Dieses Profil beschreibt die aktuelle Behandlungsepisode inkl. dem aktuellen Gesundheitszustand, Vortherapien, Molekular Pathologie Befund und NGS Bericht.
Diese gilt als Klammer, die als Ergänzung zum Fallkonzept dienen soll, da die MTB neben den klassischen In-House-Patienten jeder der folgenden PAtient Journeys abdecken kann:
Alternativ wurde die Verwendung der EpisodeOfCare-Ressource überlegt. Diese ist jedoch eher als administrativer Behandlungszeitraum anzusehen.
Daher erschien uns die Verwendung der ClinicalImpression-Ressource sinnvoller, auch wenn die ClinicalImpression hier einen Zeitraum und keinen Zeitpunkt erfasst. Sie enthält damit sowohl Referenzen auf den Zustand des/der Patient*in zum Einschlusszeitpunkt, als auch Referenzen auf die durchgeführte Diagnostik und Behandlungen sowie interdisziplinäre Konferenzen zur weiteren Behandlungsplanung.
| Name | Status | Version | Canonical | Basis |
|---|---|---|---|---|
| MII_PR_MTB_Behandlungsepisode | draft | 2024.0.0-ballot | https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-behandlungsepisode | http://hl7.org/fhir/StructureDefinition/ClinicalImpression |
| MII_PR_MTB_Behandlungsepisode (ClinicalImpression) | I | ClinicalImpression | |
| id | Σ | 0..1 | string |
| meta | S Σ | 0..1 | Meta |
| id | 0..1 | string | |
| extension | I | 0..* | Extension |
| versionId | Σ | 0..1 | id |
| lastUpdated | Σ | 0..1 | instant |
| source | Σ | 0..1 | uri |
| profile | S Σ | 0..* | canonical(StructureDefinition) |
| security | Σ | 0..* | CodingBinding |
| tag | Σ | 0..* | Coding |
| implicitRules | Σ ?! | 0..1 | uri |
| language | 0..1 | codeBinding | |
| text | 0..1 | Narrative | |
| contained | 0..* | Resource | |
| extension | I | 0..* | Extension |
| LeitlinenbehandlungStatus | S I | 0..1 | Extension(CodeableConcept) |
| modifierExtension | ?! I | 0..* | Extension |
| identifier | Σ | 0..* | Identifier |
| status | Σ ?! | 1..1 | codeBinding |
| statusReason | 0..1 | CodeableConcept | |
| code | Σ | 0..1 | CodeableConcept |
| description | Σ | 0..1 | string |
| subject | Σ | 1..1 | Reference(MII_PR_Person_Patient | MII_PR_Person_PatientPseudonymisiert) |
| encounter | Σ | 0..1 | Reference(Encounter) |
| effective[x] | Σ | 1..1 | |
| (All Slices) | |||
| effectiveDateTime | dateTime | ||
| effectivePeriod | S Σ | 1..1 | Period |
| id | 0..1 | string | |
| extension | I | 0..* | Extension |
| start | Σ I | 0..1 | dateTime |
| end | S Σ I | 0..1 | dateTime |
| date | Σ | 0..1 | dateTime |
| assessor | Σ | 0..1 | Reference(Practitioner | PractitionerRole) |
| previous | 0..1 | Reference(ClinicalImpression) | |
| problem | S Σ | 0..* | Reference(Condition | AllergyIntolerance) |
| PrimaertumorDiagnose | S Σ | 0..1 | Reference(MII_PR_MTB_Diagnose_Primaertumor | Condition) |
| investigation | 0..* | BackboneElement | |
| (All Slices) | |||
| id | 0..1 | string | |
| extension | I | 0..* | Extension |
| modifierExtension | Σ ?! I | 0..* | Extension |
| code | 1..1 | CodeableConcept | |
| item | 0..* | Reference(Observation | QuestionnaireResponse | FamilyMemberHistory | DiagnosticReport | RiskAssessment | ImagingStudy | Media) | |
| KrankengeschichteFamilie | S | 0..1 | BackboneElement |
| id | 0..1 | string | |
| extension | I | 0..* | Extension |
| modifierExtension | Σ ?! I | 0..* | Extension |
| code | 1..1 | CodeableConcept | |
| id | 0..1 | string | |
| extension | I | 0..* | Extension |
| coding | Σ | 1..* | CodingPattern |
| text | Σ | 0..1 | string |
| item | 1..1 | Reference(MII_PR_MolGen_Familienanamnese | FamilyMemberHistory) | |
| ECOG | S | 0..1 | BackboneElement |
| id | 0..1 | string | |
| extension | I | 0..* | Extension |
| modifierExtension | Σ ?! I | 0..* | Extension |
| code | 1..1 | CodeableConcept | |
| id | 0..1 | string | |
| extension | I | 0..* | Extension |
| coding | Σ | 1..* | CodingPattern |
| text | Σ | 0..1 | string |
| item | 1..1 | Reference(MII_PR_Onko_Allgemeiner_Leistungszustand_ECOG | Observation) | |
| NgsBericht | S | 0..* | BackboneElement |
| id | 0..1 | string | |
| extension | I | 0..* | Extension |
| modifierExtension | Σ ?! I | 0..* | Extension |
| code | 1..1 | CodeableConcept | |
| id | 0..1 | string | |
| extension | I | 0..* | Extension |
| coding | Σ | 1..* | CodingPattern |
| text | Σ | 0..1 | string |
| item | 1..1 | Reference(MII_PR_MTB_NGS_Bericht | DiagnosticReport) | |
| MolekularPathologieBefund | S | 0..* | BackboneElement |
| id | 0..1 | string | |
| extension | I | 0..* | Extension |
| modifierExtension | Σ ?! I | 0..* | Extension |
| code | 1..1 | CodeableConcept | |
| id | 0..1 | string | |
| extension | I | 0..* | Extension |
| coding | Σ | 1..* | CodingPattern |
| text | Σ | 0..1 | string |
| item | 1..1 | Reference(MII_PR_MTB_Molecular_Pathology_Report | DiagnosticReport) | |
| protocol | 0..* | uri | |
| summary | 0..1 | string | |
| finding | 0..* | BackboneElement | |
| id | 0..1 | string | |
| extension | I | 0..* | Extension |
| modifierExtension | Σ ?! I | 0..* | Extension |
| itemCodeableConcept | 0..1 | CodeableConcept | |
| itemReference | 0..1 | Reference(Condition | Observation | Media) | |
