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

Ressourcenprofil: MII PR Onkologie Therapieempfehlung Kombinationstherapie

Offizielle URL: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-therapieempfehlung-kombinationstherapie Version: 2027.0.0-ballot.1
Active Stand: 2026-09-15 Maschinenlesbarer Name: MII_PR_Onko_Therapieempfehlung_Kombinationstherapie

Dieses Profil beschreibt eine Empfehlung für eine Kombinationstherapie im Rahmen der Tumorkonferenz

Dieses Profil beschreibt strukturierte Therapieempfehlungen für Kombinationstherapien mittels RequestGroup. Es ermöglicht die detaillierte Abbildung von Multi-Agent-Protokollen und alternativen Therapieoptionen für molekulare Tumorboards.

Inhalt

Das RequestGroup-Profil dient als "Protokoll-Koordinator" zwischen CarePlan-Empfehlungen und spezifischen Therapieressourcen (SystemischeTherapie, MedicationRequest, etc.).

Es ermöglicht die Abbildung komplexer Therapieempfehlungen für molekulare Tumorboards und andere Tumorkonferenzen, die über einfache Kategorisierungen hinausgehen und spezifische Medikamentenkombinationen oder Therapieoptionen erfordern.

Abgrenzung zur oBDS-Standardempfehlung

Aspekt oBDS-Standardempfehlung Erweiterte Empfehlung mit RequestGroup
Verwendung Traditionelle Tumorboards Molekulare Tumorboards, komplexe Protokolle
Therapieempfehlung activity.detail.code (19.1 oBDS) activity.reference → RequestGroup
Multi-Agent-Therapien Einzelne Kategorisierung Detaillierte Protokolle mit spezifischen Agenten
FHIR Invarianten activity.detail verwendet activity.detail deaktiviert (0..0)

Grund: Die FHIR-R4-Invariante cpl-3 verhindert die gleichzeitige Verwendung von activity.detail.code und activity.reference. Beide Ansätze werden daher als getrennte Slices geführt.

Beide Varianten sind inzwischen im Tumorkonferenz-Profil selbst als Slices activity:obds (mit activity.detail.code, activity.reference auf 0..0) und activity:extended (mit activity.reference 1..1, activity.detail auf 0..0) abgebildet; ein eigenes "Detailed Recommendations"-CarePlan-Profil existiert nicht mehr. Die Struktur ist in der Artefaktdarstellung beschrieben: MII PR Onkologie Tumorkonferenz.

Anwendungsfälle

Multi-Agent-Therapieprotokolle

  • Anti-HER2-Kombination: Trastuzumab + Pertuzumab
  • CDK4/6 + Hormontherapie: Palbociclib + Letrozol
  • Triplet-Therapien: Tucatinib + Trastuzumab + Capecitabine

Alternative Therapieoptionen

  • Linientherapie: Erste-, zweite-, drittlinienoptionen basierend auf Resistenz
  • Biomarker-basiert: Verschiedene Optionen je nach Mutationsstatus
  • Klassen-basiert: "Beliebiger CDK4/6 Inhibitor" vs. spezifische Auswahl

Technische Architektur

RequestGroup als Protokoll-Koordinator

CarePlan.activity.reference → RequestGroup
├── code: oBDS-Therapietyp (ZS, CZ, IM, etc.)
├── basedOn: Reference(CarePlan) [Rückverfolgbarkeit]
└── action[].resource: Reference(SystemischeTherapie)

Therapietyp-Klassifikation

Das RequestGroup.code Element enthält die oBDS-Therapietyp-Klassifikation:

  • ZS: Zielgerichtete Substanzen
  • CZ: Chemotherapie + zielgerichtete Substanzen
  • IM: Immun-/Antikörpertherapie
  • CI: Chemo- + Immun-/Antikörpertherapie
  • CIZ: Chemo- + Immun-/Antikörpertherapie + zielgerichtete Substanzen

Wichtig: Diese Klassifikation war ursprünglich in CarePlan.activity.detail.code (oBDS 19.1), wird aber aufgrund von FHIR-Invarianten in das RequestGroup verlagert.

