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_Therapieplan - Detailed Descriptions

Active as of 2026-02-09

Definitions for the mii-pr-mtb-therapieplan resource profile.

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

0. CarePlan
Definition

Describes the intention of how one or more practitioners intend to deliver care for a particular patient, group or community for a period of time, possibly limited to care for a specific condition or set of conditions.

ShortHealthcare plan for patient or group
Control0..*
Is Modifierfalse
Alternate NamesCare Team
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. CarePlan.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. CarePlan.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. CarePlan.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. CarePlan.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 CarePlan.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 10. CarePlan.status
    Definition

    Status der Umsetzung des beschlossenen Therapieplans


    Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.

    Shortdraft | active | on-hold | revoked | completed | entered-in-error | unknown
    Comments
    active: Empfehlung bzw. Therapieoption in Umsetzung (Regelfall),
    revoked: Molekularer Tumorboard-Fall ist abgeschlossen,
    completed: Alle Empfehlungen bzw. Therapieoptionen ausgeschöpft oder Patient verstorben
    

    The unknown code is not to be used to convey other statuses. The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the care plan.

    This element is labeled as a modifier because the status contains the code entered-in-error that marks the plan as not currently valid.

    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)

    Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.

    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
    Requirements

    Allows clinicians to determine whether the plan is actionable or not.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    12. CarePlan.intent
    Definition

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

    Shortproposal | plan | order | option
    Comments

    This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

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

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

    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.

    Pattern Valueplan
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    14. CarePlan.category
    Definition

    Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", "wellness plan", etc.

    ShortType of plan
    Comments

    There may be multiple axes of categorization and one plan may serve multiple purposes. In some cases, this may be redundant with references to CarePlan.concern.

    Control10..1*
    This element is affected by the following invariants: ele-1
    BindingFor example codes, see CarePlanCategoryhttp://hl7.org/fhir/ValueSet/care-plan-category|4.0.1
    (example to http://hl7.org/fhir/ValueSet/care-plan-category)

    Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.

    TypeCodeableConcept
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

    Used for filtering what plan(s) are retrieved and displayed to different types of users.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    16. CarePlan.category.coding
    Definition

    Art der Tumorkonferenz / Therapieplanung gemäß 18.2 oBDS 2021.


    A reference to a code defined by a terminology system.

    ShortArt der Tumorkonferenz / TherapieplanungCode defined by a terminology system
    Comments

    Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

    Control10..*
    This element is affected by the following invariants: ele-1
    BindingThe codes SHALL be taken from For codes, see MII VS Onkologie Therapieplanung Typ
    (required to https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/ValueSet/mii-vs-onko-therapieplanung-typ)
    TypeCoding
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

    Allows for alternative encodings within a code system, and translations to other code systems.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    18. CarePlan.category.coding.system
    Definition

    The identification of the code system that defines the meaning of the symbol in the code.

    ShortIdentity of the terminology system
    Comments

    The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

    Control10..1
    This element is affected by the following invariants: ele-1
    Typeuri
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Requirements

    Need to be unambiguous about the source of the definition of the symbol.

    Pattern Valuehttps://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapieplanung-typ
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    20. CarePlan.category.coding.code
    Definition

    A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

    ShortSymbol in syntax defined by the system
    Comments

    Note that FHIR strings SHALL NOT exceed 1MB in size

    Control10..1
    This element is affected by the following invariants: ele-1
    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Requirements

    Need to refer to a particular code in the system.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    22. CarePlan.description
    Definition

    Protokollauszug aus dem Beschluss des Molekularen Tumorboards


    A description of the scope and nature of the plan.

    ShortProtokollauszugSummary of nature of plan
    Comments

    Note that FHIR strings SHALL NOT exceed 1MB in size

    Control0..1
    This element is affected by the following invariants: ele-1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Requirements

    Provides more detail than conveyed by category.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    24. CarePlan.subject
    Definition

    Identifies the patient or group whose intended care is described by the plan.

    ShortWho the care plan is for
    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, Patient, Group)
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Alternate Namespatient
    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. CarePlan.encounter
    Definition

    The Encounter during which this CarePlan was created or to which the creation of this record is tightly associated.

    ShortEncounter created as part of
    Comments

    This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. CarePlan activities conducted as a result of the care plan may well occur as part of other encounters.

    Control0..1
    This element is affected by the following invariants: ele-1
    TypeReference(Encounter, Encounter)
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    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. CarePlan.created
    Definition

    Erstellungsdatum des Therapieplans gemäß Beschluss des Molekularen Tumorboards


    Represents when this particular CarePlan record was created in the system, which is often a system-generated date.

    ShortErstellungsdatumDate record was first recorded
    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
    Summarytrue
    Alternate NamesauthoredOn
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    30. CarePlan.addresses
    Definition

    Identifies the conditions/problems/concerns/diagnoses/etc. whose management and/or mitigation are handled by this plan.

    ShortHealth issues this plan addresses
    Comments

    When the diagnosis is related to an allergy or intolerance, the Condition and AllergyIntolerance resources can both be used. However, to be actionable for decision support, using Condition alone is not sufficient as the allergy or intolerance condition needs to be represented as an AllergyIntolerance.

    Control0..*
    This element is affected by the following invariants: ele-1
    TypeReference(MII PR Onkologie Diagnose Primärtumor, Condition)
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

    Links plan to the conditions it manages. The element can identify risks addressed by the plan as well as active conditions. (The Condition resource can include things like "at risk for hypertension" or "fall risk".) Also scopes plans - multiple plans may exist addressing different concerns.

    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. CarePlan.supportingInfo
    Definition

    Identifies portions of the patient's record that specifically influenced the formation of the plan. These might include comorbidities, recent procedures, limitations, recent assessments, etc.

    ShortInformation considered as part of plan
    Comments

    Use "concern" to identify specific conditions addressed by the care plan.

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

    Identifies barriers and other considerations associated with the care plan.

    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')))
    SlicingThis element introduces a set of slices on CarePlan.supportingInfo. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • type @ $this
    • 34. CarePlan.supportingInfo:Behandlungsepisode
      Slice NameBehandlungsepisode
      Definition

      Aktueller Krankheitszustand und bisherige Behandlungsmaßnahmen


      Identifies portions of the patient's record that specifically influenced the formation of the plan. These might include comorbidities, recent procedures, limitations, recent assessments, etc.

      ShortBehandlungsepisodeInformation considered as part of plan
      Comments

      Use "concern" to identify specific conditions addressed by the care plan.

      Control0..1*
      This element is affected by the following invariants: ele-1
      TypeReference(MII PR MTB Behandlungsepisode, ClinicalImpression, Resource)
      Is Modifierfalse
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Requirements

      Identifies barriers and other considerations associated with the care plan.

      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')))
      36. CarePlan.activity
      Definition

      Identifies a planned action to occur as part of the plan. For example, a medication to be used, lab tests to perform, self-monitoring, education, etc.

