{ "description": "Aktueller Krankheitszustand und bisherige Behandlungsmaßnahmen", "_filename": "StructureDefinition-mii-pr-mtb-behandlungsepisode.json", "package_name": "de.medizininformatikinitiative.kerndatensatz.mtb", "date": null, "derivation": "constraint", "publisher": "Medizininformatik Initiative", "fhirVersion": "4.0.1", "name": "MII_PR_MTB_Behandlungsepisode", "abstract": false, "type": "ClinicalImpression", "experimental": null, "resourceType": "StructureDefinition", "title": "MII PR MTB Behandlungsepisode", "package_version": "2025.0.0-ballot-alpha.1", "status": "draft", "id": "5e08ca15-45fb-426a-b9cf-3ce1fc86945f", "kind": "resource", "url": "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-behandlungsepisode", "version": "2024.0.0-ballot", "differential": { "element": [ { "id": "ClinicalImpression.meta", "path": "ClinicalImpression.meta", "mustSupport": true }, { "id": "ClinicalImpression.subject", "path": "ClinicalImpression.subject", "type": [ { "code": "Reference", "targetProfile": [ "https://www.medizininformatik-initiative.de/fhir/core/modul-person/StructureDefinition/Patient", "https://www.medizininformatik-initiative.de/fhir/core/modul-person/StructureDefinition/PatientPseudonymisiert" ] } ] }, { "id": "ClinicalImpression.effective[x]", "min": 1, "path": "ClinicalImpression.effective[x]", "slicing": { "rules": "open", "ordered": false, "discriminator": [ { "path": "$this", "type": "type" } ] } }, { "path": "ClinicalImpression.effective[x]", "min": 1, "definition": "Zeitraum von Einschluss bis Abschluss im Molekularen Tumorboard", "short": "Zeitraum der Behandlungsepisode", "type": [ { "code": "Period" } ], "mustSupport": true, "sliceName": "effectivePeriod", "max": "1", "id": "ClinicalImpression.effective[x]:effectivePeriod" }, { "id": "ClinicalImpression.effective[x]:effectivePeriod.start", "path": "ClinicalImpression.effective[x].start", "short": "Einschlussdatum", "definition": "Einschlussdatum Molekulares Tumorboard" }, { "id": "ClinicalImpression.effective[x]:effectivePeriod.end", "path": "ClinicalImpression.effective[x].end", "short": "Abschlussdatum", "definition": "Abschlussdatum Molekulares Tumorboard" }, { "id": "ClinicalImpression.problem", "path": "ClinicalImpression.problem", "slicing": { "rules": "open", "ordered": false, "description": "Slice für Diagnose", "discriminator": [ { "path": "$this", "type": "type" } ] }, "mustSupport": true }, { "path": "ClinicalImpression.problem", "min": 0, "definition": "Verweise auf Diagnose des Primärtumors", "short": "Primärtumor Diagnose", "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, "sliceName": "PrimaertumorDiagnose", "max": "1", "id": "ClinicalImpression.problem:PrimaertumorDiagnose" }, { "id": "ClinicalImpression.investigation", "path": "ClinicalImpression.investigation", "slicing": { "rules": "open", "ordered": false, "description": "Slice für relevante Ermittlungen", "discriminator": [ { "path": "code.coding", "type": "value" } ] } }, { "id": "ClinicalImpression.investigation:KrankengeschichteFamilie", "max": "1", "min": 0, "path": "ClinicalImpression.investigation", "sliceName": "KrankengeschichteFamilie", "mustSupport": true }, { "id": "ClinicalImpression.investigation:KrankengeschichteFamilie.code.coding", "min": 1, "path": "ClinicalImpression.investigation.code.coding", "patternCoding": { "code": "416471007", "system": "http://snomed.info/sct", "display": "Family medical history" } }, { "id": "ClinicalImpression.investigation:KrankengeschichteFamilie.item", "max": "1", "min": 1, "path": "ClinicalImpression.investigation.item", "type": [ { "code": "Reference", "targetProfile": [ "https://www.medizininformatik-initiative.de/fhir/ext/modul-molgen/StructureDefinition/familienanamnese", "http://hl7.org/fhir/StructureDefinition/FamilyMemberHistory" ] } ], "short": "Krankengeschichte Familie", "definition": "Verweis auf familiäre Krankengeschichte" }, { "id": "ClinicalImpression.investigation:ECOG", "max": "1", "min": 0, "path": "ClinicalImpression.investigation", "sliceName": "ECOG", "mustSupport": true }, { "id": "ClinicalImpression.investigation:ECOG.code.coding", "min": 1, "path": "ClinicalImpression.investigation.code.coding", "patternCoding": { "code": "424122007", "system": "http://snomed.info/sct", "display": "ECOG performance status finding" } }, { "id": "ClinicalImpression.investigation:ECOG.item", "max": "1", "min": 1, "path": "ClinicalImpression.investigation.item", "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" ] } ], "short": "ECOG", "definition": "ECOG Performance Status" }, { "id": "ClinicalImpression.investigation:NgsBericht", "max": "*", "min": 0, "path": "ClinicalImpression.investigation", "sliceName": "NgsBericht", "mustSupport": true }, { "id": "ClinicalImpression.investigation:NgsBericht.code.coding", "min": 1, "path": "ClinicalImpression.investigation.code.coding", "patternCoding": { "code": "106221001", "system": "http://snomed.info/sct", "display": "Genetic finding" } }, { "id": "ClinicalImpression.investigation:NgsBericht.item", "max": "1", "min": 1, "path": "ClinicalImpression.investigation.item", "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" ] } ], "short": "NGS Report", "definition": "Für Molekulares Tumorboard bereitgestellter Next Generation Sequencing Bericht" }, { "id": "ClinicalImpression.investigation:MolekularPathologieBefund", "max": "*", "min": 0, "path": "ClinicalImpression.investigation", "sliceName": "MolekularPathologieBefund", "mustSupport": true }, { "id": "ClinicalImpression.investigation:MolekularPathologieBefund.code.coding", "min": 1, "path": "ClinicalImpression.investigation.code.coding", "patternCoding": { "code": "721967005", "system": "http://snomed.info/sct", "display": "Tissue pathology biopsy report" } }, { "id": "ClinicalImpression.investigation:MolekularPathologieBefund.item", "max": "1", "min": 1, "path": "ClinicalImpression.investigation.item", "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" ] } ], "short": "Molekular Pathologie Befund", "definition": "Für Molekulares Tumorboard bereitgestellter Molekular Pathologie Befund" }, { "id": "ClinicalImpression.supportingInfo", "path": "ClinicalImpression.supportingInfo", "slicing": { "rules": "open", "ordered": false, "description": "Slice für weitere Informationen", "discriminator": [ { "path": "$this", "type": "type" } ] } }, { "path": "ClinicalImpression.supportingInfo", "min": 0, "definition": "Einwilligung zum Molekularen Tumorboard", "short": "Einwilligung", "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Consent" ] } ], "mustSupport": true, "sliceName": "Einwilligung", "max": "1", "id": "ClinicalImpression.supportingInfo:Einwilligung" }, { "path": "ClinicalImpression.supportingInfo", "min": 0, "definition": "Relevante Leitlinien-basierte Vortherapie", "short": "Vortherapie", "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", "http://hl7.org/fhir/StructureDefinition/Procedure" ] } ], "mustSupport": true, "sliceName": "Vortherapie", "max": "*", "id": "ClinicalImpression.supportingInfo:Vortherapie" }, { "path": "ClinicalImpression.supportingInfo.extension", "min": 0, "definition": "Dokumentation zur Leitlinien-konformen Umsetzung der Prozedur", "short": "Leitlinie Dokumentation", "type": [ { "code": "Extension", "profile": [ "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-ex-mtb-leitlinie-dokumentation" ] } ], "mustSupport": true, "sliceName": "LeitlinieDokumentation", "max": "1", "id": "ClinicalImpression.supportingInfo:Vortherapie.extension:LeitlinieDokumentation" }, { "path": "ClinicalImpression.supportingInfo", "min": 0, "definition": "Relevanter Vorbefund", "short": "Vorbefund", "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/DiagnosticReport", "http://hl7.org/fhir/StructureDefinition/Observation" ] } ], "mustSupport": true, "sliceName": "Vorbefund", "max": "*", "id": "ClinicalImpression.supportingInfo:Vorbefund" } ] }, "contact": [ { "telecom": [ { "value": "https://www.medizininformatik-initiative.de", "system": "url" } ] } ], "baseDefinition": "http://hl7.org/fhir/StructureDefinition/ClinicalImpression" }