Implementierungsoptionen

Option 1: Pharmazeutische Klassen

Für Klassen-basierte Empfehlungen (z.B. "beliebiger CDK4/6 Inhibitor"):

RequestGroup
├── code: "CZ" (Chemotherapie + zielgerichtete Substanzen)
└── action[0].resource: Reference(SystemischeTherapie)
    └── code.text: "CDK4/6 Inhibitor (Klasse L01XE) - Palbociclib, Ribociclib oder Abemaciclib"

Anwendung: Wenn molekulares Tumorboard eine Medikamentenklasse empfiehlt und die finale Auswahl dem behandelnden Arzt überlässt.

Option 2: Spezifische Medikamentenauswahl

Für spezifische Optionen mit Auswahllogik:

RequestGroup
├── code: "ZS" (Zielgerichtete Substanzen)
├── action[0].selectionBehavior: #any
├── action[0].requiredBehavior: #must
├── action[0].action[0]: Reference(Trastuzumab) [priority: routine]
├── action[0].action[1]: Reference(T-DM1) [priority: asap]
└── action[0].action[2]: Reference(Tucatinib) [priority: stat]

Anwendung: Wenn molekulares Tumorboard spezifische Alternativen mit klaren Präferenzen basierend auf Resistenzmustern oder klinischer Situation empfiehlt.

FHIR-Invarianten-Konformität

Problem: FHIR R4 Invariant verhindert gleichzeitige Nutzung von code und action.resource Lösung: Dieses Profil akzeptiert beide Ansätze je nach Anwendungsfall:

  • Option 1: Verwendet code für Therapietyp, action.resource für Klassen-Level-Therapie
  • Option 2: Verwendet code für Therapietyp, verschachtelte action.action.resource für spezifische Optionen mit selectionBehavior

oBDS-Kontext

Mapping zu oBDS 19.1

RequestGroup.code → "19.1" "Tumorkonferenz Therapieempfehlung Typ"

Datenfelder:

  • CH: Chemotherapie
  • HO: Hormontherapie
  • IM: Immun-/Antikörpertherapie
  • ZS: Zielgerichtete Substanzen
  • SZ: Stammzelltransplantation
  • Kombinationen: CI, CZ, CIZ, IZ
  • Andere: OP, ST, WW, AS, SO

Erweiterte Strukturierung

Während oBDS nur den Therapietyp erfasst, ermöglicht RequestGroup zusätzlich:

  • Spezifische Medikamente pro Empfehlung
  • Alternative Optionen mit Prioritäten
  • Kombinationslogik für Multi-Agent-Protokolle

Terminologie-Binding

RequestGroup.code:

  • ValueSet: mii-vs-onko-therapieempfehlung-typ
  • Binding: Preferred
  • Quelle: oBDS-Therapietypen aus mii-cs-onko-therapie-typ

Die enthaltenen Codes sind in der Artefaktdarstellung aufgeführt: MII VS Onkologie Therapieempfehlung Typ.

Mapping Einheitlicher onkologischer Basisdatensatz (oBDS) zu FHIR

Die oBDS-Mappings sind in der Artefaktdarstellung des Profils hinterlegt: MII PR Onkologie Therapieempfehlung Kombinationstherapie.

Beispiele

Usages:

You can also check for usages in the FHIR IG Statistics

Formale Ansichten des Profilinhalts

Beschreibung von Profilen, Differentials, Snapshots und deren Repräsentationen.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. RequestGroup 0..* RequestGroup A group of related requests
... meta Σ 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
... status ?!SΣ 1..1 code draft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): Codes identifying the lifecycle stage of a request.
... intent ?!SΣ 1..1 code proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent (required): Codes indicating the degree of authority/intentionality associated with a request.
Required Pattern: proposal
... code SΣ 0..1 CodeableConcept Type of therapy recommendation
Binding: MII VS Onkologie Therapieempfehlung Typ (preferred)
... subject S 1..1 Reference(Patient) Who the request group is about
... encounter S 0..1 Reference(Encounter) Created as part of
... authoredOn S 1..1 dateTime When the request group was authored
... reasonReference S 0..* Reference(MII PR Onkologie Diagnose Primärtumor) Why the request group is needed
... action SC 0..* BackboneElement Proposed actions, if any
Constraints: rqg-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code S 0..* CodeableConcept Empfohlenes Therapieprotokoll
Binding: MII VS Onkologie Systemische Therapie Protokolle (extensible)
.... action SC 0..* BackboneElement Individual medications in protocol
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... resource SC 0..1 Reference(MII PR Onkologie Therapieempfehlung Medikation) The target of the action