      ShortTherapy recommendations - either oBDS standard categorization or extended molecular protocolsAction to occur as part of plan
      Control0..*
      This element is affected by the following invariants: ele-1
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Requirements

      Allows systems to prompt for performance of planned activities, and validate plans against best practice.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      cpl-3: Provide a reference or detail, not both (detail.empty() or reference.empty())
      cpl-3: Provide a reference or detail, not both (detail.empty() or reference.empty())
      SlicingThis element introduces a set of slices on CarePlan.activity. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • exists @ detail
      • profile @ reference.resolve()
      • 38. CarePlan.activity.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())
        40. CarePlan.activity.reference
        Definition

        The details of the proposed activity represented in a specific resource.

        ShortActivity details defined in specific resource
        Comments

        Standard extension exists (resource-pertainsToGoal) that allows goals to be referenced from any of the referenced resources in CarePlan.activity.reference.
        The goal should be visible when the resource referenced by CarePlan.activity.reference is viewed independently from the CarePlan. Requests that are pointed to by a CarePlan using this element should not point to this CarePlan using the "basedOn" element. i.e. Requests that are part of a CarePlan are not "based on" the CarePlan.

        Control0..1
        This element is affected by the following invariants: ele-1, cpl-3
        TypeReference(Appointment, CommunicationRequest, DeviceRequest, MedicationRequest, NutritionOrder, Task, ServiceRequest, VisionPrescription, RequestGroup, Appointment, CommunicationRequest, DeviceRequest, MedicationRequest, NutritionOrder, Task, ServiceRequest, VisionPrescription, RequestGroup)
        Is Modifierfalse
        Requirements

        Details in a form consistent with other applications and contexts of use.

        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. CarePlan.activity.detail
        Definition

        A simple summary of a planned activity suitable for a general care plan system (e.g. form driven) that doesn't know about specific resources such as procedure etc.

        ShortIn-line definition of activity
        Control0..1
        This element is affected by the following invariants: ele-1, cpl-3
        TypeBackboneElement
        Is Modifierfalse
        Requirements

        Details in a simple form for generic care plan systems.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        44. CarePlan.activity.detail.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())
        46. CarePlan.activity.detail.status
        Definition

        Identifies what progress is being made for the specific activity.

        Shortnot-started | scheduled | in-progress | on-hold | completed | cancelled | stopped | unknown | entered-in-error
        Comments

        Some aspects of status can be inferred based on the resources linked in actionTaken. Note that "status" is only as current as the plan was most recently updated.
        The unknown code is not to be used to convey other statuses. The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the activity.

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

        Codes that reflect the current state of a care plan activity within its overall life cycle.

        Typecode
        Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the activity should not be treated as valid
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Requirements

        Indicates progress against the plan, whether the activity is still relevant for the plan.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        48. CarePlan.activity.detail.doNotPerform
        Definition

        If true, indicates that the described activity is one that must NOT be engaged in when following the plan. If false, or missing, indicates that the described activity is one that should be engaged in when following the plan.

        ShortIf true, activity is prohibiting action
        Comments

        This element is labeled as a modifier because it marks an activity as an activity that is not to be performed.

        Control0..1
        This element is affected by the following invariants: ele-1
        Typeboolean
        Is Modifiertrue because If true this element negates the specified action. For example, instead of a request for a procedure, it is a request for the procedure to not occur.
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Requirements

        Captures intention to not do something that may have been previously typical.

        Meaning if MissingIf missing indicates that the described activity is one that should be engaged in when following the plan.
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        50. CarePlan.activity:obds
        Slice Nameobds
        Definition

        Standard tumor board recommendation using oBDS 19.1 therapy type categorization


        Identifies a planned action to occur as part of the plan. For example, a medication to be used, lab tests to perform, self-monitoring, education, etc.

        ShortStandard oBDS therapy recommendation with category onlyAction to occur as part of plan
        Control0..*
        This element is affected by the following invariants: ele-1
        TypeBackboneElement
        Is Modifierfalse
        Requirements

        Allows systems to prompt for performance of planned activities, and validate plans against best practice.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        cpl-3: Provide a reference or detail, not both (detail.empty() or reference.empty())
        cpl-3: Provide a reference or detail, not both (detail.empty() or reference.empty())
        52. CarePlan.activity:obds.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())
        54. CarePlan.activity:obds.reference
        Definition

        The details of the proposed activity represented in a specific resource.

        ShortActivity details defined in specific resource
        Comments

        Standard extension exists (resource-pertainsToGoal) that allows goals to be referenced from any of the referenced resources in CarePlan.activity.reference.
        The goal should be visible when the resource referenced by CarePlan.activity.reference is viewed independently from the CarePlan. Requests that are pointed to by a CarePlan using this element should not point to this CarePlan using the "basedOn" element. i.e. Requests that are part of a CarePlan are not "based on" the CarePlan.

        Control0..01
        This element is affected by the following invariants: ele-1, cpl-3
        TypeReference(Appointment, CommunicationRequest, DeviceRequest, MedicationRequest, NutritionOrder, Task, ServiceRequest, VisionPrescription, RequestGroup, Appointment, CommunicationRequest, DeviceRequest, MedicationRequest, NutritionOrder, Task, ServiceRequest, VisionPrescription, RequestGroup)
        Is Modifierfalse
        Requirements

        Details in a form consistent with other applications and contexts of use.

        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')))
        56. CarePlan.activity:obds.detail
        Definition

        A simple summary of a planned activity suitable for a general care plan system (e.g. form driven) that doesn't know about specific resources such as procedure etc.

        ShortIn-line definition of activity
        Control10..1
        This element is affected by the following invariants: ele-1, cpl-3
        TypeBackboneElement
        Is Modifierfalse
        Must Supporttrue
        Requirements

        Details in a simple form for generic care plan systems.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        tumorkonferenz-empfehlung-entscheidung-patient: Therapieabweichung aufgrund Patientenwunsch: Bei nichtangetretener oder abgebrochener Therapie ist anzugeben, ob dies dem Patientenwunsch entspricht oder ggfs. andere Gründe hat (status = 'cancelled' or status = 'stopped' implies statusReason.exists())
        58. CarePlan.activity:obds.detail.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())
        60. CarePlan.activity:obds.detail.code
        Definition

        Detailed description of the type of planned activity; e.g. what lab test, what procedure, what kind of encounter.

        ShortDetail type of activity
        Comments

        Tends to be less relevant for activities involving particular products. Codes should not convey negation - use "prohibited" instead.

        Control10..1
        This element is affected by the following invariants: ele-1
        BindingThe codes SHALL be taken from For example codes, see MII VS Onkologie Therapieempfehlung Typhttp://hl7.org/fhir/ValueSet/procedure-code|4.0.1
        (required to https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/ValueSet/mii-vs-onko-therapieempfehlung-typ)

        Detailed description of the type of activity; e.g. What lab test, what procedure, what kind of encounter.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Requirements

        Allows matching performed to planned as well as validation against protocols.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        62. CarePlan.activity:obds.detail.code.coding
        Definition

        Typ der Therapieempfehlung der Tumorkonferenz gemäß 19.1 oBDS 2021.


        A reference to a code defined by a terminology system.

