MII IG Kerndatensatz-Modul Molekulares Tumorboard
2026.0.0 - release Unknown region code '276'

MII IG Kerndatensatz-Modul Molekulares Tumorboard, published by Medizininformatik-Initiative. This guide is not an authorized publication; it is the continuous build for version 2026.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/medizininformatik-initiative/kerndatensatzmodul-molekulares-tumorboard/ and changes regularly. See the Directory of published versions

Resource Profile: MII_PR_MTB_Therapieempfehlung_Kombination - Detailed Descriptions

Active as of 2026-02-09

Definitions for the mii-pr-mtb-therapieempfehlung-kombination resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. RequestGroup
Definition

A group of related requests that can be used to capture intended activities that have inter-dependencies such as "give this medication after that one".

ShortA group of related requests
Control0..*
Is Modifierfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-4: 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-3: 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-6: A resource should have narrative for robust management (text.`div`.exists())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
2. RequestGroup.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

ShortMetadata about the resource
Control0..1
This element is affected by the following invariants: ele-1
TypeMeta
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. RequestGroup.meta.profile
Definition

A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.


A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

ShortProfiles this resource claims to conform to
Comments

It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

Control0..*
This element is affected by the following invariants: ele-1
Typecanonical(StructureDefinition, StructureDefinition)
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. RequestGroup.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
This element is affected by the following invariants: ele-1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. RequestGroup.extension:Prioritaet
Slice NamePrioritaet
Definition

Priorität der (einzelnen) Empfehlung

ShortMII EX MTB Empfehlung Priorität
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(MII EX MTB Empfehlung Priorität) (Extension Type: Choice of: decimal, positiveInt)
Must Supporttrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
10. RequestGroup.extension:Evidenzgraduierung
Slice NameEvidenzgraduierung
Definition

Evidenzgraduierung der (einzelnen) Empfehlung

ShortMII EX MTB Empfehlung Evidenzgraduierung
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(MII EX MTB Empfehlung Evidenzgraduierung) (Extension Type: CodeableConcept)
Must Supporttrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
12. RequestGroup.extension:Publikation
Slice NamePublikation
Definition

Verweis auf Publikation der (einzelnen) Empfehlung

ShortMII EX MTB Empfehlung Publikation
Control0..*
This element is affected by the following invariants: ele-1
TypeExtension(MII EX MTB Empfehlung Publikation) (Extension Type: Identifier)
Must Supporttrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
14. RequestGroup.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
This element is affected by the following invariants: ele-1
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on RequestGroup.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 16. RequestGroup.identifier
    Definition

    Allows a service to provide a unique, business identifier for the request.

    ShortBusiness identifier
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..*
    This element is affected by the following invariants: ele-1
    TypeIdentifier
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

    Allows identification of the request as it is known by various participating systems and in a way that remains consistent across servers.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    18. RequestGroup.status
    Definition

    Status der Umsetzung der Therapieempfehlung


    The current state of the request. For request groups, the status reflects the status of all the requests in the group.

    Shortdraft | active | on-hold | revoked | completed | entered-in-error | unknown
    Comments
    draft: Nicht umgesetzt,
    active: In Umsetzung,
    completed: Abgeschlossen oder abgebrochen (Patient verstorben)
    
    Control1..1
    This element is affected by the following invariants: ele-1
    BindingThe codes SHALL be taken from RequestStatushttp://hl7.org/fhir/ValueSet/request-status|4.0.1
    (required to http://hl7.org/fhir/ValueSet/request-status|4.0.1)

    Codes identifying the lifecycle stage of a request.

    Typecode
    Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    20. RequestGroup.intent
    Definition

    Da das MTB nur Empfehlungen abgibt wird hier typischerweise proposal stehen. Es sei denn diese Therapieempfehlung ist selbst nochmal Teil einer RequestGroup. In dem Fall muss hier option stehen.


    Indicates the level of authority/intentionality associated with the request and where the request fits into the workflow chain.

    Shortproposal | optionproposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
    Comments

    Note that FHIR strings SHALL NOT exceed 1MB in size

    Control1..1
    This element is affected by the following invariants: ele-1
    BindingThe codes SHALL be taken from RequestIntenthttp://hl7.org/fhir/ValueSet/request-intent|4.0.1
    (required to http://hl7.org/fhir/ValueSet/request-intent|4.0.1)

    Codes indicating the degree of authority/intentionality associated with a request.