| basis | 0..1 | string | |
| prognosisCodeableConcept | 0..* | CodeableConcept | |
| prognosisReference | 0..* | Reference(RiskAssessment) | |
| supportingInfo | 0..* | Reference(Resource) | |
| Einwilligung | S | 0..1 | Reference(MII_PR_MTB_Consent_Given) |
| Vorbefund | S | 0..* | Reference(DiagnosticReport | Observation) |
| Vortherapie | S | 0..* | Reference(MII_PR_MTB_Systemische_Vortherapie | MII_PR_Onko_Strahlentherapie | MII_PR_Onko_Operation | MII_PR_Prozedur_Procedure) |
| id | 0..1 | string | |
| extension | I | 0..* | Extension |
| LeitlinieDokumentation | S I | 0..1 | Extension(Complex) |
| reference | Σ I | 0..1 | string |
| type | Σ | 0..1 | uriBinding |
| identifier | Σ | 0..1 | Identifier |
| display | Σ | 0..1 | string |
| Therapieplan | S | 0..1 | Reference(MII_PR_MTB_Therapieplan | CarePlan) |
| note | 0..* | Annotation |
Aktueller Krankheitszustand und bisherige Behandlungsmaßnahmen |
| Feldname | Kurzbeschreibung |
|---|---|
| ClinicalImpression.meta | |
| ClinicalImpression.meta.profile | |
| ClinicalImpression.extension:LeitlinenbehandlungStatus | |
| ClinicalImpression.effective[x]:effectivePeriod | Zeitraum der Behandlungsepisode |
| ClinicalImpression.effective[x]:effectivePeriod.end | Abschlussdatum |
| ClinicalImpression.problem | |
| ClinicalImpression.problem:PrimaertumorDiagnose | Primärtumor Diagnose |
| ClinicalImpression.investigation:KrankengeschichteFamilie | |
| ClinicalImpression.investigation:ECOG | |
| ClinicalImpression.investigation:NgsBericht | |
| ClinicalImpression.investigation:MolekularPathologieBefund | |
| ClinicalImpression.supportingInfo:Einwilligung | Einwilligung |
| ClinicalImpression.supportingInfo:Vorbefund | Vorbefund |
| ClinicalImpression.supportingInfo:Vortherapie | Vortherapie |
| ClinicalImpression.supportingInfo:Vortherapie.extension:LeitlinieDokumentation | Leitlinie Dokumentation |
| ClinicalImpression.supportingInfo:Therapieplan | Therapieplan |
<StructureDefinition xmlns="http://hl7.org/fhir"> <id value="mii-pr-mtb-behandlungsepisode" /> <url value="https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-behandlungsepisode" /> <version value="2024.0.0-ballot" /> <name value="MII_PR_MTB_Behandlungsepisode" /> <title value="MII PR MTB Behandlungsepisode" /> <status value="draft" /> <publisher value="Medizininformatik Initiative" /> <contact> <telecom> <system value="url" /> <value value="https://www.medizininformatik-initiative.de" /> </telecom> </contact> <description value="Aktueller Krankheitszustand und bisherige Behandlungsmaßnahmen" /> <fhirVersion value="4.0.1" /> <kind value="resource" /> <abstract value="false" /> <type value="ClinicalImpression" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/ClinicalImpression" /> <derivation value="constraint" /> <differential> <element id="ClinicalImpression.meta"> <path value="ClinicalImpression.meta" /> <mustSupport value="true" /> </element> <element id="ClinicalImpression.meta.profile"> <path value="ClinicalImpression.meta.profile" /> <mustSupport value="true" /> </element> <element id="ClinicalImpression.extension:LeitlinenbehandlungStatus"> <path value="ClinicalImpression.extension" /> <sliceName value="LeitlinenbehandlungStatus" /> <min value="0" /> <max value="1" /> <type> <code value="Extension" /> <profile value="https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-ex-mtb-leitlinienbehandlung-status" /> </type> <mustSupport value="true" /> </element> <element id="ClinicalImpression.subject"> <path value="ClinicalImpression.subject" /> <type> <code value="Reference" /> <targetProfile value="https://www.medizininformatik-initiative.de/fhir/core/modul-person/StructureDefinition/Patient" /> <targetProfile value="https://www.medizininformatik-initiative.de/fhir/core/modul-person/StructureDefinition/PatientPseudonymisiert" /> </type> </element> <element id="ClinicalImpression.effective[x]"> <path value="ClinicalImpression.effective[x]" /> <slicing> <discriminator> <type value="type" /> <path value="$this" /> </discriminator> <ordered value="false" /> <rules value="open" /> </slicing> <min value="1" /> </element> <element id="ClinicalImpression.effective[x]:effectivePeriod"> <path value="ClinicalImpression.effective[x]" /> <sliceName value="effectivePeriod" /> <short value="Zeitraum der Behandlungsepisode" /> <definition value="Zeitraum von Einschluss bis Abschluss im Molekularen Tumorboard" /> <min value="1" /> <max value="1" /> <type> <code value="Period" /> </type> <mustSupport value="true" /> </element> <element id="ClinicalImpression.effective[x]:effectivePeriod.start"> <path value="ClinicalImpression.effective[x].start" /> <short value="Einschlussdatum" /> <definition value="Einschlussdatum Molekulares Tumorboard" /> </element> <element id="ClinicalImpression.effective[x]:effectivePeriod.end"> <path value="ClinicalImpression.effective[x].end" /> <short value="Abschlussdatum" /> <definition value="Abschlussdatum Molekulares Tumorboard" /> <mustSupport value="true" /> </element> <element id="ClinicalImpression.problem"> <path