radikale (systematische) Lymphadenektomie im Rahmen einer anderen Operation: Axillär"/>
</coding>
</code>
<subject>🔗
<reference value="Patient/mii-exa-onko-folfox-patient"/>
</subject>
<encounter>🔗
<reference value="Encounter/mii-exa-onko-folfox-encounter-surgery"/>
</encounter>
<performedDateTime value="2024-02-15"/>
<reasonReference>🔗
<reference
value="Condition/mii-exa-onko-colorectal-cancer-diagnosis"/>
</reasonReference>
<note>
<text
value="Regional lymph node dissection performed. 18 lymph nodes removed from mesenteric and para-aortic regions."/>
</note>
</Procedure>
</resource>
</entry>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/Procedure/mii-exa-onko-sigmoid-resection-part3"/>
<resource>
<Procedure>
<id value="mii-exa-onko-sigmoid-resection-part3"/>
<meta>
<profile
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-operation"/>
</meta>
<language value="de"/>
<text>
<status value="extensions"/>
</text>
<extension
url="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-ex-onko-operation-intention">
<valueCodeableConcept>
<coding>
<system
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-intention"/>
<code value="K"/>
<display value="Kurativ"/>
</coding>
</valueCodeableConcept>
</extension>
<partOf>🔗
<reference value="Procedure/mii-exa-onko-sigmoid-resection"/>
</partOf>
<status value="completed"/>
<category>
<coding>
<system value="http://snomed.info/sct"/>
<code value="387713003"/>
<display value="Surgical procedure"/>
</coding>
</category>
<code>
<coding>
<system value="http://fhir.de/CodeSystem/bfarm/ops"/>
<version value="2024"/>
<code value="5-986.x"/>
<display value="Minimalinvasive Technik: Sonstige"/>
</coding>
</code>
<subject>🔗
<reference value="Patient/mii-exa-onko-folfox-patient"/>
</subject>
<encounter>🔗
<reference value="Encounter/mii-exa-onko-folfox-encounter-surgery"/>
</encounter>
<performedDateTime value="2024-02-15"/>
<reasonReference>🔗
<reference
value="Condition/mii-exa-onko-colorectal-cancer-diagnosis"/>
</reasonReference>
<note>
<text
value="Four laparoscopic ports placed for minimally invasive approach."/>
</note>
</Procedure>
</resource>
</entry>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/Procedure/mii-exa-onko-folfox-procedure"/>
<resource>
<Procedure>
<id value="mii-exa-onko-folfox-procedure"/>
<meta>
<profile
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-systemische-therapie"/>
</meta>
<language value="de"/>
<text>
<status value="extensions"/>
</text>
<extension
url="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-ex-onko-systemische-therapie-intention">
<valueCodeableConcept>
<coding>
<system
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-intention"/>
<code value="K"/>
<display value="Kurativ"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-ex-onko-systemische-therapie-stellungzurop">
<valueCodeableConcept>
<coding>
<system
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapie-stellungzurop"/>
<code value="A"/>
<display value="Adjuvant"/>
</coding>
</valueCodeableConcept>
</extension>
<basedOn>🔗
<reference value="CarePlan/mii-exa-onko-tumorkonferenz-folfox"/>
</basedOn>
<status value="completed"/>
<category>
<coding>
<system value="http://snomed.info/sct"/>
<code value="277132007"/>
<display value="Therapeutic procedure"/>
</coding>
</category>
<code>
<coding>
<system value="http://fhir.de/CodeSystem/bfarm/ops"/>
<version value="2024"/>
<code value="8-542"/>
<display value="Nicht komplexe Chemotherapie"/>
</coding>
<coding>
<system
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-systemische-therapie-art"/>
<code value="CH"/>
<display value="Chemotherapie"/>
</coding>
</code>
<subject>🔗
<reference value="Patient/mii-exa-onko-folfox-patient"/>
</subject>
<encounter>🔗
<reference value="Encounter/mii-exa-onko-folfox-encounter-chemo"/>
</encounter>
<performedPeriod>
<start value="2024-03-20"/>
<end value="2024-09-15"/>
</performedPeriod>
<reasonReference>🔗
<reference
value="Condition/mii-exa-onko-colorectal-cancer-diagnosis"/>
</reasonReference>
<outcome>
<coding>
<system
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapie-ende-grund"/>
<code value="E"/>
<display value="Reguläres Ende"/>
</coding>
</outcome>
<note>
<text
value="Patient received 12 cycles of adjuvant FOLFOX4 chemotherapy for stage III colon cancer. Treatment completed without major complications."/>
</note>
<usedCode>
<coding>
<system
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-systemische-therapie-protokolle"/>
<code value="FOLFOX4"/>
<display value="FOLFOX4"/>
</coding>
</usedCode>
</Procedure>
</resource>
</entry>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/MedicationStatement/mii-exa-onko-folfox-5fu-statement"/>
<resource>
<MedicationStatement>
<id value="mii-exa-onko-folfox-5fu-statement"/>
<meta>
<profile
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-systemische-therapie-medikation"/>
</meta>
<language value="de"/>
<text>
<status value="generated"/>
</text>
<basedOn>🔗