    Typecode
    Is Modifiertrue because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Requirements

    Proposals/recommendations, plans and orders all use the same structure and can exist in the same fulfillment chain.

    Alternate Namescategory
    Pattern Valueproposal
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    22. RequestGroup.code
    Definition

    Classification of the therapy recommendation using oBDS therapy types (CH, HO, IM, ZS, etc.) to specify the kind of therapy being recommended.


    A code that identifies what the overall request group is.

    ShortType of therapy recommendationWhat's being requested/ordered
    Comments

    This element can be used to provide a code that captures the meaning of the request group as a whole, as opposed to the code of the action element, which captures the meaning of the individual actions within the request group.

    Control0..1
    This element is affected by the following invariants: ele-1
    BindingThe codes SHOULD be taken from For codes, see MII VS Onkologie Therapieempfehlung Typ
    (preferred to https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/ValueSet/mii-vs-onko-therapieempfehlung-typ)
    TypeCodeableConcept
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    24. RequestGroup.subject
    Definition

    The subject for which the request group was created.

    ShortWho the request group is about
    Comments

    References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

    Control10..1
    This element is affected by the following invariants: ele-1
    TypeReference(Patient, Patient, Group)
    Is Modifierfalse
    Must Supporttrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
    26. RequestGroup.encounter
    Definition

    Describes the context of the request group, if any.

    ShortCreated as part of
    Comments

    References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

    Control0..1
    This element is affected by the following invariants: ele-1
    TypeReference(Encounter, Encounter)
    Is Modifierfalse
    Must Supporttrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
    28. RequestGroup.authoredOn
    Definition

    Indicates when the request group was created.

    ShortWhen the request group was authored
    Control10..1
    This element is affected by the following invariants: ele-1
    TypedateTime
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    30. RequestGroup.author
    Definition

    Provides a reference to the author of the request group.

    ShortDevice or practitioner that authored the request group
    Comments

    References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

    Control0..1
    This element is affected by the following invariants: ele-1
    TypeReference(Practitioner, PractitionerRole, Device, Practitioner, PractitionerRole)
    Is Modifierfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
    32. RequestGroup.reasonReference
    Definition

    Indicates another resource whose existence justifies this request group.

    ShortWhy the request group is needed
    Comments

    References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

    Control0..*
    This element is affected by the following invariants: ele-1
    TypeReference(MII PR Onkologie Diagnose Primärtumor, Condition, Observation, DiagnosticReport, DocumentReference)
    Is Modifierfalse
    Must Supporttrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
    34. RequestGroup.action
    Definition

    The actions, if any, produced by the evaluation of the artifact.

    ShortProposed actions, if any
    Control10..*
    This element is affected by the following invariants: ele-1
    TypeBackboneElement
    Is Modifierfalse
    Must Supporttrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    rqg-1: Must have resource or action but not both (resource.exists() != action.exists())
    rqg-1: Must have resource or action but not both (resource.exists() != action.exists())
    36. RequestGroup.action.modifierExtension
    Definition

    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
    Summarytrue
    Requirements

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

    Alternate Namesextensions, user content, modifiers
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    38. RequestGroup.action.code
    Definition

    Spezifisches Therapieprotokoll empfohlen durch Tumorkonferenz. Bei Kombinationstherapien repräsentiert dies das Gesamtprotokoll mit einzelnen Medikamenten als Sub-Actions.


    A code that provides meaning for the action or action group. For example, a section may have a LOINC code for a section of a documentation template.

    ShortEmpfohlenes TherapieprotokollCode representing the meaning of the action or sub-actions
    Comments

    Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

    Control0..*
    This element is affected by the following invariants: ele-1
    BindingUnless not suitable, these codes SHALL be taken from For codes, see MII VS Onkologie Systemische Therapie Protokolle
    (extensible to https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/ValueSet/mii-vs-onko-systemische-therapie-protokolle)
    TypeCodeableConcept
    Is Modifierfalse
    Must Supporttrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    40. RequestGroup.action.resource
    Definition

    The resource that is the target of the action (e.g. CommunicationRequest).

    ShortThe target of the action
    Comments

    The target resource SHALL be a Request resource with a Request.intent set to "option".


    The target resource SHALL be a Request resource with a Request.intent set to "option".