value="ClinicalImpression.problem" /> <slicing> <discriminator> <type value="type" /> <path value="$this" /> </discriminator> <description value="Slice für Diagnose" /> <ordered value="false" /> <rules value="open" /> </slicing> <mustSupport value="true" /> </element> <element id="ClinicalImpression.problem:PrimaertumorDiagnose"> <path value="ClinicalImpression.problem" /> <sliceName value="PrimaertumorDiagnose" /> <short value="Primärtumor Diagnose" /> <definition value="Verweise auf Diagnose des Primärtumors" /> <min value="0" /> <max value="1" /> <type> <code value="Reference" /> <targetProfile value="https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-diagnose-primaertumor" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Condition" /> </type> <mustSupport value="true" /> </element> <element id="ClinicalImpression.investigation"> <path value="ClinicalImpression.investigation" /> <slicing> <discriminator> <type value="value" /> <path value="code.coding" /> </discriminator> <description value="Slice für relevante Ermittlungen" /> <ordered value="false" /> <rules value="open" /> </slicing> </element> <element id="ClinicalImpression.investigation:KrankengeschichteFamilie"> <path value="ClinicalImpression.investigation" /> <sliceName value="KrankengeschichteFamilie" /> <min value="0" /> <max value="1" /> <mustSupport value="true" /> </element> <element id="ClinicalImpression.investigation:KrankengeschichteFamilie.code.coding"> <path value="ClinicalImpression.investigation.code.coding" /> <min value="1" /> <patternCoding> <system value="http://snomed.info/sct" /> <code value="416471007" /> <display value="Family medical history" /> </patternCoding> </element> <element id="ClinicalImpression.investigation:KrankengeschichteFamilie.item"> <path value="ClinicalImpression.investigation.item" /> <short value="Krankengeschichte Familie" /> <definition value="Verweis auf familiäre Krankengeschichte" /> <min value="1" /> <max value="1" /> <type> <code value="Reference" /> <targetProfile value="https://www.medizininformatik-initiative.de/fhir/ext/modul-molgen/StructureDefinition/familienanamnese" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/FamilyMemberHistory" /> </type> </element> <element id="ClinicalImpression.investigation:ECOG"> <path value="ClinicalImpression.investigation" /> <sliceName value="ECOG" /> <min value="0" /> <max value="1" /> <mustSupport value="true" /> </element> <element id="ClinicalImpression.investigation:ECOG.code.coding"> <path value="ClinicalImpression.investigation.code.coding" /> <min value="1" /> <patternCoding> <system value="http://snomed.info/sct" /> <code value="424122007" /> <display value="ECOG performance status finding" /> </patternCoding> </element> <element id="ClinicalImpression.investigation:ECOG.item"> <path value="ClinicalImpression.investigation.item" /> <short value="ECOG" /> <definition value="ECOG Performance Status" /> <min value="1" /> <max value="1" /> <type> <code value="Reference" /> <targetProfile value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-allgemeiner-leistungszustand-ecog" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation" /> </type> </element> <element id="ClinicalImpression.investigation:NgsBericht"> <path value="ClinicalImpression.investigation" /> <sliceName value="NgsBericht" /> <min value="0" /> <max value="*" /> <mustSupport value="true" /> </element> <element id="ClinicalImpression.investigation:NgsBericht.code.coding"> <path value="ClinicalImpression.investigation.code.coding" /> <min value="1" /> <patternCoding> <system value="http://snomed.info/sct" /> <code value="106221001" /> <display value="Genetic finding" /> </patternCoding> </element> <element id="ClinicalImpression.investigation:NgsBericht.item"> <path value="ClinicalImpression.investigation.item" /> <short value="NGS Report" /> <definition value="Für Molekulares Tumorboard bereitgestellter Next Generation Sequencing Bericht" /> <min value="1" /> <max value="1" /> <type> <code value="Reference" /> <targetProfile value="https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-ngs-bericht" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport" /> </type> </element> <element id="ClinicalImpression.investigation:MolekularPathologieBefund"> <path value="ClinicalImpression.investigation" /> <sliceName value="MolekularPathologieBefund" /> <min value="0" /> <max value="*" /> <mustSupport value="true" /> </element> <element id="ClinicalImpression.investigation:MolekularPathologieBefund.code.coding"> <path value="ClinicalImpression.investigation.code.coding" /> <min value="1" /> <patternCoding> <system value="http://snomed.info/sct" /> <code value="721967005" /> <display value="Tissue pathology biopsy report" /> </patternCoding> </element> <element id="ClinicalImpression.investigation:MolekularPathologieBefund.item"> <path value="ClinicalImpression.investigation.item" /> <short value="Molekular Pathologie Befund" /> <definition value="Für Molekulares Tumorboard bereitgestellter Molekular Pathologie Befund" /> <min value="1" /> <max value="1" /> <type> <code