        ShortTyp der TherapieempfehlungCode defined by a terminology system
        Comments

        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

        Control0..*
        This element is affected by the following invariants: ele-1
        TypeCoding
        Is Modifierfalse
        Summarytrue
        Requirements

        Allows for alternative encodings within a code system, and translations to other code systems.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        64. CarePlan.activity:obds.detail.code.coding.system
        Definition

        The identification of the code system that defines the meaning of the symbol in the code.

        ShortIdentity of the terminology system
        Comments

        The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

        Control10..1
        This element is affected by the following invariants: ele-1
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        Need to be unambiguous about the source of the definition of the symbol.

        Pattern Valuehttps://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapie-typ
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        66. CarePlan.activity:obds.detail.code.coding.code
        Definition

        A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

        ShortSymbol in syntax defined by the system
        Comments

        Note that FHIR strings SHALL NOT exceed 1MB in size

        Control10..1
        This element is affected by the following invariants: ele-1
        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        Need to refer to a particular code in the system.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        68. CarePlan.activity:obds.detail.status
        Definition

        Status der Therapieempfehlung nach HL7 FHIR CarePlanActivityStatus | not-started | scheduled | in-progress | on-hold | completed | cancelled | stopped | unknown | entered-in-error |


        Identifies what progress is being made for the specific activity.

        ShortStatus der Therapieempfehlungnot-started | scheduled | in-progress | on-hold | completed | cancelled | stopped | unknown | entered-in-error
        Comments

        Some aspects of status can be inferred based on the resources linked in actionTaken. Note that "status" is only as current as the plan was most recently updated.
        The unknown code is not to be used to convey other statuses. The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the activity.

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

        Codes that reflect the current state of a care plan activity within its overall life cycle.

        Typecode
        Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the activity should not be treated as valid
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Requirements

        Indicates progress against the plan, whether the activity is still relevant for the plan.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        70. CarePlan.activity:obds.detail.statusReason
        Definition

        wenn Therapieabweichung - z.B. status = cancelled - Aussage ob dies durch Patientenwunsch erfolgt ist gemäß 19.2 oBDS 2021.


        Provides reason why the activity isn't yet started, is on hold, was cancelled, etc.

        ShortTherapieabweichung aufgrund Patientenwunsch der TherapieempfehlungReason for current status
        Comments

        Will generally not be present if status is "complete". Be sure to prompt to update this (or at least remove the existing value) if the status is changed.

        Control0..1
        This element is affected by the following invariants: ele-1
        BindingThe codes SHALL be taken from For codes, see MII VS Onkologie Therapieabweichung
        (required to https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/ValueSet/mii-vs-onko-therapieabweichung)
        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        72. CarePlan.activity:obds.detail.statusReason.coding
        Definition

        A reference to a code defined by a terminology system.

        ShortCode defined by a terminology system
        Comments

        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

        Control0..*
        This element is affected by the following invariants: ele-1
        TypeCoding
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        Allows for alternative encodings within a code system, and translations to other code systems.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        74. CarePlan.activity:obds.detail.statusReason.coding.system
        Definition

        The identification of the code system that defines the meaning of the symbol in the code.

        ShortIdentity of the terminology system
        Comments

        The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

        Control0..1
        This element is affected by the following invariants: ele-1
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Need to be unambiguous about the source of the definition of the symbol.

        Pattern Valuehttps://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapieabweichung
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        76. CarePlan.activity:obds.detail.statusReason.coding.code
        Definition

        A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

        ShortSymbol in syntax defined by the system
        Comments

        Note that FHIR strings SHALL NOT exceed 1MB in size

        Control0..1
        This element is affected by the following invariants: ele-1
        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        Need to refer to a particular code in the system.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        78. CarePlan.activity:obds.detail.doNotPerform
        Definition

        If true, indicates that the described activity is one that must NOT be engaged in when following the plan. If false, or missing, indicates that the described activity is one that should be engaged in when following the plan.

        ShortIf true, activity is prohibiting action
        Comments

        This element is labeled as a modifier because it marks an activity as an activity that is not to be performed.

        Control0..1
        This element is affected by the following invariants: ele-1
        Typeboolean
        Is Modifiertrue because If true this element negates the specified action. For example, instead of a request for a procedure, it is a request for the procedure to not occur.
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Requirements

        Captures intention to not do something that may have been previously typical.

        Meaning if MissingIf missing indicates that the described activity is one that should be engaged in when following the plan.
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        80. CarePlan.activity:extended
        Slice Nameextended
        Definition

        Detailed molecular tumor board recommendation using RequestGroup for structured multi-agent protocols and specific medication choices


        Identifies a planned action to occur as part of the plan. For example, a medication to be used, lab tests to perform, self-monitoring, education, etc.

        ShortExtended molecular tumor board recommendation with detailed protocolsAction to occur as part of plan
        Control0..*
        This element is affected by the following invariants: ele-1
        TypeBackboneElement
        Is Modifierfalse
        Requirements

        Allows systems to prompt for performance of planned activities, and validate plans against best practice.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        cpl-3: Provide a reference or detail, not both (detail.empty() or reference.empty())
        cpl-3: Provide a reference or detail, not both (detail.empty() or reference.empty())
        82. CarePlan.activity:extended.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())
        84. CarePlan.activity:extended.progress
        Definition

        Notes about the adherence/status/progress of the activity.

        ShortProgress notes for recommendation implementationComments about the activity status/progress
        Comments

        This element should NOT be used to describe the activity to be performed - that occurs either within the resource pointed to by activity.detail.reference or in activity.detail.description.

        Control0..*
        This element is affected by the following invariants: ele-1
        TypeAnnotation
        Is Modifierfalse
        Must Supporttrue
        Requirements

        Can be used to capture information about adherence, progress, concerns, etc.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        86. CarePlan.activity:extended.reference
        Definition

        Reference to detailed therapy recommendations: RequestGroup for complex multi-agent protocols, MedicationRequest for specific medication orders, or ServiceRequest for therapy referrals (surgery, radiation, etc.)


        The details of the proposed activity represented in a specific resource.

        ShortDetailed therapy recommendation - RequestGroup, MedicationRequest, or ServiceRequestActivity details defined in specific resource
        Comments

        Standard extension exists (resource-pertainsToGoal) that allows goals to be referenced from any of the referenced resources in CarePlan.activity.reference.
        The goal should be visible when the resource referenced by CarePlan.activity.reference is viewed independently from the CarePlan. Requests that are pointed to by a CarePlan using this element should not point to this CarePlan using the "basedOn" element. i.e. Requests that are part of a CarePlan are not "based on" the CarePlan.

        Control10..1
        This element is affected by the following invariants: ele-1, cpl-3
        TypeReference(MII PR Onkologie Therapieempfehlung Kombinationstherapie, MedicationRequest, ServiceRequest, Appointment, CommunicationRequest, DeviceRequest, MedicationRequest, NutritionOrder, Task, ServiceRequest, VisionPrescription, RequestGroup)
        Is Modifierfalse
        Must Supporttrue
        Must Support TypesNo must-support rules about the choice of types/profiles
        Requirements

        Details in a form consistent with other applications and contexts of use.

        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')))
        88. CarePlan.activity:extended.detail
        Definition

        A simple summary of a planned activity suitable for a general care plan system (e.g. form driven) that doesn't know about specific resources such as procedure etc.

