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. For a full list of available versions, see the Directory of published versions

Ressourcenprofil: MII PR Onkologie Tumorkonferenz

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

Dieses Profil beschreibt die Tumorkonferenz und die Therapieempfehlungen

Dieses Profil beschreibt die Tumorkonferenz und die Therapieempfehlungen für sowohl traditionelle als auch molekulare Tumorboard-Workflows. Die Datenfelder sind seit der Version 2021 Teil des oBDS und werden in zwei verschiedenen Modulen erfasst. Da alle beteiligten Felder sehr gut über die FHIR CarePlan-Ressource abbildbar sind, wurden alle die Tumorkonferenz- und Therapieemfpehlungsfelder im Tumorkonferenz-Profil zusammengefasst.

Unified Activity Slicing Architecture

Das Profil unterstützt zwei verschiedene Implementierungsansätze über Activity-Slicing:

obds Slice: Standard oBDS-Therapiekategorisierung

Für traditionelle Tumorboards mit oBDS 19.1 Kategorisierung:

  • Verwendung: activity[obds].detail.code für Therapietyp (CH, HO, IM, ZS, etc.)
  • Status-Tracking: activity[obds].detail.status und activity[obds].detail.statusReason für Therapieabweichungen
  • oBDS-Konformität: Vollständige Abbildung der oBDS-Felder 19.1 und 19.2

extended Slice: Molekulare Tumorboard-Protokolle

Für detaillierte molekulare Tumorboards mit strukturierten Therapieprotokollen:

  • Verwendung: activity[extended].reference → RequestGroup/MedicationRequest/ServiceRequest
  • Anwendungsfälle: Multi-Agent-Protokolle, pharmazeutische Klassen, spezifische Medikamentenauswahl
  • Erweiterte Funktionalität: Über oBDS-Kategorisierung hinausgehende Detaillierung

Gemeinsame Profilstruktur

Beide Slices teilen die gemeinsamen CarePlan-Elemente:

  • Patient-Referenz: subject
  • Primärdiagnose-Referenz: addresses
  • Tumorboard-Kategorie: category nach oBDS 18.2
  • Datum: created gemäß oBDS 18.1
  • Zusätzliche Informationen: supportingInfo für relevante Verlaufs-Stagings

Status-Management

Für obds Slice (traditionelle Tumorboards):

Die CarePlan-Ressource sieht eine verpflichtende Angabe des status-Elements einer activity vor. Die tatsächlich erfolgten Therapien werden in den Krebsregisterdaten erfasst und SOLLEN über Procedure.basedOn(Reference(CarePlan)) auf die Tumorkonferenz-Ressource verweisen.

Empfohlene Status-Codes nach FHIR CarePlanActivityStatus:

  • completed: Abgeschlossene Therapie
  • on-hold: Therapieunterbrechung für noch nicht gestartete Therapie
  • stopped: Therapieunterbrechung für bereits gestartete Therapie
  • unknown: Unbekannt, keine Statusinformationen verfügbar

Therapieabweichungen: Bei on-hold und stopped SOLL statusReason mit oBDS-Feld 'Therapieabweichung auf Wunsch des Patienten' befüllt werden.

Für extended Slice (molekulare Tumorboards):

Status-Tracking erfolgt in den referenzierten Ressourcen (RequestGroup, MedicationRequest, ServiceRequest). activity.progress kann für narrative Fortschrittsnotizen verwendet werden.

Jede Tumorkonferenz mit Therapieempfehlung SOLL als einzelne Ressource gespeichert und über CarePlan.addresses(Reference(Condition)) auf die Primärdiagnose referenzieren.

FHIR Invariant Management

Problem: FHIR R4 Invariant cpl-3 verhindert gleichzeitige Nutzung von activity.detail.code und activity.reference

Lösung: Slice-spezifische Element-Deaktivierung:

  • obds slice: activity.detail aktiviert, activity.reference deaktiviert (0..0)
  • extended slice: activity.reference aktiviert, activity.detail deaktiviert (0..0)

Implementierungsflexibilität

  • Rückwärtskompatibilität: Bestehende oBDS-Implementierungen funktionieren unverändert
  • Hybride Ansätze: Einzelne CarePlans können beide Slice-Typen verwenden
  • Schrittweise Adoption: Start mit obds slice, Erweiterung zu extended slice bei Bedarf

Anwendungsbeispiele

Traditionelles Tumorboard (obds slice):

* activity[obds].detail.code.coding = #OP "Operation"
* activity[obds].detail.status = #completed

Molekulares Tumorboard (extended slice):

* activity[extended].reference = Reference(RequestGroup/molecular-protocol)
* activity[extended].progress.text = "HR+/HER2- mit PI3K-Aktivierung - CDK4/6 Inhibitor empfohlen"

Gemischter Ansatz:

* activity[obds].detail.code.coding = #OP "Operation"
* activity[extended].reference = Reference(RequestGroup/precision-medicine-protocol)

Mapping Datensatz zu FHIR

Die Zuordnung der Datensatzfelder ist im logischen Modell dokumentiert: MII LM Onkologie.

Mapping Einheitlicher onkologischer Basisdatensatz (oBDS) zu FHIR

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

Beispiele

Traditionelle oBDS-Tumorkonferenz (obds slice):

mii-exa-onko-tumorkonferenz-01

Molekulares Tumorboard (extended slice):

mii-exa-onko-tumorkonferenz-pure-molecular

Gemischter Ansatz (beide slices):