    Control10..1
    This element is affected by the following invariants: ele-1, rqg-1
    TypeReference(MII PR MTB Therapieempfehlung Systemische Therapie, MedicationRequest, Resource)
    Is Modifierfalse
    Must Supporttrue
    Must Support TypesNo must-support rules about the choice of types/profiles
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
    42. RequestGroup.action.action
    Definition

    For combination therapy protocols, each sub-action references an individual MedicationRequest with ATC/UNII coding


    Sub actions.

    ShortIndividual medications in protocolSub action
    Control0..0*
    This element is affected by the following invariants: rqg-1
    TypeSeettp://hl7.org/fhir/StructureDefinition/RequestGroup#RequestGroup.action
    Is Modifierfalse
    Must Supporttrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

    Guidance on how to interpret the contents of this table can be foundhere

    0. RequestGroup
    2. RequestGroup.meta
    Must Supporttrue
    4. RequestGroup.extension:Prioritaet
    Slice NamePrioritaet
    Control0..1
    TypeExtension(MII EX MTB Empfehlung Priorität) (Extension Type: Choice of: decimal, positiveInt)
    Must Supporttrue
    6. RequestGroup.extension:Evidenzgraduierung
    Slice NameEvidenzgraduierung
    Control0..1
    TypeExtension(MII EX MTB Empfehlung Evidenzgraduierung) (Extension Type: CodeableConcept)
    Must Supporttrue
    8. RequestGroup.extension:Publikation
    Slice NamePublikation
    Control0..*
    TypeExtension(MII EX MTB Empfehlung Publikation) (Extension Type: Identifier)
    Must Supporttrue
    10. RequestGroup.status
    Definition

    Status der Umsetzung der Therapieempfehlung

    Comments
    draft: Nicht umgesetzt,
    active: In Umsetzung,
    completed: Abgeschlossen oder abgebrochen (Patient verstorben)
    
    12. RequestGroup.intent
    Definition

    Da das MTB nur Empfehlungen abgibt wird hier typischerweise proposal stehen. Es sei denn diese Therapieempfehlung ist selbst nochmal Teil einer RequestGroup. In dem Fall muss hier option stehen.

    Shortproposal | option
    14. RequestGroup.author
    TypeReference(Practitioner, PractitionerRole)
    16. RequestGroup.action
    Control1..?
    18. RequestGroup.action.resource
    Control1..?
    TypeReference(MII PR MTB Therapieempfehlung Systemische Therapie, MedicationRequest)
    Must Supporttrue
    Must Support TypesNo must-support rules about the choice of types/profiles
    20. RequestGroup.action.action
    Control0..0

    Guidance on how to interpret the contents of this table can be foundhere

    0. RequestGroup
    Definition

    A group of related requests that can be used to capture intended activities that have inter-dependencies such as "give this medication after that one".

    ShortA group of related requests
    Control0..*
    Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
    dom-4: 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-3: 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-6: A resource should have narrative for robust management (text.`div`.exists())
    dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
    2. RequestGroup.id
    Definition

    The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

    ShortLogical id of this artifact
    Comments

    The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

    Control0..1
    Typeid
    Summarytrue
    4. RequestGroup.meta
    Definition

    The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

    ShortMetadata about the resource
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeMeta
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    6. RequestGroup.meta.id
    Definition

    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

    ShortUnique id for inter-element referencing
    Control0..1
    Typestring
    XML FormatIn the XML format, this property is represented as an attribute.
    8. RequestGroup.meta.extension
    Definition

    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

    ShortAdditional content defined by implementations
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingThis element introduces a set of slices on RequestGroup.meta.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 10. RequestGroup.meta.versionId
      Definition

      The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

      ShortVersion specific identifier
      Comments

      The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

      Control0..1
      This element is affected by the following invariants: ele-1
      Typeid
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. RequestGroup.meta.lastUpdated
      Definition

      When the resource last changed - e.g. when the version changed.

      ShortWhen the resource version last changed
      Comments

      This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

      Control0..1
      This element is affected by the following invariants: ele-1
      Typeinstant
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      14. RequestGroup.meta.source
      Definition

      A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

      ShortIdentifies where the resource comes from
      Comments

      In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

      This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

      Control0..1
      This element is affected by the following invariants: ele-1
      Typeuri
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      16. RequestGroup.meta.profile
      Definition

      A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

      ShortProfiles this resource claims to conform to
      Comments

      It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

      Control0..*
      This element is affected by the following invariants: ele-1
      Typecanonical(StructureDefinition)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      18. RequestGroup.meta.security
      Definition

      Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

      ShortSecurity Labels applied to this resource
      Comments

      The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

      Control0..*
      This element is affected by the following invariants: ele-1
      BindingUnless not suitable, these codes SHALL be taken from All Security Labels
      (extensible to http://hl7.org/fhir/ValueSet/security-labels)

      Security Labels from the Healthcare Privacy and Security Classification System.