        ShortIn-line definition of activity
        Control0..01
        This element is affected by the following invariants: ele-1, cpl-3
        TypeBackboneElement
        Is Modifierfalse
        Requirements

        Details in a simple form for generic care plan systems.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        93. CarePlan.activity:extended/Therapieempfehlung
        Slice Nameextended/Therapieempfehlung
        Definition

        Therapieempfehlung für eine medikamentöse Systemische Therapie


        Identifies a planned action to occur as part of the plan. For example, a medication to be used, lab tests to perform, self-monitoring, education, etc.

        ShortTherapieempfehlung Systemische TherapieAction to occur as part of plan
        Control0..*
        This element is affected by the following invariants: ele-1
        TypeBackboneElement
        Is Modifierfalse
        Must Supporttrue
        Requirements

        Allows systems to prompt for performance of planned activities, and validate plans against best practice.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        cpl-3: Provide a reference or detail, not both (detail.empty() or reference.empty())
        cpl-3: Provide a reference or detail, not both (detail.empty() or reference.empty())
        95. CarePlan.activity:extended/Therapieempfehlung.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())
        97. CarePlan.activity:extended/Therapieempfehlung.reference
        Definition

        The details of the proposed activity represented in a specific resource.

        ShortActivity details defined in specific resource
        Comments

        Standard extension exists (resource-pertainsToGoal) that allows goals to be referenced from any of the referenced resources in CarePlan.activity.reference.
        The goal should be visible when the resource referenced by CarePlan.activity.reference is viewed independently from the CarePlan. Requests that are pointed to by a CarePlan using this element should not point to this CarePlan using the "basedOn" element. i.e. Requests that are part of a CarePlan are not "based on" the CarePlan.

        Control10..1
        This element is affected by the following invariants: ele-1, cpl-3
        TypeReference(MII PR MTB Therapieempfehlung Systemische Therapie, MII PR MTB Therapieempfehlung Kombinationstherapie, MedicationRequest, RequestGroup, Appointment, CommunicationRequest, DeviceRequest, MedicationRequest, NutritionOrder, Task, ServiceRequest, VisionPrescription, RequestGroup)
        Is Modifierfalse
        Must Supporttrue
        Must Support TypesNo must-support rules about the choice of types/profiles
        Requirements

        Details in a form consistent with other applications and contexts of use.

        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')))
        99. CarePlan.activity:extended/Therapieempfehlung.detail
        Definition

        A simple summary of a planned activity suitable for a general care plan system (e.g. form driven) that doesn't know about specific resources such as procedure etc.

        ShortIn-line definition of activity
        Control0..01
        This element is affected by the following invariants: ele-1, cpl-3
        TypeBackboneElement
        Is Modifierfalse
        Requirements

        Details in a simple form for generic care plan systems.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        104. CarePlan.activity:extended/HumangenetischeBeratung
        Slice Nameextended/HumangenetischeBeratung
        Definition

        Auftrag zur erneuten Human-genetischen Beratung


        Identifies a planned action to occur as part of the plan. For example, a medication to be used, lab tests to perform, self-monitoring, education, etc.

        ShortEmpfehlung Human-genetische BeratungAction to occur as part of plan
        Control0..1*
        This element is affected by the following invariants: ele-1
        TypeBackboneElement
        Is Modifierfalse
        Must Supporttrue
        Requirements

        Allows systems to prompt for performance of planned activities, and validate plans against best practice.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        cpl-3: Provide a reference or detail, not both (detail.empty() or reference.empty())
        cpl-3: Provide a reference or detail, not both (detail.empty() or reference.empty())
        106. CarePlan.activity:extended/HumangenetischeBeratung.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())
        108. CarePlan.activity:extended/HumangenetischeBeratung.reference
        Definition

        The details of the proposed activity represented in a specific resource.

        ShortActivity details defined in specific resource
        Comments

        Standard extension exists (resource-pertainsToGoal) that allows goals to be referenced from any of the referenced resources in CarePlan.activity.reference.
        The goal should be visible when the resource referenced by CarePlan.activity.reference is viewed independently from the CarePlan. Requests that are pointed to by a CarePlan using this element should not point to this CarePlan using the "basedOn" element. i.e. Requests that are part of a CarePlan are not "based on" the CarePlan.

        Control10..1
        This element is affected by the following invariants: ele-1, cpl-3
        TypeReference(MII PR MTB Human-genetische Beratung Auftrag, Appointment, CommunicationRequest, DeviceRequest, MedicationRequest, NutritionOrder, Task, ServiceRequest, VisionPrescription, RequestGroup)
        Is Modifierfalse
        Must Supporttrue
        Requirements

        Details in a form consistent with other applications and contexts of use.

        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')))
        110. CarePlan.activity:extended/HumangenetischeBeratung.detail
        Definition

        A simple summary of a planned activity suitable for a general care plan system (e.g. form driven) that doesn't know about specific resources such as procedure etc.

        ShortIn-line definition of activity
        Control0..01
        This element is affected by the following invariants: ele-1, cpl-3
        TypeBackboneElement
        Is Modifierfalse
        Requirements

        Details in a simple form for generic care plan systems.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        115. CarePlan.activity:extended/HistologieEvaluation
        Slice Nameextended/HistologieEvaluation
        Definition

        Auftrag zur erneuten Histologie-Evaluation


        Identifies a planned action to occur as part of the plan. For example, a medication to be used, lab tests to perform, self-monitoring, education, etc.

        ShortEmpfehlung Histologie-EvaluationAction to occur as part of plan
        Control0..1*
        This element is affected by the following invariants: ele-1
        TypeBackboneElement
        Is Modifierfalse
        Must Supporttrue
        Requirements

        Allows systems to prompt for performance of planned activities, and validate plans against best practice.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        cpl-3: Provide a reference or detail, not both (detail.empty() or reference.empty())
        cpl-3: Provide a reference or detail, not both (detail.empty() or reference.empty())
        117. CarePlan.activity:extended/HistologieEvaluation.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())
        119. CarePlan.activity:extended/HistologieEvaluation.reference
        Definition

        The details of the proposed activity represented in a specific resource.

        ShortActivity details defined in specific resource
        Comments

        Standard extension exists (resource-pertainsToGoal) that allows goals to be referenced from any of the referenced resources in CarePlan.activity.reference.
        The goal should be visible when the resource referenced by CarePlan.activity.reference is viewed independently from the CarePlan. Requests that are pointed to by a CarePlan using this element should not point to this CarePlan using the "basedOn" element. i.e. Requests that are part of a CarePlan are not "based on" the CarePlan.

        Control10..1
        This element is affected by the following invariants: ele-1, cpl-3
        TypeReference(MII PR MTB Histologie-Evaluation Auftrag, Appointment, CommunicationRequest, DeviceRequest, MedicationRequest, NutritionOrder, Task, ServiceRequest, VisionPrescription, RequestGroup)
        Is Modifierfalse
        Must Supporttrue
        Requirements

        Details in a form consistent with other applications and contexts of use.

        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')))
        121. CarePlan.activity:extended/HistologieEvaluation.detail
        Definition

        A simple summary of a planned activity suitable for a general care plan system (e.g. form driven) that doesn't know about specific resources such as procedure etc.