mii-exa-onko-tumorkonferenz-mixed-approach

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
.. CarePlan 0..* CarePlan Healthcare plan for patient or group
... 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
... intent ?!SΣ 1..1 code proposal | plan | order | option
Binding: CarePlanIntent (required): Codes indicating the degree of authority/intentionality associated with a care plan.
Required Pattern: plan
... category SΣ 1..1 CodeableConcept Type of plan
Binding: CarePlanCategory (example): Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.
.... coding SΣ 1..* Coding Art der Tumorkonferenz / Therapieplanung
Binding: MII VS Onkologie Therapieplanung Typ (required)
..... system SΣ 1..1 uri Identity of the terminology system
Required Pattern: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapieplanung-typ
..... code SΣ 1..1 code Symbol in syntax defined by the system
... subject SΣ 1..1 Reference(Patient) Who the care plan is for
... encounter SΣ 0..1 Reference(Encounter) Encounter created as part of
... created SΣ 1..1 dateTime Datum der Tumorkonferenz / Therapieplanung
... addresses SΣ 0..* Reference(MII PR Onkologie Diagnose Primärtumor) Health issues this plan addresses
... supportingInfo S 0..* Reference(Resource) Information considered as part of plan
... Slices for activity SC 0..* BackboneElement Therapy recommendations - either oBDS standard categorization or extended molecular protocols
Slice: Unordered, Open by exists:detail, profile:reference.resolve()
Constraints: cpl-3
.... activity:All Slices Content/Rules for all slices
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... activity:obds C 0..* BackboneElement Standard oBDS therapy recommendation with category only
Constraints: cpl-3
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... detail SC 1..1 BackboneElement In-line definition of activity
Constraints: tumorkonferenz-empfehlung-entscheidung-patient
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... code S 1..1 CodeableConcept Detail type of activity
Binding: MII VS Onkologie Therapieempfehlung Typ (required)
....... coding Σ 0..* Coding Typ der Therapieempfehlung
........ system SΣ 1..1 uri Identity of the terminology system
Required Pattern: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapie-typ
........ code SΣ 1..1 code Symbol in syntax defined by the system
...... status ?!S 1..1 code Status der Therapieempfehlung
Binding: CarePlanActivityStatus (required): Codes that reflect the current state of a care plan activity within its overall life cycle.
...... statusReason S 0..1 CodeableConcept Therapieabweichung aufgrund Patientenwunsch der Therapieempfehlung
Binding: MII VS Onkologie Therapieabweichung (required)
....... coding SΣ 0..* 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-onko/CodeSystem/mii-cs-onko-therapieabweichung
........ code SΣ 0..1 code Symbol in syntax defined by the system
...... doNotPerform ?! 0..1 boolean If true, activity is prohibiting action
.... activity:extended C 0..* BackboneElement Extended molecular tumor board recommendation with detailed protocols
Constraints: cpl-3
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... progress S 0..* Annotation Progress notes for recommendation implementation
..... reference SC 1..1 Reference(MII PR Onkologie Therapieempfehlung Kombinationstherapie | MII PR Onkologie Therapieempfehlung Medikation | MII PR Onkologie Therapieempfehlung Operation) Detailed therapy recommendation - RequestGroup, MedicationRequest, or ServiceRequest

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
CarePlan.status Base required RequestStatus 📍4.0.1 FHIR Std.
CarePlan.intent Base required Care Plan Intent 📍4.0.1 FHIR Std.
CarePlan.category Base example Care Plan Category 📍4.0.1 FHIR Std.
CarePlan.category.coding Base required MII VS Onkologie Therapieplanung Typ 📦2027.0.0-ballot.1 This IG
CarePlan.activity:obds.​detail.code Base required MII VS Onkologie Therapieempfehlung Typ 📦2027.0.0-ballot.1 This IG
CarePlan.activity:obds.​detail.status Base required CarePlanActivityStatus 📍4.0.1 FHIR Std.
CarePlan.activity:obds.​detail.statusReason Base required MII VS Onkologie Therapieabweichung 📦2027.0.0-ballot.1 This IG
CarePlan.activity:extended.​detail.status Base required CarePlanActivityStatus 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
cpl-3 error CarePlan.activity, CarePlan.activity:obds, CarePlan.activity:extended Provide a reference or detail, not both detail.empty() or reference.empty()
dom-2 error CarePlan If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error CarePlan 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 CarePlan 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 CarePlan If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice CarePlan 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()
tumorkonferenz-empfehlung-entscheidung-patient error CarePlan.activity:obds.detail Therapieabweichung aufgrund Patientenwunsch: Bei nichtangetretener oder abgebrochener Therapie ist anzugeben, ob dies dem Patientenwunsch entspricht oder ggfs. andere Gründe hat status = 'cancelled' or status = 'stopped' implies statusReason.exists()

Diese Struktur ist abgeleitet von CarePlan

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CarePlan 0..* CarePlan Healthcare plan for patient or group
... meta
.... profile S 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
... status S 1..1 code draft | active | on-hold | revoked | completed | entered-in-error | unknown
... intent S 1..1 code proposal | plan | order | option
Required Pattern: plan
.... coding S 1..* Coding Art der Tumorkonferenz / Therapieplanung
Binding: MII VS Onkologie Therapieplanung Typ (required)
..... system S 1..1 uri Identity of the terminology system
Required Pattern: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapieplanung-typ
..... code S 1..1 code Symbol in syntax defined by the system
... subject S 1..1 Reference(Patient) Who the care plan is for
... encounter S 0..1 Reference(Encounter) Encounter created as part of
... created S 1..1 dateTime Datum der Tumorkonferenz / Therapieplanung
... addresses S 0..* Reference(MII PR Onkologie Diagnose Primärtumor) Health issues this plan addresses
... supportingInfo S 0..* Reference(Resource) Information considered as part of plan
... Slices for activity S 0..* BackboneElement Therapy recommendations - either oBDS standard categorization or extended molecular protocols
Slice: Unordered, Open by exists:detail, profile:reference.resolve()
.... activity:obds 0..* BackboneElement Standard oBDS therapy recommendation with category only
..... reference 0..0 Activity details defined in specific resource
..... detail SC 1..1 BackboneElement In-line definition of activity
Constraints: tumorkonferenz-empfehlung-entscheidung-patient
...... code S 1..1 CodeableConcept Detail type of activity
Binding: MII VS Onkologie Therapieempfehlung Typ (required)
....... coding 0..* Coding Typ der Therapieempfehlung
........ system S 1..1 uri Identity of the terminology system
Required Pattern: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapie-typ
........ code S 1..1 code Symbol in syntax defined by the system
...... status S 1..1 code Status der Therapieempfehlung
...... statusReason S 0..1 CodeableConcept Therapieabweichung aufgrund Patientenwunsch der Therapieempfehlung
Binding: MII VS Onkologie Therapieabweichung (required)
....... coding S 0..* 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-onko/CodeSystem/mii-cs-onko-therapieabweichung
........ code S 0..1 code Symbol in syntax defined by the system
.... activity:extended 0..* BackboneElement Extended molecular tumor board recommendation with detailed protocols
..... progress S 0..* Annotation Progress notes for recommendation implementation
..... reference S 1..1 Reference(MII PR Onkologie Therapieempfehlung Kombinationstherapie | MII PR Onkologie Therapieempfehlung Medikation | MII PR Onkologie Therapieempfehlung Operation) Detailed therapy recommendation - RequestGroup, MedicationRequest, or ServiceRequest
..... detail 0..0 In-line definition of activity