      TypeCoding
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. RequestGroup.meta.tag
      Definition

      Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

      ShortTags applied to this resource
      Comments

      The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

      Control0..*
      This element is affected by the following invariants: ele-1
      BindingFor example codes, see CommonTags
      (example to http://hl7.org/fhir/ValueSet/common-tags)

      Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

      TypeCoding
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. RequestGroup.implicitRules
      Definition

      A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

      ShortA set of rules under which this content was created
      Comments

      Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

      Control0..1
      This element is affected by the following invariants: ele-1
      Typeuri
      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      24. RequestGroup.language
      Definition

      The base language in which the resource is written.

      ShortLanguage of the resource content
      Comments

      Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

      Control0..1
      This element is affected by the following invariants: ele-1
      BindingThe codes SHOULD be taken from CommonLanguages
      (preferred to http://hl7.org/fhir/ValueSet/languages)

      A human language.

      Additional BindingsPurpose
      AllLanguagesMax Binding
      Typecode
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      26. RequestGroup.text
      Definition

      A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

      ShortText summary of the resource, for human interpretation
      Comments

      Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

      Control0..1
      This element is affected by the following invariants: ele-1
      TypeNarrative
      Alternate Namesnarrative, html, xhtml, display
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      28. RequestGroup.contained
      Definition

      These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

      ShortContained, inline Resources
      Comments

      This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

      Control0..*
      TypeResource
      Alternate Namesinline resources, anonymous resources, contained resources
      30. RequestGroup.extension
      Definition

      May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

      ShortAdditional content defined by implementations
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      This element is affected by the following invariants: ele-1
      TypeExtension
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on RequestGroup.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 32. RequestGroup.extension:Prioritaet
        Slice NamePrioritaet
        Definition

        Priorität der (einzelnen) Empfehlung

        ShortMII EX MTB Empfehlung Priorität
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(MII EX MTB Empfehlung Priorität) (Extension Type: Choice of: decimal, positiveInt)
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        34. RequestGroup.extension:Evidenzgraduierung
        Slice NameEvidenzgraduierung
        Definition

        Evidenzgraduierung der (einzelnen) Empfehlung

        ShortMII EX MTB Empfehlung Evidenzgraduierung
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(MII EX MTB Empfehlung Evidenzgraduierung) (Extension Type: CodeableConcept)
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        36. RequestGroup.extension:Publikation
        Slice NamePublikation
        Definition

        Verweis auf Publikation der (einzelnen) Empfehlung

        ShortMII EX MTB Empfehlung Publikation
        Control0..*
        This element is affected by the following invariants: ele-1
        TypeExtension(MII EX MTB Empfehlung Publikation) (Extension Type: Identifier)
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        38. RequestGroup.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        This element is affected by the following invariants: ele-1
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on RequestGroup.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 40. RequestGroup.identifier
          Definition

          Allows a service to provide a unique, business identifier for the request.

          ShortBusiness identifier
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..*
          This element is affected by the following invariants: ele-1
          TypeIdentifier
          Must Supporttrue
          Summarytrue
          Requirements

          Allows identification of the request as it is known by various participating systems and in a way that remains consistent across servers.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          42. RequestGroup.instantiatesCanonical
          Definition

          A canonical URL referencing a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this request.

          ShortInstantiates FHIR protocol or definition
          Comments

          see Canonical References

          Control0..*
          This element is affected by the following invariants: ele-1
          Typecanonical
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          44. RequestGroup.instantiatesUri
          Definition

          A URL referencing an externally defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this request.

          ShortInstantiates external protocol or definition
          Comments

          see http://en.wikipedia.org/wiki/Uniform_resource_identifier

          Control0..*
          This element is affected by the following invariants: ele-1
          Typeuri
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          46. RequestGroup.basedOn
          Definition

          A plan, proposal or order that is fulfilled in whole or in part by this request.

          ShortFulfills plan, proposal, or order
          Comments

          References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

          Control0..*
          This element is affected by the following invariants: ele-1
          TypeReference(Resource)
          Requirements

          Allows tracing of authorization for the request and tracking whether proposals/recommendations were acted upon.