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
RequestGroup.status Base required RequestStatus 📍4.0.1 FHIR Std.
RequestGroup.intent Base required RequestIntent 📍4.0.1 FHIR Std.
RequestGroup.code Base preferred MII VS Onkologie Therapieempfehlung Typ 📦2027.0.0-ballot.1 This IG
RequestGroup.action.​code Base extensible MII VS Onkologie Systemische Therapie Protokolle 📦2027.0.0-ballot.1 This IG

Constraints

Id Grade Path(s) Description Expression
dom-2 error RequestGroup If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error RequestGroup 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 RequestGroup 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 RequestGroup If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice RequestGroup 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()
rqg-1 error RequestGroup.action Must have resource or action but not both resource.exists() != action.exists()

Diese Struktur ist abgeleitet von RequestGroup

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. RequestGroup 0..* RequestGroup A group of related requests
... meta
.... profile S 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
... identifier S 0..* Identifier Business identifier
... status S 1..1 code draft | active | on-hold | revoked | completed | entered-in-error | unknown
... code S 0..1 CodeableConcept Type of therapy recommendation
Binding: MII VS Onkologie Therapieempfehlung Typ (preferred)
... subject S 1..1 Reference(Patient) Who the request group is about
... encounter S 0..1 Reference(Encounter) Created as part of
... authoredOn S 1..1 dateTime When the request group was authored
... reasonReference S 0..* Reference(MII PR Onkologie Diagnose Primärtumor) Why the request group is needed
... action S 0..* BackboneElement Proposed actions, if any
.... code S 0..* CodeableConcept Empfohlenes Therapieprotokoll
Binding: MII VS Onkologie Systemische Therapie Protokolle (extensible)
.... action S 0..* BackboneElement Individual medications in protocol
..... resource S 0..1 Reference(MII PR Onkologie Therapieempfehlung Medikation) The target of the action