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
CarePlan.category.coding Base required MII VS Onkologie Therapieplanung Typ 📦2027.0.0-ballot.1 This IG
CarePlan.activity:obds.​detail.code Base required MII VS Onkologie Therapieempfehlung Typ 📦2027.0.0-ballot.1 This IG
CarePlan.activity:obds.​detail.statusReason Base required MII VS Onkologie Therapieabweichung 📦2027.0.0-ballot.1 This IG

Constraints

Id Grade Path(s) Description Expression
tumorkonferenz-empfehlung-entscheidung-patient error CarePlan.activity:obds.detail Therapieabweichung aufgrund Patientenwunsch: Bei nichtangetretener oder abgebrochener Therapie ist anzugeben, ob dies dem Patientenwunsch entspricht oder ggfs. andere Gründe hat status = 'cancelled' or status = 'stopped' implies statusReason.exists()
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CarePlan 0..* CarePlan Healthcare plan for patient or group
... 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
... 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 External Ids for this plan
... instantiatesCanonical Σ 0..* canonical(PlanDefinition | Questionnaire | Measure | ActivityDefinition | OperationDefinition) Instantiates FHIR protocol or definition
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
... basedOn Σ 0..* Reference(CarePlan) Fulfills CarePlan
... replaces Σ 0..* Reference(CarePlan) CarePlan replaced by this CarePlan
... partOf Σ 0..* Reference(CarePlan) Part of referenced CarePlan
... status ?!SΣ 1..1 code draft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.
... intent ?!SΣ 1..1 code proposal | plan | order | option
Binding: CarePlanIntent (required): Codes indicating the degree of authority/intentionality associated with a care plan.
Required Pattern: plan
... category SΣ 1..1 CodeableConcept Type of plan
Binding: CarePlanCategory (example): Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.
.... 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 SΣ 1..* Coding Art der Tumorkonferenz / Therapieplanung
Binding: MII VS Onkologie Therapieplanung Typ (required)
..... 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 SΣ 1..1 uri Identity of the terminology system
Required Pattern: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapieplanung-typ
..... version Σ 0..1 string Version of the system - if relevant
..... code SΣ 1..1 code Symbol in syntax defined by the system
..... 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
... title Σ 0..1 string Human-friendly name for the care plan
... description Σ 0..1 string Summary of nature of plan
... subject SΣ 1..1 Reference(Patient) Who the care plan is for
... encounter SΣ 0..1 Reference(Encounter) Encounter created as part of
... period Σ 0..1 Period Time period plan covers
... created SΣ 1..1 dateTime Datum der Tumorkonferenz / Therapieplanung
... author Σ 0..1 Reference(Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam) Who is the designated responsible party
... contributor 0..* Reference(Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam) Who provided the content of the care plan
... careTeam 0..* Reference(CareTeam) Who's involved in plan?
... addresses SΣ 0..* Reference(MII PR Onkologie Diagnose Primärtumor) Health issues this plan addresses
... supportingInfo S 0..* Reference(Resource) Information considered as part of plan
... goal 0..* Reference(Goal) Desired outcome of plan
... Slices for activity SC 0..* BackboneElement Therapy recommendations - either oBDS standard categorization or extended molecular protocols
Slice: Unordered, Open by exists:detail, profile:reference.resolve()
Constraints: cpl-3
.... activity:All Slices Content/Rules for all slices
..... 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
..... outcomeCodeableConcept 0..* CodeableConcept Results of the activity
Binding: CarePlanActivityOutcome (example): Identifies the results of the activity.
..... outcomeReference 0..* Reference(Resource) Appointment, Encounter, Procedure, etc.
..... progress 0..* Annotation Comments about the activity status/progress
..... reference C 0..1 Reference(Appointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | Task | ServiceRequest | VisionPrescription | RequestGroup) Activity details defined in specific resource
..... detail C 0..1 BackboneElement In-line definition of activity
...... 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 0..1 code Appointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | Task | ServiceRequest | VisionPrescription
Binding: CarePlanActivityKind (required): Resource types defined as part of FHIR that can be represented as in-line definitions of a care plan activity.
...... instantiatesCanonical 0..* canonical(PlanDefinition | ActivityDefinition | Questionnaire | Measure | OperationDefinition) Instantiates FHIR protocol or definition
...... instantiatesUri 0..* uri Instantiates external protocol or definition
...... code 0..1 CodeableConcept Detail type of activity
Binding: ProcedureCodes(SNOMEDCT) (example): Detailed description of the type of activity; e.g. What lab test, what procedure, what kind of encounter.
...... reasonCode 0..* CodeableConcept Why activity should be done or why activity was prohibited
Binding: SNOMEDCTClinicalFindings (example): Identifies why a care plan activity is needed. Can include any health condition codes as well as such concepts as "general wellness", prophylaxis, surgical preparation, etc.
...... reasonReference 0..* Reference(Condition | Observation | DiagnosticReport | DocumentReference) Why activity is needed
...... goal 0..* Reference(Goal) Goals this activity relates to
...... status ?! 1..1 code not-started | scheduled | in-progress | on-hold | completed | cancelled | stopped | unknown | entered-in-error
Binding: CarePlanActivityStatus (required): Codes that reflect the current state of a care plan activity within its overall life cycle.