          Alternate Namesfulfills
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
          48. RequestGroup.replaces
          Definition

          Completed or terminated request(s) whose function is taken by this new request.

          ShortRequest(s) replaced by this request
          Comments

          The replacement could be because the initial request was immediately rejected (due to an issue) or because the previous request was completed, but the need for the action described by the request remains ongoing.

          Control0..*
          This element is affected by the following invariants: ele-1
          TypeReference(Resource)
          Requirements

          Allows tracing the continuation of a therapy or administrative process instantiated through multiple requests.

          Alternate Namessupersedes, prior, renewed order
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
          50. RequestGroup.groupIdentifier
          Definition

          A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition, prescription or similar form.

          ShortComposite request this is part of
          Comments

          Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.

          Control0..1
          This element is affected by the following invariants: ele-1
          TypeIdentifier
          Summarytrue
          Requirements

          Some business processes need to know if multiple items were ordered as part of the same "prescription" or "requisition" for billing or other purposes.

          Alternate Namesgrouperid, requisition
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          52. RequestGroup.status
          Definition

          Status der Umsetzung der Therapieempfehlung

          Comments
          draft: Nicht umgesetzt,
          active: In Umsetzung,
          completed: Abgeschlossen oder abgebrochen (Patient verstorben)
          
          Control1..1
          This element is affected by the following invariants: ele-1
          BindingThe codes SHALL be taken from RequestStatus
          (required to http://hl7.org/fhir/ValueSet/request-status|4.0.1)

          Codes identifying the lifecycle stage of a request.

          Typecode
          Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          54. RequestGroup.intent
          Definition

          Da das MTB nur Empfehlungen abgibt wird hier typischerweise proposal stehen. Es sei denn diese Therapieempfehlung ist selbst nochmal Teil einer RequestGroup. In dem Fall muss hier option stehen.

          Shortproposal | option
          Comments

          Note that FHIR strings SHALL NOT exceed 1MB in size

          Control1..1
          This element is affected by the following invariants: ele-1
          BindingThe codes SHALL be taken from RequestIntent
          (required to http://hl7.org/fhir/ValueSet/request-intent|4.0.1)

          Codes indicating the degree of authority/intentionality associated with a request.

          Typecode
          Is Modifiertrue because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

          Proposals/recommendations, plans and orders all use the same structure and can exist in the same fulfillment chain.

          Alternate Namescategory
          Pattern Valueproposal
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          56. RequestGroup.priority
          Definition

          Indicates how quickly the request should be addressed with respect to other requests.

          Shortroutine | urgent | asap | stat
          Comments

          Note that FHIR strings SHALL NOT exceed 1MB in size

          Control0..1
          This element is affected by the following invariants: ele-1
          BindingThe codes SHALL be taken from RequestPriority
          (required to http://hl7.org/fhir/ValueSet/request-priority|4.0.1)

          Identifies the level of importance to be assigned to actioning the request.

          Typecode
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Meaning if MissingIf missing, this request should be performed with normal priority
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          58. RequestGroup.code
          Definition

          Classification of the therapy recommendation using oBDS therapy types (CH, HO, IM, ZS, etc.) to specify the kind of therapy being recommended.

          ShortType of therapy recommendation
          Comments

          This element can be used to provide a code that captures the meaning of the request group as a whole, as opposed to the code of the action element, which captures the meaning of the individual actions within the request group.

          Control0..1
          This element is affected by the following invariants: ele-1
          BindingThe codes SHOULD be taken from MII VS Onkologie Therapieempfehlung Typ
          (preferred to https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/ValueSet/mii-vs-onko-therapieempfehlung-typ)
          TypeCodeableConcept
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          60. RequestGroup.subject
          Definition

          The subject for which the request group was created.

          ShortWho the request group is about
          Comments

          References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

          Control1..1
          This element is affected by the following invariants: ele-1
          TypeReference(Patient)
          Must Supporttrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
          62. RequestGroup.encounter
          Definition

          Describes the context of the request group, if any.

          ShortCreated as part of
          Comments

          References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

          Control0..1
          This element is affected by the following invariants: ele-1
          TypeReference(Encounter)
          Must Supporttrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
          64. RequestGroup.authoredOn
          Definition

          Indicates when the request group was created.