        ShortIn-line definition of activity
        Control0..01
        This element is affected by the following invariants: ele-1, cpl-3
        TypeBackboneElement
        Is Modifierfalse
        Requirements

        Details in a simple form for generic care plan systems.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        126. CarePlan.activity:extended/Biopsie
        Slice Nameextended/Biopsie
        Definition

        Auftrag zur erneuten Biopsie


        Identifies a planned action to occur as part of the plan. For example, a medication to be used, lab tests to perform, self-monitoring, education, etc.

        ShortEmpfehlung BiopsieAction to occur as part of plan
        Control0..*
        This element is affected by the following invariants: ele-1
        TypeBackboneElement
        Is Modifierfalse
        Must Supporttrue
        Requirements

        Allows systems to prompt for performance of planned activities, and validate plans against best practice.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        cpl-3: Provide a reference or detail, not both (detail.empty() or reference.empty())
        cpl-3: Provide a reference or detail, not both (detail.empty() or reference.empty())
        128. CarePlan.activity:extended/Biopsie.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())
        130. CarePlan.activity:extended/Biopsie.reference
        Definition

        The details of the proposed activity represented in a specific resource.

        ShortActivity details defined in specific resource
        Comments

        Standard extension exists (resource-pertainsToGoal) that allows goals to be referenced from any of the referenced resources in CarePlan.activity.reference.
        The goal should be visible when the resource referenced by CarePlan.activity.reference is viewed independently from the CarePlan. Requests that are pointed to by a CarePlan using this element should not point to this CarePlan using the "basedOn" element. i.e. Requests that are part of a CarePlan are not "based on" the CarePlan.

        Control10..1
        This element is affected by the following invariants: ele-1, cpl-3
        TypeReference(MII PR MTB Biopsie Auftrag, Appointment, CommunicationRequest, DeviceRequest, MedicationRequest, NutritionOrder, Task, ServiceRequest, VisionPrescription, RequestGroup)
        Is Modifierfalse
        Must Supporttrue
        Requirements

        Details in a form consistent with other applications and contexts of use.

        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')))
        132. CarePlan.activity:extended/Biopsie.detail
        Definition

        A simple summary of a planned activity suitable for a general care plan system (e.g. form driven) that doesn't know about specific resources such as procedure etc.

        ShortIn-line definition of activity
        Control0..01
        This element is affected by the following invariants: ele-1, cpl-3
        TypeBackboneElement
        Is Modifierfalse
        Requirements

        Details in a simple form for generic care plan systems.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        137. CarePlan.activity:extended/Studieneinschlussempfehlung
        Slice Nameextended/Studieneinschlussempfehlung
        Definition

        Anfrage zum Studieneinschluss


        Identifies a planned action to occur as part of the plan. For example, a medication to be used, lab tests to perform, self-monitoring, education, etc.

        ShortStudieneinschlussempfehlungAction to occur as part of plan
        Control0..*
        This element is affected by the following invariants: ele-1
        TypeBackboneElement
        Is Modifierfalse
        Must Supporttrue
        Requirements

        Allows systems to prompt for performance of planned activities, and validate plans against best practice.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        cpl-3: Provide a reference or detail, not both (detail.empty() or reference.empty())
        cpl-3: Provide a reference or detail, not both (detail.empty() or reference.empty())
        139. CarePlan.activity:extended/Studieneinschlussempfehlung.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())
        141. CarePlan.activity:extended/Studieneinschlussempfehlung.reference
        Definition

        The details of the proposed activity represented in a specific resource.

        ShortActivity details defined in specific resource
        Comments

        Standard extension exists (resource-pertainsToGoal) that allows goals to be referenced from any of the referenced resources in CarePlan.activity.reference.
        The goal should be visible when the resource referenced by CarePlan.activity.reference is viewed independently from the CarePlan. Requests that are pointed to by a CarePlan using this element should not point to this CarePlan using the "basedOn" element. i.e. Requests that are part of a CarePlan are not "based on" the CarePlan.

        Control10..1
        This element is affected by the following invariants: ele-1, cpl-3
        TypeReference(MII PR MTB Studieneinschluss Anfrage, Appointment, CommunicationRequest, DeviceRequest, MedicationRequest, NutritionOrder, Task, ServiceRequest, VisionPrescription, RequestGroup)
        Is Modifierfalse
        Must Supporttrue
        Requirements

        Details in a form consistent with other applications and contexts of use.

        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')))
        143. CarePlan.activity:extended/Studieneinschlussempfehlung.detail
        Definition

        A simple summary of a planned activity suitable for a general care plan system (e.g. form driven) that doesn't know about specific resources such as procedure etc.

        ShortIn-line definition of activity
        Control0..01
        This element is affected by the following invariants: ele-1, cpl-3
        TypeBackboneElement
        Is Modifierfalse
        Requirements

        Details in a simple form for generic care plan systems.

        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. CarePlan
        2. CarePlan.meta
        Must Supporttrue
        4. CarePlan.status
        Definition

        Status der Umsetzung des beschlossenen Therapieplans

        Comments
        active: Empfehlung bzw. Therapieoption in Umsetzung (Regelfall),
        revoked: Molekularer Tumorboard-Fall ist abgeschlossen,
        completed: Alle Empfehlungen bzw. Therapieoptionen ausgeschöpft oder Patient verstorben
        
        6. CarePlan.description
        Definition

        Protokollauszug aus dem Beschluss des Molekularen Tumorboards

        ShortProtokollauszug
        Must Supporttrue
        8. CarePlan.created
        Definition

        Erstellungsdatum des Therapieplans gemäß Beschluss des Molekularen Tumorboards

        ShortErstellungsdatum
        10. CarePlan.supportingInfo
        SlicingThis element introduces a set of slices on CarePlan.supportingInfo. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • type @ $this
        • 12. CarePlan.supportingInfo:Behandlungsepisode
          Slice NameBehandlungsepisode
          Definition

          Aktueller Krankheitszustand und bisherige Behandlungsmaßnahmen

          ShortBehandlungsepisode
          Control0..1
          TypeReference(MII PR MTB Behandlungsepisode, ClinicalImpression)
          Must Supporttrue
          Must Support TypesNo must-support rules about the choice of types/profiles
          14. CarePlan.activity:extended/Therapieempfehlung
          Slice Nameextended/Therapieempfehlung
          Definition

          Therapieempfehlung für eine medikamentöse Systemische Therapie

          ShortTherapieempfehlung Systemische Therapie
          Control0..*
          Must Supporttrue
          16. CarePlan.activity:extended/Therapieempfehlung.reference
          Control1..?
          TypeReference(MII PR MTB Therapieempfehlung Systemische Therapie, MII PR MTB Therapieempfehlung Kombinationstherapie, MedicationRequest, RequestGroup)
          Must Supporttrue
          Must Support TypesNo must-support rules about the choice of types/profiles
          18. CarePlan.activity:extended/Therapieempfehlung.detail
          Control0..0
          20. CarePlan.activity:extended/HumangenetischeBeratung
          Slice Nameextended/HumangenetischeBeratung
          Definition