...... statusReason 0..1 CodeableConcept Reason for current status
...... doNotPerform ?! 0..1 boolean If true, activity is prohibiting action
...... scheduled[x] 0..1 When activity is to occur
....... scheduledTiming Timing
....... scheduledPeriod Period
....... scheduledString string
...... location 0..1 Reference(Location) Where it should happen
...... performer 0..* Reference(Practitioner | PractitionerRole | Organization | RelatedPerson | Patient | CareTeam | HealthcareService | Device) Who will be responsible?
...... product[x] 0..1 What is to be administered/supplied
Binding: SNOMEDCTMedicationCodes (example): A product supplied or administered as part of a care plan activity.
....... productCodeableConcept CodeableConcept
....... productReference Reference(Medication | Substance)
...... dailyAmount 0..1 SimpleQuantity(4.0.1) How to consume/day?
...... quantity 0..1 SimpleQuantity(4.0.1) How much to administer/supply/consume
...... description 0..1 string Extra info describing activity to perform
.... activity:obds C 0..* BackboneElement Standard oBDS therapy recommendation with category only
Constraints: cpl-3
..... 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
..... outcomeCodeableConcept 0..* CodeableConcept Results of the activity
Binding: CarePlanActivityOutcome (example): Identifies the results of the activity.
..... outcomeReference 0..* Reference(Resource) Appointment, Encounter, Procedure, etc.
..... progress 0..* Annotation Comments about the activity status/progress
..... detail SC 1..1 BackboneElement In-line definition of activity
Constraints: tumorkonferenz-empfehlung-entscheidung-patient
...... 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 0..1 code Appointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | Task | ServiceRequest | VisionPrescription
Binding: CarePlanActivityKind (required): Resource types defined as part of FHIR that can be represented as in-line definitions of a care plan activity.
...... instantiatesCanonical 0..* canonical(PlanDefinition | ActivityDefinition | Questionnaire | Measure | OperationDefinition) Instantiates FHIR protocol or definition
...... instantiatesUri 0..* uri Instantiates external protocol or definition
...... code S 1..1 CodeableConcept Detail type of activity
Binding: MII VS Onkologie Therapieempfehlung Typ (required)
....... 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 Typ der Therapieempfehlung
........ 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 SΣ 1..1 uri Identity of the terminology system
Required Pattern: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapie-typ
........ version Σ 0..1 string Version of the system - if relevant
........ code SΣ 1..1 code Symbol in syntax defined by the system
........ 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
...... reasonCode 0..* CodeableConcept Why activity should be done or why activity was prohibited
Binding: SNOMEDCTClinicalFindings (example): Identifies why a care plan activity is needed. Can include any health condition codes as well as such concepts as "general wellness", prophylaxis, surgical preparation, etc.
...... reasonReference 0..* Reference(Condition | Observation | DiagnosticReport | DocumentReference) Why activity is needed
...... goal 0..* Reference(Goal) Goals this activity relates to
...... status ?!S 1..1 code Status der Therapieempfehlung
Binding: CarePlanActivityStatus (required): Codes that reflect the current state of a care plan activity within its overall life cycle.
...... statusReason S 0..1 CodeableConcept Therapieabweichung aufgrund Patientenwunsch der Therapieempfehlung
Binding: MII VS Onkologie Therapieabweichung (required)
....... 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 SΣ 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-onko/CodeSystem/mii-cs-onko-therapieabweichung
........ version Σ 0..1 string Version of the system - if relevant
........ code SΣ 0..1 code Symbol in syntax defined by the system
........ 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
...... doNotPerform ?! 0..1 boolean If true, activity is prohibiting action
...... scheduled[x] 0..1 When activity is to occur
....... scheduledTiming Timing
....... scheduledPeriod Period
....... scheduledString string
...... location 0..1 Reference(Location) Where it should happen
...... performer 0..* Reference(Practitioner | PractitionerRole | Organization | RelatedPerson | Patient | CareTeam | HealthcareService | Device) Who will be responsible?
...... product[x] 0..1 What is to be administered/supplied
Binding: SNOMEDCTMedicationCodes (example): A product supplied or administered as part of a care plan activity.
....... productCodeableConcept CodeableConcept
....... productReference Reference(Medication | Substance)
...... dailyAmount 0..1 SimpleQuantity(4.0.1) How to consume/day?
...... quantity 0..1 SimpleQuantity(4.0.1) How much to administer/supply/consume
...... description 0..1 string Extra info describing activity to perform
.... activity:extended C 0..* BackboneElement Extended molecular tumor board recommendation with detailed protocols
Constraints: cpl-3
..... 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
..... outcomeCodeableConcept 0..* CodeableConcept Results of the activity
Binding: CarePlanActivityOutcome (example): Identifies the results of the activity.
..... outcomeReference 0..* Reference(Resource) Appointment, Encounter, Procedure, etc.
..... progress S 0..* Annotation Progress notes for recommendation implementation
..... reference SC 1..1 Reference(MII PR Onkologie Therapieempfehlung Kombinationstherapie | MII PR Onkologie Therapieempfehlung Medikation | MII PR Onkologie Therapieempfehlung Operation) Detailed therapy recommendation - RequestGroup, MedicationRequest, or ServiceRequest
... note 0..* Annotation Comments about the plan