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
RequestGroup.code Base preferred MII VS Onkologie Therapieempfehlung Typ 📦2027.0.0-ballot.1 This IG
RequestGroup.action.​code Base extensible MII VS Onkologie Systemische Therapie Protokolle 📦2027.0.0-ballot.1 This IG
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. RequestGroup 0..* RequestGroup A group of related requests
... id Σ 0..1 id Logical id of this artifact
... meta Σ 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
... 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 SΣ 0..* Identifier Business identifier
... instantiatesCanonical Σ 0..* canonical() Instantiates FHIR protocol or definition
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
... basedOn 0..* Reference(Resource) Fulfills plan, proposal, or order
... replaces 0..* Reference(Resource) Request(s) replaced by this request
... groupIdentifier Σ 0..1 Identifier Composite request this is part of
... status ?!SΣ 1..1 code draft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): Codes identifying the lifecycle stage of a request.
... intent ?!SΣ 1..1 code proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent (required): Codes indicating the degree of authority/intentionality associated with a request.
Required Pattern: proposal
... priority Σ 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
... code SΣ 0..1 CodeableConcept Type of therapy recommendation
Binding: MII VS Onkologie Therapieempfehlung Typ (preferred)
... subject S 1..1 Reference(Patient) Who the request group is about
... encounter S 0..1 Reference(Encounter) Created as part of
... authoredOn S 1..1 dateTime When the request group was authored
... author 0..1 Reference(Device | Practitioner | PractitionerRole) Device or practitioner that authored the request group
... reasonCode 0..* CodeableConcept Why the request group is needed
... reasonReference S 0..* Reference(MII PR Onkologie Diagnose Primärtumor) Why the request group is needed
... note 0..* Annotation Additional notes about the response
... action SC 0..* BackboneElement Proposed actions, if any
Constraints: rqg-1
.... 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
.... prefix 0..1 string User-visible prefix for the action (e.g. 1. or A.)
.... title 0..1 string User-visible title
.... description Σ 0..1 string Short description of the action
.... textEquivalent Σ 0..1 string Static text equivalent of the action, used if the dynamic aspects cannot be interpreted by the receiving system
.... priority 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
.... code S 0..* CodeableConcept Empfohlenes Therapieprotokoll
Binding: MII VS Onkologie Systemische Therapie Protokolle (extensible)
.... documentation 0..* RelatedArtifact Supporting documentation for the intended performer of the action
.... condition 0..* BackboneElement Whether or not the action is applicable
..... 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
..... kind 1..1 code applicability | start | stop
Binding: ActionConditionKind (required): The kind of condition for the action.
..... expression 0..1 Expression Boolean-valued expression
.... relatedAction 0..* BackboneElement Relationship to another action
..... 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
..... actionId 1..1 id What action this is related to
..... relationship 1..1 code before-start | before | before-end | concurrent-with-start | concurrent | concurrent-with-end | after-start | after | after-end
Binding: ActionRelationshipType (required): Defines the types of relationships between actions.
..... offset[x] 0..1 Time offset for the relationship
...... offsetDuration Duration
...... offsetRange Range
.... timing[x] 0..1 When the action should take place
..... timingDateTime dateTime
..... timingAge Age
..... timingPeriod Period
..... timingDuration Duration
..... timingRange Range
..... timingTiming Timing
.... participant 0..* Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Device) Who should perform the action
.... type 0..1 CodeableConcept create | update | remove | fire-event
Binding: ActionType (extensible): The type of action to be performed.
.... groupingBehavior 0..1 code visual-group | logical-group | sentence-group
Binding: ActionGroupingBehavior (required): Defines organization behavior of a group.
.... selectionBehavior 0..1 code any | all | all-or-none | exactly-one | at-most-one | one-or-more
Binding: ActionSelectionBehavior (required): Defines selection behavior of a group.
.... requiredBehavior 0..1 code must | could | must-unless-documented
Binding: ActionRequiredBehavior (required): Defines expectations around whether an action or action group is required.
.... precheckBehavior 0..1 code yes | no
Binding: ActionPrecheckBehavior (required): Defines selection frequency behavior for an action or group.
.... cardinalityBehavior 0..1 code single | multiple
Binding: ActionCardinalityBehavior (required): Defines behavior for an action or a group for how many times that item may be repeated.
.... resource C 0..1 Reference(Resource) The target of the action
.... action SC 0..* BackboneElement Individual medications in protocol
..... 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
..... prefix 0..1 string User-visible prefix for the action (e.g. 1. or A.)
..... title 0..1 string User-visible title
..... description Σ 0..1 string Short description of the action
..... textEquivalent Σ 0..1 string Static text equivalent of the action, used if the dynamic aspects cannot be interpreted by the receiving system
..... priority 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
..... code 0..* CodeableConcept Code representing the meaning of the action or sub-actions
..... documentation 0..* RelatedArtifact Supporting documentation for the intended performer of the action
..... condition 0..* BackboneElement Whether or not the action is applicable
...... 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
...... kind 1..1 code applicability | start | stop
Binding: ActionConditionKind (required): The kind of condition for the action.
...... expression 0..1 Expression Boolean-valued expression
..... relatedAction 0..* BackboneElement Relationship to another action
...... 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
...... actionId 1..1 id What action this is related to
...... relationship 1..1 code before-start | before | before-end | concurrent-with-start | concurrent | concurrent-with-end | after-start | after | after-end
Binding: ActionRelationshipType (required): Defines the types of relationships between actions.
...... offset[x] 0..1 Time offset for the relationship
....... offsetDuration Duration
....... offsetRange Range
..... timing[x] 0..1 When the action should take place
...... timingDateTime dateTime
...... timingAge Age
...... timingPeriod Period
...... timingDuration Duration
...... timingRange Range
...... timingTiming Timing
..... participant 0..* Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Device) Who should perform the action
..... type 0..1 CodeableConcept create | update | remove | fire-event
Binding: ActionType (extensible): The type of action to be performed.
..... groupingBehavior 0..1 code visual-group | logical-group | sentence-group
Binding: ActionGroupingBehavior (required): Defines organization behavior of a group.
..... selectionBehavior 0..1 code any | all | all-or-none | exactly-one | at-most-one | one-or-more
Binding: ActionSelectionBehavior (required): Defines selection behavior of a group.
..... requiredBehavior 0..1 code must | could | must-unless-documented
Binding: ActionRequiredBehavior (required): Defines expectations around whether an action or action group is required.
..... precheckBehavior 0..1 code yes | no
Binding: ActionPrecheckBehavior (required): Defines selection frequency behavior for an action or group.
..... cardinalityBehavior 0..1 code single | multiple
Binding: ActionCardinalityBehavior (required): Defines behavior for an action or a group for how many times that item may be repeated.
..... resource SC 0..1 Reference(MII PR Onkologie Therapieempfehlung Medikation) The target of the action
..... action C 0..* See action (RequestGroup) Sub action