          Auftrag zur erneuten Human-genetischen Beratung

          ShortEmpfehlung Human-genetische Beratung
          Control0..1
          Must Supporttrue
          22. CarePlan.activity:extended/HumangenetischeBeratung.reference
          Control1..?
          TypeReference(MII PR MTB Human-genetische Beratung Auftrag)
          Must Supporttrue
          24. CarePlan.activity:extended/HumangenetischeBeratung.detail
          Control0..0
          26. CarePlan.activity:extended/HistologieEvaluation
          Slice Nameextended/HistologieEvaluation
          Definition

          Auftrag zur erneuten Histologie-Evaluation

          ShortEmpfehlung Histologie-Evaluation
          Control0..1
          Must Supporttrue
          28. CarePlan.activity:extended/HistologieEvaluation.reference
          Control1..?
          TypeReference(MII PR MTB Histologie-Evaluation Auftrag)
          Must Supporttrue
          30. CarePlan.activity:extended/HistologieEvaluation.detail
          Control0..0
          32. CarePlan.activity:extended/Biopsie
          Slice Nameextended/Biopsie
          Definition

          Auftrag zur erneuten Biopsie

          ShortEmpfehlung Biopsie
          Control0..*
          Must Supporttrue
          34. CarePlan.activity:extended/Biopsie.reference
          Control1..?
          TypeReference(MII PR MTB Biopsie Auftrag)
          Must Supporttrue
          36. CarePlan.activity:extended/Biopsie.detail
          Control0..0
          38. CarePlan.activity:extended/Studieneinschlussempfehlung
          Slice Nameextended/Studieneinschlussempfehlung
          Definition

          Anfrage zum Studieneinschluss

          ShortStudieneinschlussempfehlung
          Control0..*
          Must Supporttrue
          40. CarePlan.activity:extended/Studieneinschlussempfehlung.reference
          Control1..?
          TypeReference(MII PR MTB Studieneinschluss Anfrage)
          Must Supporttrue
          42. CarePlan.activity:extended/Studieneinschlussempfehlung.detail
          Control0..0

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

          0. CarePlan
          Definition

          Describes the intention of how one or more practitioners intend to deliver care for a particular patient, group or community for a period of time, possibly limited to care for a specific condition or set of conditions.

          ShortHealthcare plan for patient or group
          Control0..*
          Alternate NamesCare Team
          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. CarePlan.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. CarePlan.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. CarePlan.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. CarePlan.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 CarePlan.meta.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 10. CarePlan.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. CarePlan.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. CarePlan.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. CarePlan.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. CarePlan.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. CarePlan.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. CarePlan.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. CarePlan.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. CarePlan.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. CarePlan.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. CarePlan.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 CarePlan.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 32. CarePlan.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 CarePlan.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 34. CarePlan.identifier
                Definition

                Business identifiers assigned to this care plan by the performer or other systems which remain constant as the resource is updated and propagates from server to server.

                ShortExternal Ids for this plan
                Comments

                This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

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

                Allows identification of the care plan 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()))
                36. CarePlan.instantiatesCanonical
                Definition

                The URL pointing to a FHIR-defined protocol, guideline, questionnaire or other definition that is adhered to in whole or in part by this CarePlan.

                ShortInstantiates FHIR protocol or definition
                Comments

                see Canonical References

                Control0..*
                This element is affected by the following invariants: ele-1
                Typecanonical(PlanDefinition, Questionnaire, Measure, ActivityDefinition, OperationDefinition)
                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()))
                38. CarePlan.instantiatesUri
                Definition

                The URL pointing to an externally maintained protocol, guideline, questionnaire or other definition that is adhered to in whole or in part by this CarePlan.

                ShortInstantiates external protocol or definition
                Comments

                This might be an HTML page, PDF, etc. or could just be a non-resolvable URI 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()))
                40. CarePlan.basedOn
                Definition

                A care plan that is fulfilled in whole or in part by this care plan.

                ShortFulfills CarePlan
                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(CarePlan)
                Summarytrue
                Requirements

                Allows tracing of the care plan 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')))
                42. CarePlan.replaces
                Definition

                Completed or terminated care plan whose function is taken by this new care plan.

                ShortCarePlan replaced by this CarePlan
                Comments

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

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

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

                Alternate Namessupersedes
                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')))
                44. CarePlan.partOf
                Definition

                A larger care plan of which this particular care plan is a component or step.

                ShortPart of referenced CarePlan
                Comments

                Each care plan is an independent request, such that having a care plan be part of another care plan can cause issues with cascading statuses. As such, this element is still being discussed.

                Control0..*
                This element is affected by the following invariants: ele-1
                TypeReference(CarePlan)
                Summarytrue
                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')))
                46. CarePlan.status
                Definition

                Status der Umsetzung des beschlossenen Therapieplans

                Comments
                active: Empfehlung bzw. Therapieoption in Umsetzung (Regelfall),
                revoked: Molekularer Tumorboard-Fall ist abgeschlossen,
                completed: Alle Empfehlungen bzw. Therapieoptionen ausgeschöpft oder 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)

                Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record.

                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
                Requirements

                Allows clinicians to determine whether the plan is actionable or not.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                48. CarePlan.intent
                Definition

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

                Shortproposal | plan | order | option
                Comments

                This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

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

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

                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.

                Pattern Valueplan
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                50. CarePlan.category
                Definition

                Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", "wellness plan", etc.

                ShortType of plan
                Comments

                There may be multiple axes of categorization and one plan may serve multiple purposes. In some cases, this may be redundant with references to CarePlan.concern.

                Control1..1
                This element is affected by the following invariants: ele-1
                BindingFor example codes, see CarePlanCategory
                (example to http://hl7.org/fhir/ValueSet/care-plan-category)

                Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc.

                TypeCodeableConcept
                Must Supporttrue
                Summarytrue
                Requirements

                Used for filtering what plan(s) are retrieved and displayed to different types of users.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                52. CarePlan.category.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.
                54. CarePlan.category.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 CarePlan.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 56. CarePlan.category.coding
                  Definition

                  Art der Tumorkonferenz / Therapieplanung gemäß 18.2 oBDS 2021.

                  ShortArt der Tumorkonferenz / Therapieplanung
                  Comments

                  Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                  Control1..*
                  This element is affected by the following invariants: ele-1
                  BindingThe codes SHALL be taken from MII VS Onkologie Therapieplanung Typ
                  (required to https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/ValueSet/mii-vs-onko-therapieplanung-typ)
                  TypeCoding
                  Must Supporttrue
                  Summarytrue
                  Requirements

                  Allows for alternative encodings within a code system, and translations to other code systems.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  58. CarePlan.category.coding.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.
                  60. CarePlan.category.coding.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 CarePlan.category.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 62. CarePlan.category.coding.system
                    Definition

                    The identification of the code system that defines the meaning of the symbol in the code.

                    ShortIdentity of the terminology system
                    Comments

                    The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                    Control1..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
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    Need to be unambiguous about the source of the definition of the symbol.