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
CarePlan.meta.security Base extensible SecurityLabels 📍4.0.1 FHIR Std.
CarePlan.meta.tag Base example Common Tags 📍4.0.1 FHIR Std.
CarePlan.language Base preferred Common Languages 📍4.0.1 FHIR Std.
CarePlan.status Base required RequestStatus 📍4.0.1 FHIR Std.
CarePlan.intent Base required Care Plan Intent 📍4.0.1 FHIR Std.
CarePlan.category Base example Care Plan Category 📍4.0.1 FHIR Std.
CarePlan.category.coding Base required MII VS Onkologie Therapieplanung Typ 📦2027.0.0-ballot.1 This IG
CarePlan.activity.outcomeCodeableConcept Base example Care Plan Activity Outcome 📍4.0.1 FHIR Std.
CarePlan.activity.detail.​kind Base required Care Plan Activity Kind 📍4.0.1 FHIR Std.
CarePlan.activity.detail.​code Base example Procedure Codes (SNOMED CT) 📍4.0.1 FHIR Std.
CarePlan.activity.detail.​reasonCode Base example SNOMED CT Clinical Findings 📍4.0.1 FHIR Std.
CarePlan.activity.detail.​status Base required CarePlanActivityStatus 📍4.0.1 FHIR Std.
CarePlan.activity.detail.​product[x] Base example SNOMED CT Medication Codes 📍4.0.1 FHIR Std.
CarePlan.activity:obds.​outcomeCodeableConcept Base example Care Plan Activity Outcome 📍4.0.1 FHIR Std.
CarePlan.activity:obds.​detail.kind Base required Care Plan Activity Kind 📍4.0.1 FHIR Std.
CarePlan.activity:obds.​detail.code Base required MII VS Onkologie Therapieempfehlung Typ 📦2027.0.0-ballot.1 This IG
CarePlan.activity:obds.​detail.reasonCode Base example SNOMED CT Clinical Findings 📍4.0.1 FHIR Std.
CarePlan.activity:obds.​detail.status Base required CarePlanActivityStatus 📍4.0.1 FHIR Std.
CarePlan.activity:obds.​detail.statusReason Base required MII VS Onkologie Therapieabweichung 📦2027.0.0-ballot.1 This IG
CarePlan.activity:obds.​detail.product[x] Base example SNOMED CT Medication Codes 📍4.0.1 FHIR Std.
CarePlan.activity:extended.​outcomeCodeableConcept Base example Care Plan Activity Outcome 📍4.0.1 FHIR Std.
CarePlan.activity:extended.​detail.kind Base required Care Plan Activity Kind 📍4.0.1 FHIR Std.
CarePlan.activity:extended.​detail.code Base example Procedure Codes (SNOMED CT) 📍4.0.1 FHIR Std.
CarePlan.activity:extended.​detail.reasonCode Base example SNOMED CT Clinical Findings 📍4.0.1 FHIR Std.
CarePlan.activity:extended.​detail.status Base required CarePlanActivityStatus 📍4.0.1 FHIR Std.
CarePlan.activity:extended.​detail.product[x] Base example SNOMED CT Medication Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
cpl-3 error CarePlan.activity, CarePlan.activity:obds, CarePlan.activity:extended Provide a reference or detail, not both detail.empty() or reference.empty()
dom-2 error CarePlan If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error CarePlan 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 CarePlan 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 CarePlan If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice CarePlan 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()
tumorkonferenz-empfehlung-entscheidung-patient error CarePlan.activity:obds.detail Therapieabweichung aufgrund Patientenwunsch: Bei nichtangetretener oder abgebrochener Therapie ist anzugeben, ob dies dem Patientenwunsch entspricht oder ggfs. andere Gründe hat status = 'cancelled' or status = 'stopped' implies statusReason.exists()

Schlüsselelemente-Ansicht

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CarePlan 0..* CarePlan Healthcare plan for patient or group
... 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
... intent ?!SΣ 1..1 code proposal | plan | order | option
Binding: CarePlanIntent (required): Codes indicating the degree of authority/intentionality associated with a care plan.
Required Pattern: plan
... category SΣ 1..1 CodeableConcept Type of plan
Binding: CarePlanCategory (example): Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.
.... coding SΣ 1..* Coding Art der Tumorkonferenz / Therapieplanung
Binding: MII VS Onkologie Therapieplanung Typ (required)
..... system SΣ 1..1 uri Identity of the terminology system
Required Pattern: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapieplanung-typ
..... code SΣ 1..1 code Symbol in syntax defined by the system
... subject SΣ 1..1 Reference(Patient) Who the care plan is for
... encounter SΣ 0..1 Reference(Encounter) Encounter created as part of
... created SΣ 1..1 dateTime Datum der Tumorkonferenz / Therapieplanung
... addresses SΣ 0..* Reference(MII PR Onkologie Diagnose Primärtumor) Health issues this plan addresses
... supportingInfo S 0..* Reference(Resource) Information considered as part of plan
... Slices for activity SC 0..* BackboneElement Therapy recommendations - either oBDS standard categorization or extended molecular protocols
Slice: Unordered, Open by exists:detail, profile:reference.resolve()
Constraints: cpl-3
.... activity:All Slices Content/Rules for all slices
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... activity:obds C 0..* BackboneElement Standard oBDS therapy recommendation with category only
Constraints: cpl-3
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... detail SC 1..1 BackboneElement In-line definition of activity
Constraints: tumorkonferenz-empfehlung-entscheidung-patient
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... code S 1..1 CodeableConcept Detail type of activity
Binding: MII VS Onkologie Therapieempfehlung Typ (required)
....... coding Σ 0..* Coding Typ der Therapieempfehlung
........ system SΣ 1..1 uri Identity of the terminology system
Required Pattern: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapie-typ
........ code SΣ 1..1 code Symbol in syntax defined by the system
...... status ?!S 1..1 code Status der Therapieempfehlung
Binding: CarePlanActivityStatus (required): Codes that reflect the current state of a care plan activity within its overall life cycle.
...... statusReason S 0..1 CodeableConcept Therapieabweichung aufgrund Patientenwunsch der Therapieempfehlung
Binding: MII VS Onkologie Therapieabweichung (required)
....... coding SΣ 0..* 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-onko/CodeSystem/mii-cs-onko-therapieabweichung
........ code SΣ 0..1 code Symbol in syntax defined by the system
...... doNotPerform ?! 0..1 boolean If true, activity is prohibiting action
.... activity:extended C 0..* BackboneElement Extended molecular tumor board recommendation with detailed protocols
Constraints: cpl-3
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... progress S 0..* Annotation Progress notes for recommendation implementation
..... reference SC 1..1 Reference(MII PR Onkologie Therapieempfehlung Kombinationstherapie | MII PR Onkologie Therapieempfehlung Medikation | MII PR Onkologie Therapieempfehlung Operation) Detailed therapy recommendation - RequestGroup, MedicationRequest, or ServiceRequest