value="Reference" /> <targetProfile value="https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-molecular-pathology-report" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport" /> </type> </element> <element id="ClinicalImpression.supportingInfo"> <path value="ClinicalImpression.supportingInfo" /> <slicing> <discriminator> <type value="profile" /> <path value="$this.resolve()" /> </discriminator> <description value="Slice für weitere Informationen" /> <ordered value="false" /> <rules value="open" /> </slicing> </element> <element id="ClinicalImpression.supportingInfo:Einwilligung"> <path value="ClinicalImpression.supportingInfo" /> <sliceName value="Einwilligung" /> <short value="Einwilligung" /> <definition value="Einwilligung zum Molekularen Tumorboard" /> <min value="0" /> <max value="1" /> <type> <code value="Reference" /> <targetProfile value="https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-consent-given" /> </type> <mustSupport value="true" /> </element> <element id="ClinicalImpression.supportingInfo:Vorbefund"> <path value="ClinicalImpression.supportingInfo" /> <sliceName value="Vorbefund" /> <short value="Vorbefund" /> <definition value="Relevanter Vorbefund" /> <min value="0" /> <max value="*" /> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/DiagnosticReport" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation" /> </type> <mustSupport value="true" /> </element> <element id="ClinicalImpression.supportingInfo:Vortherapie"> <path value="ClinicalImpression.supportingInfo" /> <sliceName value="Vortherapie" /> <short value="Vortherapie" /> <definition value="Relevante Leitlinien-basierte Vortherapie" /> <min value="0" /> <max value="*" /> <type> <code value="Reference" /> <targetProfile value="https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-systemische-vortherapie" /> <targetProfile value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-strahlentherapie" /> <targetProfile value="https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-operation" /> <targetProfile value="https://www.medizininformatik-initiative.de/fhir/core/modul-prozedur/StructureDefinition/Procedure" /> </type> <mustSupport value="true" /> </element> <element id="ClinicalImpression.supportingInfo:Vortherapie.extension:LeitlinieDokumentation"> <path value="ClinicalImpression.supportingInfo.extension" /> <sliceName value="LeitlinieDokumentation" /> <short value="Leitlinie Dokumentation" /> <definition value="Dokumentation zur Leitlinien-konformen Umsetzung der Prozedur" /> <min value="0" /> <max value="1" /> <type> <code value="Extension" /> <profile value="https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-ex-mtb-leitlinie-dokumentation" /> </type> <mustSupport value="true" /> </element> <element id="ClinicalImpression.supportingInfo:Therapieplan"> <path value="ClinicalImpression.supportingInfo" /> <sliceName value="Therapieplan" /> <short value="Therapieplan" /> <definition value="Therapieplan gemäß Beschluss des Molekularen Tumorboards" /> <min value="0" /> <max value="1" /> <type> <code value="Reference" /> <targetProfile value="https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-therapieplan" /> <targetProfile value="http://hl7.org/fhir/StructureDefinition/CarePlan" /> </type> <mustSupport value="true" /> </element> </differential> </StructureDefinition>
{ "resourceType": "StructureDefinition", "id": "mii-pr-mtb-behandlungsepisode", "url": "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-behandlungsepisode", "version": "2024.0.0-ballot", "name": "MII_PR_MTB_Behandlungsepisode", "title": "MII PR MTB Behandlungsepisode", "status": "draft", "publisher": "Medizininformatik Initiative", "contact": [ { "telecom": [ { "system": "url", "value": "https://www.medizininformatik-initiative.de" } ] } ], "description": "Aktueller Krankheitszustand und bisherige Behandlungsmaßnahmen", "fhirVersion": "4.0.1", "kind": "resource", "abstract": false, "type": "ClinicalImpression", "baseDefinition": "http://hl7.org/fhir/StructureDefinition/ClinicalImpression", "derivation": "constraint", "differential": { "element": [ { "id": "ClinicalImpression.meta", "path": "ClinicalImpression.meta", "mustSupport": true }, { "id": "ClinicalImpression.meta.profile", "path": "ClinicalImpression.meta.profile", "mustSupport": 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"ClinicalImpression.effective[x]", "sliceName": "effectivePeriod", "short": "Zeitraum der Behandlungsepisode", "definition": "Zeitraum von Einschluss bis Abschluss im Molekularen Tumorboard", "min": 1, "max": "1", "type": [ { "code": "Period" } ], "mustSupport": true }, { "id": "ClinicalImpression.effective[x]:effectivePeriod.start", "path": "ClinicalImpression.effective[x].start", "short": "Einschlussdatum", "definition": "Einschlussdatum Molekulares Tumorboard" }, { "id": "ClinicalImpression.effective[x]:effectivePeriod.end", "path": "ClinicalImpression.effective[x].end", "short": "Abschlussdatum", "definition": "Abschlussdatum Molekulares Tumorboard", "mustSupport": true }, { "id": "ClinicalImpression.problem", "path": "ClinicalImpression.problem", "slicing": { "discriminator": [ { "type": "type", "path": "$this" } ], "rules": "open", "description": "Slice für Diagnose", "ordered": false }, "mustSupport": true }, { "id": "ClinicalImpression.problem:PrimaertumorDiagnose", "path": "ClinicalImpression.problem", "sliceName": "PrimaertumorDiagnose", "short": "Primärtumor Diagnose", "definition": "Verweise auf Diagnose des Primärtumors", "min": 0, "max": "1", "type": [ { "code": "Reference", "targetProfile": [ "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-diagnose-primaertumor", "http://hl7.org/fhir/StructureDefinition/Condition" ] } ], "mustSupport": true }, { "id": "ClinicalImpression.investigation", "path": "ClinicalImpression.investigation", "slicing": { "discriminator": [ { "type": "value", "path": "code.coding" } ], "rules": "open", "description": "Slice für relevante Ermittlungen", "ordered": false } }, { "id": "ClinicalImpression.investigation:KrankengeschichteFamilie", "path": "ClinicalImpression.investigation", "sliceName": "KrankengeschichteFamilie", "min": 0, "max": "1", "mustSupport": true }, { "id": "ClinicalImpression.investigation:KrankengeschichteFamilie.code.coding", "path": "ClinicalImpression.investigation.code.coding", "min": 1, "patternCoding": { "code": "416471007", "system": "http://snomed.info/sct", "display": "Family medical history" } }, { "id": "ClinicalImpression.investigation:KrankengeschichteFamilie.item", "path": "ClinicalImpression.investigation.item", "short": "Krankengeschichte Familie", "definition": "Verweis auf familiäre Krankengeschichte", "min": 1, "max": "1", "type": [ { "code": "Reference", "targetProfile": [ "https://www.medizininformatik-initiative.de/fhir/ext/modul-molgen/StructureDefinition/familienanamnese", "http://hl7.org/fhir/StructureDefinition/FamilyMemberHistory" ] } ] }, { "id": "ClinicalImpression.investigation:ECOG", "path": "ClinicalImpression.investigation", "sliceName": "ECOG", "min": 0, "max": "1", "mustSupport": true }, { "id": "ClinicalImpression.investigation:ECOG.code.coding", "path": "ClinicalImpression.investigation.code.coding", "min": 1, "patternCoding": { "code": "424122007", "system": "http://snomed.info/sct", "display": "ECOG performance status finding" } }, { "id": "ClinicalImpression.investigation:ECOG.item", "path": "ClinicalImpression.investigation.item", "short": "ECOG", "definition": "ECOG Performance Status", "min": 1, "max": "1", "type": [ { "code": "Reference", "targetProfile": [ "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-allgemeiner-leistungszustand-ecog", "http://hl7.org/fhir/StructureDefinition/Observation" ] } ] }, { "id": "ClinicalImpression.investigation:NgsBericht", "path": "ClinicalImpression.investigation", "sliceName": "NgsBericht", "min": 0, "max": "*", "mustSupport": true }, { "id": "ClinicalImpression.investigation:NgsBericht.code.coding", "path": "ClinicalImpression.investigation.code.coding", "min": 1, "patternCoding": { "code": "106221001", "system": "http://snomed.info/sct", "display": "Genetic finding" } }, { "id": "ClinicalImpression.investigation:NgsBericht.item", "path": "ClinicalImpression.investigation.item", "short": "NGS Report", "definition": "Für Molekulares Tumorboard bereitgestellter Next Generation Sequencing Bericht", "min": 1, "max": "1", "type": [ { "code": "Reference", "targetProfile": [ "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-ngs-bericht", "http://hl7.org/fhir/StructureDefinition/DiagnosticReport" ] } ] }, { "id": "ClinicalImpression.investigation:MolekularPathologieBefund", "path": "ClinicalImpression.investigation", "sliceName": "MolekularPathologieBefund", "min": 0, "max": "*", "mustSupport": true }, { "id": "ClinicalImpression.investigation:MolekularPathologieBefund.code.coding", "path": "ClinicalImpression.investigation.code.coding", "min": 1, "patternCoding": { "code": "721967005", "system": "http://snomed.info/sct", "display": "Tissue pathology biopsy report" } }, { "id": "ClinicalImpression.investigation:MolekularPathologieBefund.item", "path": "ClinicalImpression.investigation.item", "short": "Molekular Pathologie Befund", "definition": "Für Molekulares Tumorboard bereitgestellter Molekular Pathologie Befund", "min": 1, "max": "1", "type": [ { "code": "Reference", "targetProfile": [ "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-molecular-pathology-report", "http://hl7.org/fhir/StructureDefinition/DiagnosticReport" ] } ] }, { "id": "ClinicalImpression.supportingInfo", "path": "ClinicalImpression.supportingInfo", "slicing": { "discriminator": [ { "type": "profile", "path": "$this.resolve()" } ], "rules": "open", "description": "Slice für weitere Informationen", "ordered": false } }, { "id": "ClinicalImpression.supportingInfo:Einwilligung", "path": "ClinicalImpression.supportingInfo", "sliceName": "Einwilligung", "short": "Einwilligung", "definition": "Einwilligung zum Molekularen Tumorboard", "min": 0, "max": "1", "type": [ { "code": "Reference", "targetProfile": [ "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-consent-given" ] } ], "mustSupport": true }, { "id": "ClinicalImpression.supportingInfo:Vorbefund", "path": "ClinicalImpression.supportingInfo", "sliceName": "Vorbefund", "short": "Vorbefund", "definition": "Relevanter Vorbefund", "min": 0, "max": "*", "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/DiagnosticReport", "http://hl7.org/fhir/StructureDefinition/Observation" ] } ], "mustSupport": true }, { "id": "ClinicalImpression.supportingInfo:Vortherapie", "path": "ClinicalImpression.supportingInfo", "sliceName": "Vortherapie", "short": "Vortherapie", "definition": "Relevante Leitlinien-basierte Vortherapie", "min": 0, "max": "*", "type": [ { "code": "Reference", "targetProfile": [ "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-systemische-vortherapie", "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-strahlentherapie", "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-operation", "https://www.medizininformatik-initiative.de/fhir/core/modul-prozedur/StructureDefinition/Procedure" ] } ], "mustSupport": true }, { "id": "ClinicalImpression.supportingInfo:Vortherapie.extension:LeitlinieDokumentation", "path": "ClinicalImpression.supportingInfo.extension", "sliceName": "LeitlinieDokumentation", "short": "Leitlinie Dokumentation", "definition": "Dokumentation zur Leitlinien-konformen Umsetzung der Prozedur", "min": 0, "max": "1", "type": [ { "code": "Extension", "profile": [ "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-ex-mtb-leitlinie-dokumentation" ] } ], "mustSupport": true }, { "id": "ClinicalImpression.supportingInfo:Therapieplan", "path": "ClinicalImpression.supportingInfo", "sliceName": "Therapieplan", "short": "Therapieplan", "definition": "Therapieplan gemäß Beschluss des Molekularen Tumorboards", "min": 0, "max": "1", "type": [ { "code": "Reference", "targetProfile": [ "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-therapieplan", "http://hl7.org/fhir/StructureDefinition/CarePlan" ] } ], "mustSupport": true } ] } }
Mapping Datensatz zu FHIR
| Datensatz | Erklaerung | FHIR |
|---|---|---|
| Behandlungsepisode | Behandlungsepisode | ClinicalImpression |
| Zeitraum der Behandlungsepisode | Zeitraum von Einschluss bis Abschluss im Molekulare Tumorboard | ClinicalImpression.effectivePeriod |
| Verweis auf Krankengeschichte Familie | Verweis auf die familiäre Krankengeschichte | ClinicalImpression.investigation.item:Reference(FamilyMemberHistory) |
| Verweis auf Vorbefund | Verweis auf relevanten Vorbefund | ClinicalImpression.supportingInfo:Reference(DiagnosticReport or Observation) |
| Verweis auf NGS Bericht | Verweis auf Next Generation Sequencing Bericht | ClinicalImpression.investigation.item:Reference(DiagnosticReport) |
| Verweis auf Molekular Pathologie Befund | Verweis auf Molekular Pathologie Befund | ClinicalImpression.investigation.item:Reference(DiagnosticReport) |
| Leitlinie Dokumentation | Dokumentation zur Leitlinien-konformen Umsetzung der Prozedur | ClinicalImpression.supportingInfo.extension(LeitlinieDokumentation) |
| Status Leitlinienbehandlung | Status der Leitlinienbehandlung | ClinicalImpression.extension(LeitlinenbehandlungStatus) |
| Verweis auf Behandlungsepisode | Verweis auf Behandlungsepisode mit Angaben zum aktuellen Krankheitszustand und bisherige Behandlungsmaßnahmen | CarePlan.supportingInfo:Reference(ClinicalImpression) |
Suchparameter
Folgende Suchparameter sind für dieses Modul relevant, auch in Kombination:
Der Suchparameter "_id" MUSS unterstützt werden:
Beispiele:
GET [base]/ClinicalImpression?_id=12345
Anwendungshinweise: Weitere Informationen zur Suche nach "_id" finden sich in der FHIR-Basisspezifikation - Abschnitt "Parameters for all resources".
Der Suchparameter "_profile" MUSS unterstützt werden:
Beispiele:
GET [base]/ClinicalImpression?_profile=https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-behandlungsepisode
Anwendungshinweise: Weitere Informationen zur Suche nach "_profile" finden sich in der FHIR-Basisspezifikation - Abschnitt "Token Search".
Der Suchparameter "period-end" MUSS unterstützt werden:
Beispiele:
GET [base]/ClinicalImpression?period-end=eq2025-01-01
Anwendungshinweise: Weitere Informationen zur Suche nach "period-end" finden sich in der FHIR-Basisspezifikation - Abschnitt "Date Search".
Der Suchparameter "problem" MUSS unterstützt werden:
Beispiele:
GET [base]/ClinicalImpression?problem=Condition/example
Anwendungshinweise: Weitere Informationen zur Suche nach "problem" finden sich in der FHIR-Basisspezifikation - Abschnitt "Reference Search".
Der Suchparameter "investigation" MUSS unterstützt werden:
Beispiele:
GET [base]/ClinicalImpression?investigation=DiagnosticReport/example
Anwendungshinweise: Weitere Informationen zur Suche nach "investigation" finden sich in der FHIR-Basisspezifikation - Abschnitt "Reference Search".
Der Suchparameter "supporting-info" MUSS unterstützt werden:
Beispiele:
GET [base]/ClinicalImpression?supporting-info=DiagnosticReport/example
Anwendungshinweise: Weitere Informationen zur Suche nach "supporting-info" finden sich in der FHIR-Basisspezifikation - Abschnitt "Reference Search".