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
RequestGroup.meta.security Base extensible SecurityLabels 📍4.0.1 FHIR Std.
RequestGroup.meta.tag Base example Common Tags 📍4.0.1 FHIR Std.
RequestGroup.language Base preferred Common Languages 📍4.0.1 FHIR Std.
RequestGroup.status Base required RequestStatus 📍4.0.1 FHIR Std.
RequestGroup.intent Base required RequestIntent 📍4.0.1 FHIR Std.
RequestGroup.priority Base required Request priority 📍4.0.1 FHIR Std.
RequestGroup.code Base preferred MII VS Onkologie Therapieempfehlung Typ 📦2027.0.0-ballot.1 This IG
RequestGroup.action.​priority Base required Request priority 📍4.0.1 FHIR Std.
RequestGroup.action.​code Base extensible MII VS Onkologie Systemische Therapie Protokolle 📦2027.0.0-ballot.1 This IG
RequestGroup.action.​condition.kind Base required ActionConditionKind 📍4.0.1 FHIR Std.
RequestGroup.action.​relatedAction.relationship Base required ActionRelationshipType 📍4.0.1 FHIR Std.
RequestGroup.action.​type Base extensible ActionType 📍4.0.1 FHIR Std.
RequestGroup.action.​groupingBehavior Base required ActionGroupingBehavior 📍4.0.1 FHIR Std.
RequestGroup.action.​selectionBehavior Base required ActionSelectionBehavior 📍4.0.1 FHIR Std.
RequestGroup.action.​requiredBehavior Base required ActionRequiredBehavior 📍4.0.1 FHIR Std.
RequestGroup.action.​precheckBehavior Base required ActionPrecheckBehavior 📍4.0.1 FHIR Std.
RequestGroup.action.​cardinalityBehavior Base required ActionCardinalityBehavior 📍4.0.1 FHIR Std.
RequestGroup.action.​action.priority Base required Request priority 📍4.0.1 FHIR Std.
RequestGroup.action.​action.condition.kind Base required ActionConditionKind 📍4.0.1 FHIR Std.
RequestGroup.action.​action.relatedAction.​relationship Base required ActionRelationshipType 📍4.0.1 FHIR Std.
RequestGroup.action.​action.type Base extensible ActionType 📍4.0.1 FHIR Std.
RequestGroup.action.​action.groupingBehavior Base required ActionGroupingBehavior 📍4.0.1 FHIR Std.
RequestGroup.action.​action.selectionBehavior Base required ActionSelectionBehavior 📍4.0.1 FHIR Std.
RequestGroup.action.​action.requiredBehavior Base required ActionRequiredBehavior 📍4.0.1 FHIR Std.
RequestGroup.action.​action.precheckBehavior Base required ActionPrecheckBehavior 📍4.0.1 FHIR Std.
RequestGroup.action.​action.cardinalityBehavior Base required ActionCardinalityBehavior 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error RequestGroup If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error RequestGroup 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 RequestGroup 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 RequestGroup If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice RequestGroup 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()
rqg-1 error RequestGroup.action Must have resource or action but not both resource.exists() != action.exists()