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
CarePlan.status Base required RequestStatus 📍4.0.1 FHIR Std.
CarePlan.intent Base required Care Plan Intent 📍4.0.1 FHIR Std.
CarePlan.category Base example Care Plan Category 📍4.0.1 FHIR Std.
CarePlan.category.coding Base required MII VS Onkologie Therapieplanung Typ 📦2027.0.0-ballot.1 This IG
CarePlan.activity:obds.​detail.code Base required MII VS Onkologie Therapieempfehlung Typ 📦2027.0.0-ballot.1 This IG
CarePlan.activity:obds.​detail.status Base required CarePlanActivityStatus 📍4.0.1 FHIR Std.
CarePlan.activity:obds.​detail.statusReason Base required MII VS Onkologie Therapieabweichung 📦2027.0.0-ballot.1 This IG
CarePlan.activity:extended.​detail.status Base required CarePlanActivityStatus 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
cpl-3 error CarePlan.activity, CarePlan.activity:obds, CarePlan.activity:extended Provide a reference or detail, not both detail.empty() or reference.empty()
dom-2 error CarePlan If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error CarePlan 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 CarePlan 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 CarePlan If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice CarePlan 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()
tumorkonferenz-empfehlung-entscheidung-patient error CarePlan.activity:obds.detail Therapieabweichung aufgrund Patientenwunsch: Bei nichtangetretener oder abgebrochener Therapie ist anzugeben, ob dies dem Patientenwunsch entspricht oder ggfs. andere Gründe hat status = 'cancelled' or status = 'stopped' implies statusReason.exists()

Differential-Ansicht

Diese Struktur ist abgeleitet von CarePlan

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CarePlan 0..* CarePlan Healthcare plan for patient or group
... meta
.... profile S 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
... status S 1..1 code draft | active | on-hold | revoked | completed | entered-in-error | unknown
... intent S 1..1 code proposal | plan | order | option
Required Pattern: plan
.... coding S 1..* Coding Art der Tumorkonferenz / Therapieplanung
Binding: MII VS Onkologie Therapieplanung Typ (required)
..... system S 1..1 uri Identity of the terminology system
Required Pattern: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapieplanung-typ
..... code S 1..1 code Symbol in syntax defined by the system
... subject S 1..1 Reference(Patient) Who the care plan is for
... encounter S 0..1 Reference(Encounter) Encounter created as part of
... created S 1..1 dateTime Datum der Tumorkonferenz / Therapieplanung
... addresses S 0..* Reference(MII PR Onkologie Diagnose Primärtumor) Health issues this plan addresses
... supportingInfo S 0..* Reference(Resource) Information considered as part of plan
... Slices for activity S 0..* BackboneElement Therapy recommendations - either oBDS standard categorization or extended molecular protocols
Slice: Unordered, Open by exists:detail, profile:reference.resolve()
.... activity:obds 0..* BackboneElement Standard oBDS therapy recommendation with category only
..... reference 0..0 Activity details defined in specific resource
..... detail SC 1..1 BackboneElement In-line definition of activity
Constraints: tumorkonferenz-empfehlung-entscheidung-patient
...... code S 1..1 CodeableConcept Detail type of activity
Binding: MII VS Onkologie Therapieempfehlung Typ (required)
....... coding 0..* Coding Typ der Therapieempfehlung
........ system S 1..1 uri Identity of the terminology system
Required Pattern: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapie-typ
........ code S 1..1 code Symbol in syntax defined by the system
...... status S 1..1 code Status der Therapieempfehlung
...... statusReason S 0..1 CodeableConcept Therapieabweichung aufgrund Patientenwunsch der Therapieempfehlung
Binding: MII VS Onkologie Therapieabweichung (required)
....... coding S 0..* 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-onko/CodeSystem/mii-cs-onko-therapieabweichung
........ code S 0..1 code Symbol in syntax defined by the system
.... activity:extended 0..* BackboneElement Extended molecular tumor board recommendation with detailed protocols
..... progress S 0..* Annotation Progress notes for recommendation implementation
..... reference S 1..1 Reference(MII PR Onkologie Therapieempfehlung Kombinationstherapie | MII PR Onkologie Therapieempfehlung Medikation | MII PR Onkologie Therapieempfehlung Operation) Detailed therapy recommendation - RequestGroup, MedicationRequest, or ServiceRequest
..... detail 0..0 In-line definition of activity

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
CarePlan.category.coding Base required MII VS Onkologie Therapieplanung Typ 📦2027.0.0-ballot.1 This IG
CarePlan.activity:obds.​detail.code Base required MII VS Onkologie Therapieempfehlung Typ 📦2027.0.0-ballot.1 This IG
CarePlan.activity:obds.​detail.statusReason Base required MII VS Onkologie Therapieabweichung 📦2027.0.0-ballot.1 This IG

Constraints

Id Grade Path(s) Description Expression
tumorkonferenz-empfehlung-entscheidung-patient error CarePlan.activity:obds.detail Therapieabweichung aufgrund Patientenwunsch: Bei nichtangetretener oder abgebrochener Therapie ist anzugeben, ob dies dem Patientenwunsch entspricht oder ggfs. andere Gründe hat status = 'cancelled' or status = 'stopped' implies statusReason.exists()