TODO: SP Leitlinienbehandlung Status Extension
Beispiele
Beispiel: Beschluss MTB-Fall für Kim Musterperson vom 28.03.2023 (siehe Beschreibung von Szenarien fuer die Anwendung der Module)
| CarePlan.id[0] | mii-exa-mtb-kim-musterperson-therapieplan |
| CarePlan.meta[0].profile[0] | https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-therapieplan |
| CarePlan.status[0] | active |
| CarePlan.intent[0] | plan |
| CarePlan.category[0].coding[0].system[0] | https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapieplanung-typ |
| CarePlan.category[0].coding[0].code[0] | praeth |
| CarePlan.subject[0].reference[0] | Patient/PatientKimMusterperson |
| CarePlan.created[0] | 2023-03-28 |
| CarePlan.addresses[0].reference[0] | Condition/PatientKimMusterperson-PrimaryDiagnosis-2 |
| CarePlan.supportingInfo[0].reference[0] | ClinicalImpression/mii-exa-mtb-kim-musterperson-behandlungsepisode |
| CarePlan.activity[0].outcomeReference[0].reference[0] | Procedure/MTBChemo2Procedure |
| CarePlan.activity[0].reference[0].reference[0] | MedicationRequest/mii-exa-mtb-medication-request-mirvetuximab |
| CarePlan.activity[0].detail[0].code[0].coding[0].system[0] | https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapie-typ |
| CarePlan.activity[0].detail[0].code[0].coding[0].code[0] | IZ |
| CarePlan.activity[0].detail[0].code[0].coding[0].display[0] | Immun-/Antikörpertherapie + zielgerichtete Substanzen |
| CarePlan.activity[0].detail[0].status[0] | completed |
| CarePlan.activity[1].reference[0].reference[0] | ServiceRequest/mii-exa-mtb-study-request-cldn6 |
| CarePlan.activity[1].detail[0].code[0].coding[0].system[0] | https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapie-typ |
| CarePlan.activity[1].detail[0].code[0].coding[0].code[0] | IZ |
| CarePlan.activity[1].detail[0].code[0].coding[0].display[0] | Immun-/Antikörpertherapie + zielgerichtete Substanzen |
| CarePlan.activity[1].detail[0].status[0] | not-started |
| CarePlan.activity[2].reference[0].reference[0] | ServiceRequest/mii-exa-mtb-study-request-tedova |
| CarePlan.activity[2].detail[0].code[0].coding[0].system[0] | https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapie-typ |
| CarePlan.activity[2].detail[0].code[0].coding[0].code[0] | IZ |
| CarePlan.activity[2].detail[0].code[0].coding[0].display[0] | Immun-/Antikörpertherapie + zielgerichtete Substanzen |
| CarePlan.activity[2].detail[0].status[0] | not-started |
| CarePlan.activity[3].reference[0].reference[0] | ServiceRequest/mii-exa-mtb-study-request-ccne1 |
| CarePlan.activity[3].detail[0].code[0].coding[0].system[0] | https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapie-typ |
| CarePlan.activity[3].detail[0].code[0].coding[0].code[0] | ZS |
| CarePlan.activity[3].detail[0].code[0].coding[0].display[0] | zielgerichtete Substanzen |
| CarePlan.activity[3].detail[0].status[0] | not-started |
| CarePlan.activity[4].reference[0].reference[0] | MedicationRequest/mii-exa-mtb-medication-request-trastuzumab-deruxtecan |
| CarePlan.activity[4].detail[0].code[0].coding[0].system[0] | https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapie-typ |
| CarePlan.activity[4].detail[0].code[0].coding[0].code[0] | IZ |
| CarePlan.activity[4].detail[0].code[0].coding[0].display[0] | Immun-/Antikörpertherapie + zielgerichtete Substanzen |
| CarePlan.activity[4].detail[0].status[0] | not-started |
| CarePlan.activity[5].reference[0].reference[0] | RequestGroup/mii-exa-mtb-request-group-adavosertib-carboplatin |
| CarePlan.activity[5].detail[0].code[0].coding[0].system[0] | https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapie-typ |
| CarePlan.activity[5].detail[0].code[0].coding[0].code[0] | CZ |
| CarePlan.activity[5].detail[0].code[0].coding[0].display[0] | Chemotherapie + zielgerichtete Substanzen |
| CarePlan.activity[5].detail[0].status[0] | not-started |
| CarePlan.activity[6].reference[0].reference[0] | RequestGroup/mii-exa-mtb-request-group-lunresertib-camonsertib |
| CarePlan.activity[6].detail[0].code[0].coding[0].system[0] | https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapie-typ |
| CarePlan.activity[6].detail[0].code[0].coding[0].code[0] | ZS |
| CarePlan.activity[6].detail[0].code[0].coding[0].display[0] | zielgerichtete Substanzen |
| CarePlan.activity[6].detail[0].status[0] | not-started |
| CarePlan.activity[7].reference[0].reference[0] | MedicationRequest/mii-exa-mtb-medication-request-cobimetinib |
| CarePlan.activity[7].detail[0].code[0].coding[0].system[0] | https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapie-typ |
| CarePlan.activity[7].detail[0].code[0].coding[0].code[0] | ZS |
| CarePlan.activity[7].detail[0].code[0].coding[0].display[0] | zielgerichtete Substanzen |
| CarePlan.activity[7].detail[0].status[0] | not-started |
| CarePlan.activity[8].reference[0].reference[0] | ServiceRequest/mii-exa-mtb-kim-humangenetische-beratung-aszites |
| CarePlan.activity[8].detail[0].code[0].coding[0].system[0] | https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapie-typ |