                    Pattern Valuehttps://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapieplanung-typ
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    64. CarePlan.category.coding.version
                    Definition

                    The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                    ShortVersion of the system - if relevant
                    Comments

                    Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                    NoteThis is a business version Id, not a resource version Id (see discussion)
                    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()))
                    66. CarePlan.category.coding.code
                    Definition

                    A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                    ShortSymbol in syntax defined by the system
                    Comments

                    Note that FHIR strings SHALL NOT exceed 1MB in size

                    Control1..1
                    This element is affected by the following invariants: ele-1
                    Typecode
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    Need to refer to a particular code in the system.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    68. CarePlan.category.coding.display
                    Definition

                    A representation of the meaning of the code in the system, following the rules of the system.

                    ShortRepresentation defined by the 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
                    Requirements

                    Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    70. CarePlan.category.coding.userSelected
                    Definition

                    Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                    ShortIf this coding was chosen directly by the user
                    Comments

                    Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    Typeboolean
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    72. CarePlan.category.text
                    Definition

                    A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                    ShortPlain text representation of the concept
                    Comments

                    Very often the text is the same as a displayName of one of the codings.

                    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
                    Requirements

                    The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    74. CarePlan.title
                    Definition

                    Human-friendly name for the care plan.

                    ShortHuman-friendly name for the care plan
                    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()))
                    76. CarePlan.description
                    Definition

                    Protokollauszug aus dem Beschluss des Molekularen Tumorboards

                    ShortProtokollauszug
                    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
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    Provides more detail than conveyed by category.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    78. CarePlan.subject
                    Definition

                    Identifies the patient or group whose intended care is described by the plan.

                    ShortWho the care plan is for
                    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
                    Summarytrue
                    Alternate Namespatient
                    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')))
                    80. CarePlan.encounter
                    Definition

                    The Encounter during which this CarePlan was created or to which the creation of this record is tightly associated.

                    ShortEncounter created as part of
                    Comments

                    This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. CarePlan activities conducted as a result of the care plan may well occur as part of other encounters.

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeReference(Encounter)
                    Must Supporttrue
                    Summarytrue
                    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')))
                    82. CarePlan.period
                    Definition

                    Indicates when the plan did (or is intended to) come into effect and end.

                    ShortTime period plan covers
                    Comments

                    Any activities scheduled as part of the plan should be constrained to the specified period regardless of whether the activities are planned within a single encounter/episode or across multiple encounters/episodes (e.g. the longitudinal management of a chronic condition).

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

                    Allows tracking what plan(s) are in effect at a particular time.

                    Alternate Namestiming
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
                    84. CarePlan.created
                    Definition

                    Erstellungsdatum des Therapieplans gemäß Beschluss des Molekularen Tumorboards

                    ShortErstellungsdatum
                    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
                    Summarytrue
                    Alternate NamesauthoredOn
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    86. CarePlan.author
                    Definition

                    When populated, the author is responsible for the care plan. The care plan is attributed to the author.

                    ShortWho is the designated responsible party
                    Comments

                    The author may also be a contributor. For example, an organization can be an author, but not listed as a contributor.

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeReference(Patient, Practitioner, PractitionerRole, Device, RelatedPerson, Organization, CareTeam)
                    Summarytrue
                    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')))
                    88. CarePlan.contributor
                    Definition

                    Identifies the individual(s) or organization who provided the contents of the care plan.

                    ShortWho provided the content of the care plan
                    Comments

                    Collaborative care plans may have multiple contributors.

                    Control0..*
                    This element is affected by the following invariants: ele-1
                    TypeReference(Patient, Practitioner, PractitionerRole, Device, RelatedPerson, Organization, CareTeam)
                    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')))
                    90. CarePlan.careTeam
                    Definition

                    Identifies all people and organizations who are expected to be involved in the care envisioned by this plan.

                    ShortWho's involved in plan?
                    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(CareTeam)
                    Requirements

                    Allows representation of care teams, helps scope care plan. In some cases may be a determiner of access permissions.

                    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')))
                    92. CarePlan.addresses
                    Definition

                    Identifies the conditions/problems/concerns/diagnoses/etc. whose management and/or mitigation are handled by this plan.

                    ShortHealth issues this plan addresses
                    Comments

                    When the diagnosis is related to an allergy or intolerance, the Condition and AllergyIntolerance resources can both be used. However, to be actionable for decision support, using Condition alone is not sufficient as the allergy or intolerance condition needs to be represented as an AllergyIntolerance.

                    Control0..*
                    This element is affected by the following invariants: ele-1
                    TypeReference(MII PR Onkologie Diagnose Primärtumor)
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    Links plan to the conditions it manages. The element can identify risks addressed by the plan as well as active conditions. (The Condition resource can include things like "at risk for hypertension" or "fall risk".) Also scopes plans - multiple plans may exist addressing different concerns.

                    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')))
                    94. CarePlan.supportingInfo
                    Definition

                    Identifies portions of the patient's record that specifically influenced the formation of the plan. These might include comorbidities, recent procedures, limitations, recent assessments, etc.

                    ShortInformation considered as part of plan
                    Comments

                    Use "concern" to identify specific conditions addressed by the care plan.

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

                    Identifies barriers and other considerations associated with the care plan.

                    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')))
                    SlicingThis element introduces a set of slices on CarePlan.supportingInfo. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • type @ $this
                    • 96. CarePlan.supportingInfo:Behandlungsepisode
                      Slice NameBehandlungsepisode
                      Definition

                      Aktueller Krankheitszustand und bisherige Behandlungsmaßnahmen

                      ShortBehandlungsepisode
                      Comments

                      Use "concern" to identify specific conditions addressed by the care plan.

                      Control0..1
                      This element is affected by the following invariants: ele-1
                      TypeReference(MII PR MTB Behandlungsepisode, ClinicalImpression)
                      Must Supporttrue
                      Must Support TypesNo must-support rules about the choice of types/profiles
                      Requirements

                      Identifies barriers and other considerations associated with the care plan.

                      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')))
                      98. CarePlan.goal
                      Definition

                      Describes the intended objective(s) of carrying out the care plan.

                      ShortDesired outcome of plan
                      Comments

                      Goal can be achieving a particular change or merely maintaining a current state or even slowing a decline.

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

                      Provides context for plan. Allows plan effectiveness to be evaluated by clinicians.

                      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')))
                      100. CarePlan.activity
                      Definition

                      Identifies a planned action to occur as part of the plan. For example, a medication to be used, lab tests to perform, self-monitoring, education, etc.

                      ShortTherapy recommendations - either oBDS standard categorization or extended molecular protocols
                      Control0..*
                      This element is affected by the following invariants: ele-1
                      TypeBackboneElement
                      Must Supporttrue
                      Requirements

                      Allows systems to prompt for performance of planned activities, and validate plans against best practice.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      cpl-3: Provide a reference or detail, not both (detail.empty() or reference.empty())
                      SlicingThis element introduces a set of slices on CarePlan.activity. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • exists @ detail
                      • profile @ reference.resolve()
                      • 102. CarePlan.activity.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.
                        104. CarePlan.activity.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 CarePlan.activity.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 106. CarePlan.activity.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())
                          108. CarePlan.activity.outcomeCodeableConcept
                          Definition

                          Identifies the outcome at the point when the status of the activity is assessed. For example, the outcome of an education activity could be patient understands (or not).