          ShortWhen the request group was authored
          Control1..1
          This element is affected by the following invariants: ele-1
          TypedateTime
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          66. RequestGroup.author
          Definition

          Provides a reference to the author of the request group.

          ShortDevice or practitioner that authored the request group
          Comments

          References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

          Control0..1
          This element is affected by the following invariants: ele-1
          TypeReference(Practitioner, PractitionerRole)
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
          68. RequestGroup.reasonCode
          Definition

          Describes the reason for the request group in coded or textual form.

          ShortWhy the request group is needed
          Comments

          Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

          Control0..*
          This element is affected by the following invariants: ele-1
          TypeCodeableConcept
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          70. RequestGroup.reasonReference
          Definition

          Indicates another resource whose existence justifies this request group.

          ShortWhy the request group is needed
          Comments

          References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

          Control0..*
          This element is affected by the following invariants: ele-1
          TypeReference(MII PR Onkologie Diagnose Primärtumor)
          Must Supporttrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
          72. RequestGroup.note
          Definition

          Provides a mechanism to communicate additional information about the response.

          ShortAdditional notes about the response
          Comments

          For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).

          Control0..*
          This element is affected by the following invariants: ele-1
          TypeAnnotation
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          74. RequestGroup.action
          Definition

          The actions, if any, produced by the evaluation of the artifact.

          ShortProposed actions, if any
          Control1..*
          This element is affected by the following invariants: ele-1
          TypeBackboneElement
          Must Supporttrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          rqg-1: Must have resource or action but not both (resource.exists() != action.exists())
          76. RequestGroup.action.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          XML FormatIn the XML format, this property is represented as an attribute.
          78. RequestGroup.action.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          This element is affected by the following invariants: ele-1
          TypeExtension
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on RequestGroup.action.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 80. RequestGroup.action.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            82. RequestGroup.action.prefix
            Definition

            A user-visible prefix for the action.

            ShortUser-visible prefix for the action (e.g. 1. or A.)
            Comments

            Note that FHIR strings SHALL NOT exceed 1MB in size

            Control0..1
            This element is affected by the following invariants: ele-1
            Typestring
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            84. RequestGroup.action.title
            Definition

            The title of the action displayed to a user.

            ShortUser-visible title
            Comments

            Note that FHIR strings SHALL NOT exceed 1MB in size

            Control0..1
            This element is affected by the following invariants: ele-1
            Typestring
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            86. RequestGroup.action.description
            Definition

            A short description of the action used to provide a summary to display to the user.

            ShortShort description of the action
            Comments

            Note that FHIR strings SHALL NOT exceed 1MB in size

            Control0..1
            This element is affected by the following invariants: ele-1
            Typestring
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            88. RequestGroup.action.textEquivalent
            Definition

            A text equivalent of the action to be performed. This provides a human-interpretable description of the action when the definition is consumed by a system that might not be capable of interpreting it dynamically.

            ShortStatic text equivalent of the action, used if the dynamic aspects cannot be interpreted by the receiving system
            Comments

            Note that FHIR strings SHALL NOT exceed 1MB in size

            Control0..1
            This element is affected by the following invariants: ele-1
            Typestring
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            90. RequestGroup.action.priority
            Definition

            Indicates how quickly the action should be addressed with respect to other actions.

            Shortroutine | urgent | asap | stat
            Comments

            Note that FHIR strings SHALL NOT exceed 1MB in size

            Control0..1
            This element is affected by the following invariants: ele-1
            BindingThe codes SHALL be taken from RequestPriority
            (required to http://hl7.org/fhir/ValueSet/request-priority|4.0.1)

            Identifies the level of importance to be assigned to actioning the request.

            Typecode
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            92. RequestGroup.action.code
            Definition

            Spezifisches Therapieprotokoll empfohlen durch Tumorkonferenz. Bei Kombinationstherapien repräsentiert dies das Gesamtprotokoll mit einzelnen Medikamenten als Sub-Actions.

            ShortEmpfohlenes Therapieprotokoll
            Comments

            Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

            Control0..*
            This element is affected by the following invariants: ele-1
            BindingUnless not suitable, these codes SHALL be taken from MII VS Onkologie Systemische Therapie Protokolle
            (extensible to https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/ValueSet/mii-vs-onko-systemische-therapie-protokolle)
            TypeCodeableConcept
            Must Supporttrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            94. RequestGroup.action.documentation
            Definition

            Didactic or other informational resources associated with the action that can be provided to the CDS recipient. Information resources can include inline text commentary and links to web resources.