| CarePlan.activity[8].detail[0].code[0].coding[0].code[0] | SO |
| CarePlan.activity[8].detail[0].code[0].coding[0].display[0] | Sonstiges |
| CarePlan.activity[8].detail[0].status[0] | completed |
| CarePlan.activity[9].reference[0].reference[0] | ServiceRequest/mii-exa-mtb-kim-histologie-evaluation-aszites |
| CarePlan.activity[9].detail[0].code[0].coding[0].system[0] | https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapie-typ |
| CarePlan.activity[9].detail[0].code[0].coding[0].code[0] | SO |
| CarePlan.activity[9].detail[0].code[0].coding[0].display[0] | Sonstiges |
| CarePlan.activity[9].detail[0].status[0] | not-started |
| CarePlan.activity[10].reference[0].reference[0] | ServiceRequest/mii-exa-mtb-kim-rebiopsie-aszites |
| CarePlan.activity[10].detail[0].code[0].coding[0].system[0] | https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapie-typ |
| CarePlan.activity[10].detail[0].code[0].coding[0].code[0] | SO |
| CarePlan.activity[10].detail[0].code[0].coding[0].display[0] | Sonstiges |
| CarePlan.activity[10].detail[0].status[0] | completed |
{ "resourceType": "CarePlan", "id": "mii-exa-mtb-kim-musterperson-therapieplan", "meta": { "profile": [ "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-therapieplan" ] }, "category": [ { "coding": [ { "system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapieplanung-typ", "code": "praeth" } ] } ], "addresses": [ { "reference": "Condition/PatientKimMusterperson-PrimaryDiagnosis-2" } ], "supportingInfo": [ { "reference": "ClinicalImpression/mii-exa-mtb-kim-musterperson-behandlungsepisode" } ], "activity": [ { "detail": { "code": { "coding": [ { "code": "IZ", "system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapie-typ", "display": "Immun-/Antikörpertherapie + zielgerichtete Substanzen" } ] }, "status": "completed" }, "outcomeReference": [ { "reference": "Procedure/MTBChemo2Procedure" } ], "reference": { "reference": "MedicationRequest/mii-exa-mtb-medication-request-mirvetuximab" } }, { "detail": { "code": { "coding": [ { "code": "IZ", "system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapie-typ", "display": "Immun-/Antikörpertherapie + zielgerichtete Substanzen" } ] }, "status": "not-started" }, "reference": { "reference": "ServiceRequest/mii-exa-mtb-study-request-cldn6" } }, { "detail": { "code": { "coding": [ { "code": "IZ", "system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapie-typ", "display": "Immun-/Antikörpertherapie + zielgerichtete Substanzen" } ] }, "status": "not-started" }, "reference": { "reference": "ServiceRequest/mii-exa-mtb-study-request-tedova" } }, { "detail": { "code": { "coding": [ { "code": "ZS", "system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapie-typ", "display": "zielgerichtete Substanzen" } ] }, "status": "not-started" }, "reference": { "reference": "ServiceRequest/mii-exa-mtb-study-request-ccne1" } }, { "detail": { "code": { "coding": [ { "code": "IZ", "system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapie-typ", "display": "Immun-/Antikörpertherapie + zielgerichtete Substanzen" } ] }, "status": "not-started" }, "reference": { "reference": "MedicationRequest/mii-exa-mtb-medication-request-trastuzumab-deruxtecan" } }, { "detail": { "code": { "coding": [ { "code": "CZ", "system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapie-typ", "display": "Chemotherapie + zielgerichtete Substanzen" } ] }, "status": "not-started" }, "reference": { "reference": "RequestGroup/mii-exa-mtb-request-group-adavosertib-carboplatin" } }, { "detail": { "code": { "coding": [ { "code": "ZS", "system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapie-typ", "display": "zielgerichtete Substanzen" } ] }, "status": "not-started" }, "reference": { "reference": "RequestGroup/mii-exa-mtb-request-group-lunresertib-camonsertib" } }, { "detail": { "code": { "coding": [ { "code": "ZS", "system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapie-typ", "display": "zielgerichtete Substanzen" } ] }, "status": "not-started" }, "reference": { "reference": "MedicationRequest/mii-exa-mtb-medication-request-cobimetinib" } }, { "detail": { "code": { "coding": [ { "code": "SO", "system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapie-typ", "display": "Sonstiges" } ] }, "status": "completed" }, "reference": { "reference": "ServiceRequest/mii-exa-mtb-kim-humangenetische-beratung-aszites" } }, { "detail": { "code": { "coding": [ { "code": "SO", "system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapie-typ", "display": "Sonstiges" } ] }, "status": "not-started" }, "reference": { "reference": "ServiceRequest/mii-exa-mtb-kim-histologie-evaluation-aszites" } }, { "detail": { "code": { "coding": [ { "code": "SO", "system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapie-typ", "display": "Sonstiges" } ] }, "status": "completed" }, "reference": { "reference": "ServiceRequest/mii-exa-mtb-kim-rebiopsie-aszites" } } ], "intent": "plan", "status": "active", "subject": { "reference": "Patient/PatientKimMusterperson" }, "created": "2023-03-28" }