Schlüsselelemente-Ansicht

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. RequestGroup 0..* RequestGroup A group of related requests
... meta Σ 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
... status ?!SΣ 1..1 code draft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): Codes identifying the lifecycle stage of a request.
... intent ?!SΣ 1..1 code proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent (required): Codes indicating the degree of authority/intentionality associated with a request.
Required Pattern: proposal
... code SΣ 0..1 CodeableConcept Type of therapy recommendation
Binding: MII VS Onkologie Therapieempfehlung Typ (preferred)
... subject S 1..1 Reference(Patient) Who the request group is about
... encounter S 0..1 Reference(Encounter) Created as part of
... authoredOn S 1..1 dateTime When the request group was authored
... reasonReference S 0..* Reference(MII PR Onkologie Diagnose Primärtumor) Why the request group is needed
... action SC 0..* BackboneElement Proposed actions, if any
Constraints: rqg-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code S 0..* CodeableConcept Empfohlenes Therapieprotokoll
Binding: MII VS Onkologie Systemische Therapie Protokolle (extensible)
.... action SC 0..* BackboneElement Individual medications in protocol
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... resource SC 0..1 Reference(MII PR Onkologie Therapieempfehlung Medikation) The target of the action

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
RequestGroup.status Base required RequestStatus 📍4.0.1 FHIR Std.
RequestGroup.intent Base required RequestIntent 📍4.0.1 FHIR Std.
RequestGroup.code Base preferred MII VS Onkologie Therapieempfehlung Typ 📦2027.0.0-ballot.1 This IG
RequestGroup.action.​code Base extensible MII VS Onkologie Systemische Therapie Protokolle 📦2027.0.0-ballot.1 This IG

Constraints

Id Grade Path(s) Description Expression
dom-2 error RequestGroup If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error RequestGroup 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 RequestGroup 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 RequestGroup If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice RequestGroup 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()
rqg-1 error RequestGroup.action Must have resource or action but not both resource.exists() != action.exists()

Differential-Ansicht

Diese Struktur ist abgeleitet von RequestGroup

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. RequestGroup 0..* RequestGroup A group of related requests
... meta
.... profile S 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
... identifier S 0..* Identifier Business identifier
... status S 1..1 code draft | active | on-hold | revoked | completed | entered-in-error | unknown
... code S 0..1 CodeableConcept Type of therapy recommendation
Binding: MII VS Onkologie Therapieempfehlung Typ (preferred)
... subject S 1..1 Reference(Patient) Who the request group is about
... encounter S 0..1 Reference(Encounter) Created as part of
... authoredOn S 1..1 dateTime When the request group was authored
... reasonReference S 0..* Reference(MII PR Onkologie Diagnose Primärtumor) Why the request group is needed
... action S 0..* BackboneElement Proposed actions, if any
.... code S 0..* CodeableConcept Empfohlenes Therapieprotokoll
Binding: MII VS Onkologie Systemische Therapie Protokolle (extensible)
.... action S 0..* BackboneElement Individual medications in protocol
..... resource S 0..1 Reference(MII PR Onkologie Therapieempfehlung Medikation) The target of the action

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
RequestGroup.code Base preferred MII VS Onkologie Therapieempfehlung Typ 📦2027.0.0-ballot.1 This IG
RequestGroup.action.​code Base extensible MII VS Onkologie Systemische Therapie Protokolle 📦2027.0.0-ballot.1 This IG