<reference value="CarePlan/mii-exa-onko-tumorkonferenz-folfox"/>
</basedOn>
<partOf>🔗
<reference value="Procedure/mii-exa-onko-folfox-procedure"/>
</partOf>
<status value="completed"/>
<medicationCodeableConcept>
<coding>
<system value="http://fhir.de/CodeSystem/bfarm/atc"/>
<code value="L01BC02"/>
<display value="Fluorouracil"/>
</coding>
<text value="5-Fluorouracil (5-FU)"/>
</medicationCodeableConcept>
<subject>🔗
<reference value="Patient/mii-exa-onko-folfox-patient"/>
</subject>
<effectivePeriod>
<start value="2024-03-20"/>
<end value="2024-09-15"/>
</effectivePeriod>
<note>
<text value="FOLFOX4"/>
</note>
</MedicationStatement>
</resource>
</entry>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/MedicationStatement/mii-exa-onko-folfox-leucovorin-statement"/>
<resource>
<MedicationStatement>
<id value="mii-exa-onko-folfox-leucovorin-statement"/>
<meta>
<profile
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-systemische-therapie-medikation"/>
</meta>
<language value="de"/>
<text>
<status value="generated"/>
</text>
<basedOn>🔗
<reference value="CarePlan/mii-exa-onko-tumorkonferenz-folfox"/>
</basedOn>
<partOf>🔗
<reference value="Procedure/mii-exa-onko-folfox-procedure"/>
</partOf>
<status value="completed"/>
<medicationCodeableConcept>
<coding>
<system value="http://fhir.de/CodeSystem/bfarm/atc"/>
<code value="V03AF03"/>
<display value="Calciumfolinat"/>
</coding>
<text value="Leucovorin (Folinsäure)"/>
</medicationCodeableConcept>
<subject>🔗
<reference value="Patient/mii-exa-onko-folfox-patient"/>
</subject>
<effectivePeriod>
<start value="2024-03-20"/>
<end value="2024-09-15"/>
</effectivePeriod>
<note>
<text value="FOLFOX4"/>
</note>
</MedicationStatement>
</resource>
</entry>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/MedicationStatement/mii-exa-onko-folfox-oxaliplatin-statement"/>
<resource>
<MedicationStatement>
<id value="mii-exa-onko-folfox-oxaliplatin-statement"/>
<meta>
<profile
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-systemische-therapie-medikation"/>
</meta>
<language value="de"/>
<text>
<status value="generated"/>
</text>
<basedOn>🔗
<reference value="CarePlan/mii-exa-onko-tumorkonferenz-folfox"/>
</basedOn>
<partOf>🔗
<reference value="Procedure/mii-exa-onko-folfox-procedure"/>
</partOf>
<status value="completed"/>
<medicationCodeableConcept>
<coding>
<system value="http://fhir.de/CodeSystem/bfarm/atc"/>
<code value="L01XA03"/>
<display value="Oxaliplatin"/>
</coding>
<text value="Oxaliplatin"/>
</medicationCodeableConcept>
<subject>🔗
<reference value="Patient/mii-exa-onko-folfox-patient"/>
</subject>
<effectivePeriod>
<start value="2024-03-20"/>
<end value="2024-09-15"/>
</effectivePeriod>
<note>
<text value="FOLFOX4"/>
</note>
</MedicationStatement>
</resource>
</entry>
<entry>
<fullUrl
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/Observation/mii-exa-onko-folfox-verlauf-6months"/>
<resource>
<Observation>
<id value="mii-exa-onko-folfox-verlauf-6months"/>
<meta>
<profile
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-verlauf"/>
</meta>
<language value="de"/>
<text>
<status value="generated"/>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="396432002"/>
<display
value="Status of regression of tumor (observable entity)"/>
</coding>
</code>
<subject>🔗
<reference value="Patient/mii-exa-onko-folfox-patient"/>
</subject>
<focus>🔗
<reference
value="Condition/mii-exa-onko-colorectal-cancer-diagnosis"/>
</focus>
<effectiveDateTime value="2025-03-15"/>
<valueCodeableConcept>
<coding>
<system
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-verlauf-gesamtbeurteilung"/>
<code value="V"/>
<display value="Vollremission (complete remission, CR)"/>
</coding>
</valueCodeableConcept>
<note>
<text
value="Patient completed 12 cycles of adjuvant FOLFOX4. CT scan and colonoscopy show no evidence of recurrence. CEA level normal (2.1 ng/mL). Patient is disease-free at 6-month follow-up. Plan: Continue surveillance with CEA and imaging every 3-6 months."/>
</note>
<component>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="445200009"/>
<display
value="Status of residual neoplasm (observable entity)"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-verlauf-primaertumor"/>
<code value="K"/>
<display value="Kein Tumor nachweisbar"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="399656008"/>
<display
value="Presence of metastatic neoplasm in regional lymph node (observable entity)"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-verlauf-lymphknoten"/>
<code value="K"/>
<display value="kein Lymphknotenbefall nachweisbar"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="399608002"/>
<display
value="Status of distant metastasis (observable entity)"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system
value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-verlauf-fernmetastasen"/>
<code value="K"/>
<display value="Keine Fernmetastasen nachweisbar"/>
</coding>
</valueCodeableConcept>
</component>
</Observation>
</resource>
</entry>
</Bundle>