            ShortSupporting documentation for the intended performer of the action
            Comments

            Each related artifact is either an attachment, or a reference to another knowledge resource, but not both.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeRelatedArtifact
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            96. RequestGroup.action.condition
            Definition

            An expression that describes applicability criteria, or start/stop conditions for the action.

            ShortWhether or not the action is applicable
            Comments

            When multiple conditions of the same kind are present, the effects are combined using AND semantics, so the overall condition is true only if all of the conditions are true.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeBackboneElement
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            98. RequestGroup.action.condition.id
            Definition

            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

            ShortUnique id for inter-element referencing
            Control0..1
            Typestring
            XML FormatIn the XML format, this property is represented as an attribute.
            100. RequestGroup.action.condition.extension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            ShortAdditional content defined by implementations
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on RequestGroup.action.condition.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 102. RequestGroup.action.condition.modifierExtension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

              ShortExtensions that cannot be ignored even if unrecognized
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              This element is affected by the following invariants: ele-1
              TypeExtension
              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
              Summarytrue
              Requirements

              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

              Alternate Namesextensions, user content, modifiers
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              104. RequestGroup.action.condition.kind
              Definition

              The kind of condition.

              Shortapplicability | start | stop
              Comments

              Applicability criteria are used to determine immediate applicability when a plan definition is applied to a given context. Start and stop criteria are carried through application and used to describe enter/exit criteria for an action.

              Control1..1
              This element is affected by the following invariants: ele-1
              BindingThe codes SHALL be taken from ActionConditionKind
              (required to http://hl7.org/fhir/ValueSet/action-condition-kind|4.0.1)

              The kind of condition for the action.

              Typecode
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              106. RequestGroup.action.condition.expression
              Definition

              An expression that returns true or false, indicating whether or not the condition is satisfied.

              ShortBoolean-valued expression
              Comments

              The expression may be inlined, or may be a reference to a named expression within a logic library referenced by the library element.

              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExpression
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              exp-1: An expression or a reference must be provided (expression.exists() or reference.exists())
              108. RequestGroup.action.relatedAction
              Definition

              A relationship to another action such as "before" or "30-60 minutes after start of".

              ShortRelationship to another action
              Control0..*
              This element is affected by the following invariants: ele-1
              TypeBackboneElement
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              110. RequestGroup.action.relatedAction.id
              Definition

              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

              ShortUnique id for inter-element referencing
              Control0..1
              Typestring
              XML FormatIn the XML format, this property is represented as an attribute.
              112. RequestGroup.action.relatedAction.extension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

              ShortAdditional content defined by implementations
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              This element is affected by the following invariants: ele-1
              TypeExtension
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              SlicingThis element introduces a set of slices on RequestGroup.action.relatedAction.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 114. RequestGroup.action.relatedAction.modifierExtension
                Definition

                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                ShortExtensions that cannot be ignored even if unrecognized
                Comments

                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                Control0..*
                This element is affected by the following invariants: ele-1
                TypeExtension
                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                Summarytrue
                Requirements

                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                Alternate Namesextensions, user content, modifiers
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                116. RequestGroup.action.relatedAction.actionId
                Definition

                The element id of the action this is related to.

                ShortWhat action this is related to
                Comments

                RFC 4122

                Control1..1
                This element is affected by the following invariants: ele-1
                Typeid
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                118. RequestGroup.action.relatedAction.relationship
                Definition

                The relationship of this action to the related action.

                Shortbefore-start | before | before-end | concurrent-with-start | concurrent | concurrent-with-end | after-start | after | after-end
                Comments

                Note that FHIR strings SHALL NOT exceed 1MB in size

                Control1..1
                This element is affected by the following invariants: ele-1
                BindingThe codes SHALL be taken from ActionRelationshipType
                (required to http://hl7.org/fhir/ValueSet/action-relationship-type|4.0.1)

                Defines the types of relationships between actions.

                Typecode
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                120. RequestGroup.action.relatedAction.offset[x]
                Definition

                A duration or range of durations to apply to the relationship. For example, 30-60 minutes before.

                ShortTime offset for the relationship
                Control0..1
                This element is affected by the following invariants: ele-1
                TypeChoice of: Duration, Range
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                122. RequestGroup.action.timing[x]
                Definition

                An optional value describing when the action should be performed.