Snapshot-AnsichtView

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. RequestGroup 0..* RequestGroup A group of related requests
... id Σ 0..1 id Logical id of this artifact
... meta Σ 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
... 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 SΣ 0..* Identifier Business identifier
... instantiatesCanonical Σ 0..* canonical() Instantiates FHIR protocol or definition
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
... basedOn 0..* Reference(Resource) Fulfills plan, proposal, or order
... replaces 0..* Reference(Resource) Request(s) replaced by this request
... groupIdentifier Σ 0..1 Identifier Composite request this is part of
... status ?!SΣ 1..1 code draft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): Codes identifying the lifecycle stage of a request.
... intent ?!SΣ 1..1 code proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent (required): Codes indicating the degree of authority/intentionality associated with a request.
Required Pattern: proposal
... priority Σ 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
... code SΣ 0..1 CodeableConcept Type of therapy recommendation
Binding: MII VS Onkologie Therapieempfehlung Typ (preferred)
... subject S 1..1 Reference(Patient) Who the request group is about
... encounter S 0..1 Reference(Encounter) Created as part of
... authoredOn S 1..1 dateTime When the request group was authored
... author 0..1 Reference(Device | Practitioner | PractitionerRole) Device or practitioner that authored the request group
... reasonCode 0..* CodeableConcept Why the request group is needed
... reasonReference S 0..* Reference(MII PR Onkologie Diagnose Primärtumor) Why the request group is needed
... note 0..* Annotation Additional notes about the response
... action SC 0..* BackboneElement Proposed actions, if any
Constraints: rqg-1
.... 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
.... prefix 0..1 string User-visible prefix for the action (e.g. 1. or A.)
.... title 0..1 string User-visible title
.... description Σ 0..1 string Short description of the action
.... textEquivalent Σ 0..1 string Static text equivalent of the action, used if the dynamic aspects cannot be interpreted by the receiving system
.... priority 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
.... code S 0..* CodeableConcept Empfohlenes Therapieprotokoll
Binding: MII VS Onkologie Systemische Therapie Protokolle (extensible)
.... documentation 0..* RelatedArtifact Supporting documentation for the intended performer of the action
.... condition 0..* BackboneElement Whether or not the action is applicable
..... 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
..... kind 1..1 code applicability | start | stop
Binding: ActionConditionKind (required): The kind of condition for the action.
..... expression 0..1 Expression Boolean-valued expression
.... relatedAction 0..* BackboneElement Relationship to another action
..... 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
..... actionId 1..1 id What action this is related to
..... relationship 1..1 code before-start | before | before-end | concurrent-with-start | concurrent | concurrent-with-end | after-start | after | after-end
Binding: ActionRelationshipType (required): Defines the types of relationships between actions.
..... offset[x] 0..1 Time offset for the relationship
...... offsetDuration Duration
...... offsetRange Range
.... timing[x] 0..1 When the action should take place
..... timingDateTime dateTime
..... timingAge Age
..... timingPeriod Period
..... timingDuration Duration
..... timingRange Range
..... timingTiming Timing
.... participant 0..* Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Device) Who should perform the action
.... type 0..1 CodeableConcept create | update | remove | fire-event
Binding: ActionType (extensible): The type of action to be performed.
.... groupingBehavior 0..1 code visual-group | logical-group | sentence-group
Binding: ActionGroupingBehavior (required): Defines organization behavior of a group.
.... selectionBehavior 0..1 code any | all | all-or-none | exactly-one | at-most-one | one-or-more
Binding: ActionSelectionBehavior (required): Defines selection behavior of a group.
.... requiredBehavior 0..1 code must | could | must-unless-documented
Binding: ActionRequiredBehavior (required): Defines expectations around whether an action or action group is required.
.... precheckBehavior 0..1 code yes | no
Binding: ActionPrecheckBehavior (required): Defines selection frequency behavior for an action or group.
.... cardinalityBehavior 0..1 code single | multiple
Binding: ActionCardinalityBehavior (required): Defines behavior for an action or a group for how many times that item may be repeated.
.... resource C 0..1 Reference(Resource) The target of the action
.... action SC 0..* BackboneElement Individual medications in protocol
..... 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
..... prefix 0..1 string User-visible prefix for the action (e.g. 1. or A.)
..... title 0..1 string User-visible title
..... description Σ 0..1 string Short description of the action
..... textEquivalent Σ 0..1 string Static text equivalent of the action, used if the dynamic aspects cannot be interpreted by the receiving system
..... priority 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
..... code 0..* CodeableConcept Code representing the meaning of the action or sub-actions
..... documentation 0..* RelatedArtifact Supporting documentation for the intended performer of the action
..... condition 0..* BackboneElement Whether or not the action is applicable
...... 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
...... kind 1..1 code applicability | start | stop
Binding: ActionConditionKind (required): The kind of condition for the action.
...... expression 0..1 Expression Boolean-valued expression
..... relatedAction 0..* BackboneElement Relationship to another action
...... 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
...... actionId 1..1 id What action this is related to
...... relationship 1..1 code before-start | before | before-end | concurrent-with-start | concurrent | concurrent-with-end | after-start | after | after-end
Binding: ActionRelationshipType (required): Defines the types of relationships between actions.
...... offset[x] 0..1 Time offset for the relationship
....... offsetDuration Duration
....... offsetRange Range
..... timing[x] 0..1 When the action should take place
...... timingDateTime dateTime
...... timingAge Age
...... timingPeriod Period
...... timingDuration Duration
...... timingRange Range
...... timingTiming Timing
..... participant 0..* Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Device) Who should perform the action
..... type 0..1 CodeableConcept create | update | remove | fire-event
Binding: ActionType (extensible): The type of action to be performed.
..... groupingBehavior 0..1 code visual-group | logical-group | sentence-group
Binding: ActionGroupingBehavior (required): Defines organization behavior of a group.
..... selectionBehavior 0..1 code any | all | all-or-none | exactly-one | at-most-one | one-or-more
Binding: ActionSelectionBehavior (required): Defines selection behavior of a group.
..... requiredBehavior 0..1 code must | could | must-unless-documented
Binding: ActionRequiredBehavior (required): Defines expectations around whether an action or action group is required.
..... precheckBehavior 0..1 code yes | no
Binding: ActionPrecheckBehavior (required): Defines selection frequency behavior for an action or group.
..... cardinalityBehavior 0..1 code single | multiple
Binding: ActionCardinalityBehavior (required): Defines behavior for an action or a group for how many times that item may be repeated.
..... resource SC 0..1 Reference(MII PR Onkologie Therapieempfehlung Medikation) The target of the action
..... action C 0..* See action (RequestGroup) Sub action