Snapshot-AnsichtView

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CarePlan 0..* CarePlan Healthcare plan for patient or group
... 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
... 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 External Ids for this plan
... instantiatesCanonical Σ 0..* canonical(PlanDefinition | Questionnaire | Measure | ActivityDefinition | OperationDefinition) Instantiates FHIR protocol or definition
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
... basedOn Σ 0..* Reference(CarePlan) Fulfills CarePlan
... replaces Σ 0..* Reference(CarePlan) CarePlan replaced by this CarePlan
... partOf Σ 0..* Reference(CarePlan) Part of referenced CarePlan
... status ?!SΣ 1..1 code draft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.
... intent ?!SΣ 1..1 code proposal | plan | order | option
Binding: CarePlanIntent (required): Codes indicating the degree of authority/intentionality associated with a care plan.
Required Pattern: plan
... category SΣ 1..1 CodeableConcept Type of plan
Binding: CarePlanCategory (example): Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.
.... 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 SΣ 1..* Coding Art der Tumorkonferenz / Therapieplanung
Binding: MII VS Onkologie Therapieplanung Typ (required)
..... 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 SΣ 1..1 uri Identity of the terminology system
Required Pattern: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapieplanung-typ
..... version Σ 0..1 string Version of the system - if relevant
..... code SΣ 1..1 code Symbol in syntax defined by the system
..... 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
... title Σ 0..1 string Human-friendly name for the care plan
... description Σ 0..1 string Summary of nature of plan
... subject SΣ 1..1 Reference(Patient) Who the care plan is for
... encounter SΣ 0..1 Reference(Encounter) Encounter created as part of
... period Σ 0..1 Period Time period plan covers
... created SΣ 1..1 dateTime Datum der Tumorkonferenz / Therapieplanung
... author Σ 0..1 Reference(Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam) Who is the designated responsible party
... contributor 0..* Reference(Patient | Practitioner | PractitionerRole | Device | RelatedPerson | Organization | CareTeam) Who provided the content of the care plan
... careTeam 0..* Reference(CareTeam) Who's involved in plan?
... addresses SΣ 0..* Reference(MII PR Onkologie Diagnose Primärtumor) Health issues this plan addresses
... supportingInfo S 0..* Reference(Resource) Information considered as part of plan
... goal 0..* Reference(Goal) Desired outcome of plan
... Slices for activity SC 0..* BackboneElement Therapy recommendations - either oBDS standard categorization or extended molecular protocols
Slice: Unordered, Open by exists:detail, profile:reference.resolve()
Constraints: cpl-3
.... activity:All Slices Content/Rules for all slices
..... 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
..... outcomeCodeableConcept 0..* CodeableConcept Results of the activity
Binding: CarePlanActivityOutcome (example): Identifies the results of the activity.
..... outcomeReference 0..* Reference(Resource) Appointment, Encounter, Procedure, etc.
..... progress 0..* Annotation Comments about the activity status/progress
..... reference C 0..1 Reference(Appointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | Task | ServiceRequest | VisionPrescription | RequestGroup) Activity details defined in specific resource
..... detail C 0..1 BackboneElement In-line definition of activity
...... 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 0..1 code Appointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | Task | ServiceRequest | VisionPrescription
Binding: CarePlanActivityKind (required): Resource types defined as part of FHIR that can be represented as in-line definitions of a care plan activity.
...... instantiatesCanonical 0..* canonical(PlanDefinition | ActivityDefinition | Questionnaire | Measure | OperationDefinition) Instantiates FHIR protocol or definition
...... instantiatesUri 0..* uri Instantiates external protocol or definition
...... code 0..1 CodeableConcept Detail type of activity
Binding: ProcedureCodes(SNOMEDCT) (example): Detailed description of the type of activity; e.g. What lab test, what procedure, what kind of encounter.
...... reasonCode 0..* CodeableConcept Why activity should be done or why activity was prohibited
Binding: SNOMEDCTClinicalFindings (example): Identifies why a care plan activity is needed. Can include any health condition codes as well as such concepts as "general wellness", prophylaxis, surgical preparation, etc.
...... reasonReference 0..* Reference(Condition | Observation | DiagnosticReport | DocumentReference) Why activity is needed
...... goal 0..* Reference(Goal) Goals this activity relates to
...... status ?! 1..1 code not-started | scheduled | in-progress | on-hold | completed | cancelled | stopped | unknown | entered-in-error
Binding: CarePlanActivityStatus (required): Codes that reflect the current state of a care plan activity within its overall life cycle.
...... statusReason 0..1 CodeableConcept Reason for current status
...... doNotPerform ?! 0..1 boolean If true, activity is prohibiting action
...... scheduled[x] 0..1 When activity is to occur
....... scheduledTiming Timing
....... scheduledPeriod Period
....... scheduledString string
...... location 0..1 Reference(Location) Where it should happen
...... performer 0..* Reference(Practitioner | PractitionerRole | Organization | RelatedPerson | Patient | CareTeam | HealthcareService | Device) Who will be responsible?
...... product[x] 0..1 What is to be administered/supplied
Binding: SNOMEDCTMedicationCodes (example): A product supplied or administered as part of a care plan activity.
....... productCodeableConcept CodeableConcept
....... productReference Reference(Medication | Substance)
...... dailyAmount 0..1 SimpleQuantity(4.0.1) How to consume/day?
...... quantity 0..1 SimpleQuantity(4.0.1) How much to administer/supply/consume
...... description 0..1 string Extra info describing activity to perform
.... activity:obds C 0..* BackboneElement Standard oBDS therapy recommendation with category only
Constraints: cpl-3
..... 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
..... outcomeCodeableConcept 0..* CodeableConcept Results of the activity
Binding: CarePlanActivityOutcome (example): Identifies the results of the activity.
..... outcomeReference 0..* Reference(Resource) Appointment, Encounter, Procedure, etc.
..... progress 0..* Annotation Comments about the activity status/progress
..... detail SC 1..1 BackboneElement In-line definition of activity
Constraints: tumorkonferenz-empfehlung-entscheidung-patient
...... 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 0..1 code Appointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | Task | ServiceRequest | VisionPrescription
Binding: CarePlanActivityKind (required): Resource types defined as part of FHIR that can be represented as in-line definitions of a care plan activity.
...... instantiatesCanonical 0..* canonical(PlanDefinition | ActivityDefinition | Questionnaire | Measure | OperationDefinition) Instantiates FHIR protocol or definition
...... instantiatesUri 0..* uri Instantiates external protocol or definition
...... code S 1..1 CodeableConcept Detail type of activity
Binding: MII VS Onkologie Therapieempfehlung Typ (required)
....... 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 Typ der Therapieempfehlung
........ 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 SΣ 1..1 uri Identity of the terminology system
Required Pattern: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapie-typ
........ version Σ 0..1 string Version of the system - if relevant
........ code SΣ 1..1 code Symbol in syntax defined by the system
........ 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
...... reasonCode 0..* CodeableConcept Why activity should be done or why activity was prohibited
Binding: SNOMEDCTClinicalFindings (example): Identifies why a care plan activity is needed. Can include any health condition codes as well as such concepts as "general wellness", prophylaxis, surgical preparation, etc.
...... reasonReference 0..* Reference(Condition | Observation | DiagnosticReport | DocumentReference) Why activity is needed
...... goal 0..* Reference(Goal) Goals this activity relates to
...... status ?!S 1..1 code Status der Therapieempfehlung
Binding: CarePlanActivityStatus (required): Codes that reflect the current state of a care plan activity within its overall life cycle.
...... statusReason S 0..1 CodeableConcept Therapieabweichung aufgrund Patientenwunsch der Therapieempfehlung
Binding: MII VS Onkologie Therapieabweichung (required)
....... 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 SΣ 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-onko/CodeSystem/mii-cs-onko-therapieabweichung
........ version Σ 0..1 string Version of the system - if relevant
........ code SΣ 0..1 code Symbol in syntax defined by the system
........ 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
...... doNotPerform ?! 0..1 boolean If true, activity is prohibiting action
...... scheduled[x] 0..1 When activity is to occur
....... scheduledTiming Timing
....... scheduledPeriod Period
....... scheduledString string
...... location 0..1 Reference(Location) Where it should happen
...... performer 0..* Reference(Practitioner | PractitionerRole | Organization | RelatedPerson | Patient | CareTeam | HealthcareService | Device) Who will be responsible?
...... product[x] 0..1 What is to be administered/supplied
Binding: SNOMEDCTMedicationCodes (example): A product supplied or administered as part of a care plan activity.
....... productCodeableConcept CodeableConcept
....... productReference Reference(Medication | Substance)
...... dailyAmount 0..1 SimpleQuantity(4.0.1) How to consume/day?
...... quantity 0..1 SimpleQuantity(4.0.1) How much to administer/supply/consume
...... description 0..1 string Extra info describing activity to perform
.... activity:extended C 0..* BackboneElement Extended molecular tumor board recommendation with detailed protocols
Constraints: cpl-3
..... 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
..... outcomeCodeableConcept 0..* CodeableConcept Results of the activity
Binding: CarePlanActivityOutcome (example): Identifies the results of the activity.
..... outcomeReference 0..* Reference(Resource) Appointment, Encounter, Procedure, etc.
..... progress S 0..* Annotation Progress notes for recommendation implementation
..... reference SC 1..1 Reference(MII PR Onkologie Therapieempfehlung Kombinationstherapie | MII PR Onkologie Therapieempfehlung Medikation | MII PR Onkologie Therapieempfehlung Operation) Detailed therapy recommendation - RequestGroup, MedicationRequest, or ServiceRequest
... note 0..* Annotation Comments about the plan