                ShortWhen the action should take place
                Control0..1
                This element is affected by the following invariants: ele-1
                TypeChoice of: dateTime, Age, Period, Duration, Range, Timing
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                124. RequestGroup.action.participant
                Definition

                The participant that should perform or be responsible for this action.

                ShortWho should perform the action
                Comments

                References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                Control0..*
                This element is affected by the following invariants: ele-1
                TypeReference(Patient, Practitioner, PractitionerRole, RelatedPerson, Device)
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                126. RequestGroup.action.type
                Definition

                The type of action to perform (create, update, remove).

                Shortcreate | update | remove | fire-event
                Comments

                Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                Control0..1
                This element is affected by the following invariants: ele-1
                BindingUnless not suitable, these codes SHALL be taken from ActionType
                (extensible to http://hl7.org/fhir/ValueSet/action-type)

                The type of action to be performed.

                TypeCodeableConcept
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                128. RequestGroup.action.groupingBehavior
                Definition

                Defines the grouping behavior for the action and its children.

                Shortvisual-group | logical-group | sentence-group
                Comments

                Note that FHIR strings SHALL NOT exceed 1MB in size

                Control0..1
                This element is affected by the following invariants: ele-1
                BindingThe codes SHALL be taken from ActionGroupingBehavior
                (required to http://hl7.org/fhir/ValueSet/action-grouping-behavior|4.0.1)

                Defines organization behavior of a group.

                Typecode
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                130. RequestGroup.action.selectionBehavior
                Definition

                Defines the selection behavior for the action and its children.

                Shortany | all | all-or-none | exactly-one | at-most-one | one-or-more
                Comments

                Note that FHIR strings SHALL NOT exceed 1MB in size

                Control0..1
                This element is affected by the following invariants: ele-1
                BindingThe codes SHALL be taken from ActionSelectionBehavior
                (required to http://hl7.org/fhir/ValueSet/action-selection-behavior|4.0.1)

                Defines selection behavior of a group.

                Typecode
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                132. RequestGroup.action.requiredBehavior
                Definition

                Defines expectations around whether an action is required.

                Shortmust | could | must-unless-documented
                Comments

                Note that FHIR strings SHALL NOT exceed 1MB in size

                Control0..1
                This element is affected by the following invariants: ele-1
                BindingThe codes SHALL be taken from ActionRequiredBehavior
                (required to http://hl7.org/fhir/ValueSet/action-required-behavior|4.0.1)

                Defines expectations around whether an action or action group is required.

                Typecode
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                134. RequestGroup.action.precheckBehavior
                Definition

                Defines whether the action should usually be preselected.

                Shortyes | no
                Comments

                Note that FHIR strings SHALL NOT exceed 1MB in size

                Control0..1
                This element is affected by the following invariants: ele-1
                BindingThe codes SHALL be taken from ActionPrecheckBehavior
                (required to http://hl7.org/fhir/ValueSet/action-precheck-behavior|4.0.1)

                Defines selection frequency behavior for an action or group.

                Typecode
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                136. RequestGroup.action.cardinalityBehavior
                Definition

                Defines whether the action can be selected multiple times.

                Shortsingle | multiple
                Comments

                Note that FHIR strings SHALL NOT exceed 1MB in size

                Control0..1
                This element is affected by the following invariants: ele-1
                BindingThe codes SHALL be taken from ActionCardinalityBehavior
                (required to http://hl7.org/fhir/ValueSet/action-cardinality-behavior|4.0.1)

                Defines behavior for an action or a group for how many times that item may be repeated.

                Typecode
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                138. RequestGroup.action.resource
                Definition

                The resource that is the target of the action (e.g. CommunicationRequest).

                ShortThe target of the action
                Comments

                The target resource SHALL be a Request resource with a Request.intent set to "option".

                Control1..1
                This element is affected by the following invariants: ele-1, rqg-1
                TypeReference(MII PR MTB Therapieempfehlung Systemische Therapie, MedicationRequest)
                Must Supporttrue
                Must Support TypesNo must-support rules about the choice of types/profiles
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                140. RequestGroup.action.action
                Definition

                For combination therapy protocols, each sub-action references an individual MedicationRequest with ATC/UNII coding

                ShortIndividual medications in protocol
                Control0..0
                This element is affected by the following invariants: rqg-1
                TypeSeettp://hl7.org/fhir/StructureDefinition/RequestGroup#RequestGroup.action
                Must Supporttrue