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
RequestGroup.meta.security Base extensible SecurityLabels 📍4.0.1 FHIR Std.
RequestGroup.meta.tag Base example Common Tags 📍4.0.1 FHIR Std.
RequestGroup.language Base preferred Common Languages 📍4.0.1 FHIR Std.
RequestGroup.status Base required RequestStatus 📍4.0.1 FHIR Std.
RequestGroup.intent Base required RequestIntent 📍4.0.1 FHIR Std.
RequestGroup.priority Base required Request priority 📍4.0.1 FHIR Std.
RequestGroup.code Base preferred MII VS Onkologie Therapieempfehlung Typ 📦2027.0.0-ballot.1 This IG
RequestGroup.action.​priority Base required Request priority 📍4.0.1 FHIR Std.
RequestGroup.action.​code Base extensible MII VS Onkologie Systemische Therapie Protokolle 📦2027.0.0-ballot.1 This IG
RequestGroup.action.​condition.kind Base required ActionConditionKind 📍4.0.1 FHIR Std.
RequestGroup.action.​relatedAction.relationship Base required ActionRelationshipType 📍4.0.1 FHIR Std.
RequestGroup.action.​type Base extensible ActionType 📍4.0.1 FHIR Std.
RequestGroup.action.​groupingBehavior Base required ActionGroupingBehavior 📍4.0.1 FHIR Std.
RequestGroup.action.​selectionBehavior Base required ActionSelectionBehavior 📍4.0.1 FHIR Std.
RequestGroup.action.​requiredBehavior Base required ActionRequiredBehavior 📍4.0.1 FHIR Std.
RequestGroup.action.​precheckBehavior Base required ActionPrecheckBehavior 📍4.0.1 FHIR Std.
RequestGroup.action.​cardinalityBehavior Base required ActionCardinalityBehavior 📍4.0.1 FHIR Std.
RequestGroup.action.​action.priority Base required Request priority 📍4.0.1 FHIR Std.
RequestGroup.action.​action.condition.kind Base required ActionConditionKind 📍4.0.1 FHIR Std.
RequestGroup.action.​action.relatedAction.​relationship Base required ActionRelationshipType 📍4.0.1 FHIR Std.
RequestGroup.action.​action.type Base extensible ActionType 📍4.0.1 FHIR Std.
RequestGroup.action.​action.groupingBehavior Base required ActionGroupingBehavior 📍4.0.1 FHIR Std.
RequestGroup.action.​action.selectionBehavior Base required ActionSelectionBehavior 📍4.0.1 FHIR Std.
RequestGroup.action.​action.requiredBehavior Base required ActionRequiredBehavior 📍4.0.1 FHIR Std.
RequestGroup.action.​action.precheckBehavior Base required ActionPrecheckBehavior 📍4.0.1 FHIR Std.
RequestGroup.action.​action.cardinalityBehavior Base required ActionCardinalityBehavior 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error RequestGroup If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error RequestGroup 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 RequestGroup 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 RequestGroup If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice RequestGroup 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()
rqg-1 error RequestGroup.action Must have resource or action but not both resource.exists() != action.exists()

 

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