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
CarePlan.meta.security Base extensible SecurityLabels 📍4.0.1 FHIR Std.
CarePlan.meta.tag Base example Common Tags 📍4.0.1 FHIR Std.
CarePlan.language Base preferred Common Languages 📍4.0.1 FHIR Std.
CarePlan.status Base required RequestStatus 📍4.0.1 FHIR Std.
CarePlan.intent Base required Care Plan Intent 📍4.0.1 FHIR Std.
CarePlan.category Base example Care Plan Category 📍4.0.1 FHIR Std.
CarePlan.category.coding Base required MII VS Onkologie Therapieplanung Typ 📦2027.0.0-ballot.1 This IG
CarePlan.activity.outcomeCodeableConcept Base example Care Plan Activity Outcome 📍4.0.1 FHIR Std.
CarePlan.activity.detail.​kind Base required Care Plan Activity Kind 📍4.0.1 FHIR Std.
CarePlan.activity.detail.​code Base example Procedure Codes (SNOMED CT) 📍4.0.1 FHIR Std.
CarePlan.activity.detail.​reasonCode Base example SNOMED CT Clinical Findings 📍4.0.1 FHIR Std.
CarePlan.activity.detail.​status Base required CarePlanActivityStatus 📍4.0.1 FHIR Std.
CarePlan.activity.detail.​product[x] Base example SNOMED CT Medication Codes 📍4.0.1 FHIR Std.
CarePlan.activity:obds.​outcomeCodeableConcept Base example Care Plan Activity Outcome 📍4.0.1 FHIR Std.
CarePlan.activity:obds.​detail.kind Base required Care Plan Activity Kind 📍4.0.1 FHIR Std.
CarePlan.activity:obds.​detail.code Base required MII VS Onkologie Therapieempfehlung Typ 📦2027.0.0-ballot.1 This IG
CarePlan.activity:obds.​detail.reasonCode Base example SNOMED CT Clinical Findings 📍4.0.1 FHIR Std.
CarePlan.activity:obds.​detail.status Base required CarePlanActivityStatus 📍4.0.1 FHIR Std.
CarePlan.activity:obds.​detail.statusReason Base required MII VS Onkologie Therapieabweichung 📦2027.0.0-ballot.1 This IG
CarePlan.activity:obds.​detail.product[x] Base example SNOMED CT Medication Codes 📍4.0.1 FHIR Std.
CarePlan.activity:extended.​outcomeCodeableConcept Base example Care Plan Activity Outcome 📍4.0.1 FHIR Std.
CarePlan.activity:extended.​detail.kind Base required Care Plan Activity Kind 📍4.0.1 FHIR Std.
CarePlan.activity:extended.​detail.code Base example Procedure Codes (SNOMED CT) 📍4.0.1 FHIR Std.
CarePlan.activity:extended.​detail.reasonCode Base example SNOMED CT Clinical Findings 📍4.0.1 FHIR Std.
CarePlan.activity:extended.​detail.status Base required CarePlanActivityStatus 📍4.0.1 FHIR Std.
CarePlan.activity:extended.​detail.product[x] Base example SNOMED CT Medication Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
cpl-3 error CarePlan.activity, CarePlan.activity:obds, CarePlan.activity:extended Provide a reference or detail, not both detail.empty() or reference.empty()
dom-2 error CarePlan If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error CarePlan 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 CarePlan 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 CarePlan If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice CarePlan 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()
tumorkonferenz-empfehlung-entscheidung-patient error CarePlan.activity:obds.detail Therapieabweichung aufgrund Patientenwunsch: Bei nichtangetretener oder abgebrochener Therapie ist anzugeben, ob dies dem Patientenwunsch entspricht oder ggfs. andere Gründe hat status = 'cancelled' or status = 'stopped' implies statusReason.exists()

 

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