                          ShortResults of the activity
                          Comments

                          Note that this should not duplicate the activity status (e.g. completed or in progress).

                          Control0..*
                          This element is affected by the following invariants: ele-1
                          BindingFor example codes, see CarePlanActivityOutcome
                          (example to http://hl7.org/fhir/ValueSet/care-plan-activity-outcome)

                          Identifies the results of the activity.

                          TypeCodeableConcept
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          110. CarePlan.activity.outcomeReference
                          Definition

                          Details of the outcome or action resulting from the activity. The reference to an "event" resource, such as Procedure or Encounter or Observation, is the result/outcome of the activity itself. The activity can be conveyed using CarePlan.activity.detail OR using the CarePlan.activity.reference (a reference to a “request” resource).

                          ShortAppointment, Encounter, Procedure, etc.
                          Comments

                          The activity outcome is independent of the outcome of the related goal(s). For example, if the goal is to achieve a target body weight of 150 lbs and an activity is defined to diet, then the activity outcome could be calories consumed whereas the goal outcome is an observation for the actual body weight measured.

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

                          Links plan to resulting actions.

                          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')))
                          112. CarePlan.activity.progress
                          Definition

                          Notes about the adherence/status/progress of the activity.

                          ShortComments about the activity status/progress
                          Comments

                          This element should NOT be used to describe the activity to be performed - that occurs either within the resource pointed to by activity.detail.reference or in activity.detail.description.

                          Control0..*
                          This element is affected by the following invariants: ele-1
                          TypeAnnotation
                          Requirements

                          Can be used to capture information about adherence, progress, concerns, etc.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          114. CarePlan.activity.reference
                          Definition

                          The details of the proposed activity represented in a specific resource.

                          ShortActivity details defined in specific resource
                          Comments

                          Standard extension exists (resource-pertainsToGoal) that allows goals to be referenced from any of the referenced resources in CarePlan.activity.reference.
                          The goal should be visible when the resource referenced by CarePlan.activity.reference is viewed independently from the CarePlan. Requests that are pointed to by a CarePlan using this element should not point to this CarePlan using the "basedOn" element. i.e. Requests that are part of a CarePlan are not "based on" the CarePlan.

                          Control0..1
                          This element is affected by the following invariants: ele-1, cpl-3
                          TypeReference(Appointment, CommunicationRequest, DeviceRequest, MedicationRequest, NutritionOrder, Task, ServiceRequest, VisionPrescription, RequestGroup)
                          Requirements

                          Details in a form consistent with other applications and contexts of use.

                          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')))
                          116. CarePlan.activity.detail
                          Definition

                          A simple summary of a planned activity suitable for a general care plan system (e.g. form driven) that doesn't know about specific resources such as procedure etc.

                          ShortIn-line definition of activity
                          Control0..1
                          This element is affected by the following invariants: ele-1, cpl-3
                          TypeBackboneElement
                          Requirements

                          Details in a simple form for generic care plan systems.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          118. CarePlan.activity.detail.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.
                          120. CarePlan.activity.detail.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 CarePlan.activity.detail.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 122. CarePlan.activity.detail.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())
                            124. CarePlan.activity.detail.kind
                            Definition

                            A description of the kind of resource the in-line definition of a care plan activity is representing. The CarePlan.activity.detail is an in-line definition when a resource is not referenced using CarePlan.activity.reference. For example, a MedicationRequest, a ServiceRequest, or a CommunicationRequest.

                            ShortAppointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | Task | ServiceRequest | VisionPrescription
                            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 CarePlanActivityKind
                            (required to http://hl7.org/fhir/ValueSet/care-plan-activity-kind|4.0.1)

                            Resource types defined as part of FHIR that can be represented as in-line definitions of a care plan activity.

                            Typecode
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Requirements

                            May determine what types of extensions are permitted.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            126. CarePlan.activity.detail.instantiatesCanonical
                            Definition

                            The URL pointing to a FHIR-defined protocol, guideline, questionnaire or other definition that is adhered to in whole or in part by this CarePlan activity.

                            ShortInstantiates FHIR protocol or definition
                            Comments

                            see Canonical References

                            Control0..*
                            This element is affected by the following invariants: ele-1
                            Typecanonical(PlanDefinition, ActivityDefinition, Questionnaire, Measure, OperationDefinition)
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Requirements

                            Allows Questionnaires that the patient (or practitioner) should fill in to fulfill the care plan activity.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            128. CarePlan.activity.detail.instantiatesUri
                            Definition

                            The URL pointing to an externally maintained protocol, guideline, questionnaire or other definition that is adhered to in whole or in part by this CarePlan activity.

                            ShortInstantiates external protocol or definition
                            Comments

                            This might be an HTML page, PDF, etc. or could just be a non-resolvable URI 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
                            Requirements

                            Allows Questionnaires that the patient (or practitioner) should fill in to fulfill the care plan activity.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            130. CarePlan.activity.detail.code
                            Definition

                            Detailed description of the type of planned activity; e.g. what lab test, what procedure, what kind of encounter.

                            ShortDetail type of activity
                            Comments

                            Tends to be less relevant for activities involving particular products. Codes should not convey negation - use "prohibited" instead.

                            Control0..1
                            This element is affected by the following invariants: ele-1
                            BindingFor example codes, see ProcedureCodes(SNOMEDCT)
                            (example to http://hl7.org/fhir/ValueSet/procedure-code)

                            Detailed description of the type of activity; e.g. What lab test, what procedure, what kind of encounter.

                            TypeCodeableConcept
                            Requirements

                            Allows matching performed to planned as well as validation against protocols.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            132. CarePlan.activity.detail.reasonCode
                            Definition

                            Provides the rationale that drove the inclusion of this particular activity as part of the plan or the reason why the activity was prohibited.

                            ShortWhy activity should be done or why activity was prohibited
                            Comments

                            This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonCondition instead.

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

                            Identifies why a care plan activity is needed. Can include any health condition codes as well as such concepts as "general wellness", prophylaxis, surgical preparation, etc.

                            TypeCodeableConcept
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            134. CarePlan.activity.detail.reasonReference
                            Definition

                            Indicates another resource, such as the health condition(s), whose existence justifies this request and drove the inclusion of this particular activity as part of the plan.

                            ShortWhy activity is needed
                            Comments

                            Conditions can be identified at the activity level that are not identified as reasons for the overall plan.

                            Control0..*
                            This element is affected by the following invariants: ele-1
                            TypeReference(Condition, Observation, DiagnosticReport, DocumentReference)
                            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')))
                            136. CarePlan.activity.detail.goal
                            Definition

                            Internal reference that identifies the goals that this activity is intended to contribute towards meeting.

                            ShortGoals this activity relates to
                            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(Goal)
                            Requirements

                            So that participants know the link explicitly.

                            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')))
                            138. CarePlan.activity.detail.status
                            Definition

                            Identifies what progress is being made for the specific activity.

                            Shortnot-started | scheduled | in-progress | on-hold | completed | cancelled | stopped | unknown | entered-in-error
                            Comments

                            Some aspects of status can be inferred based on the resources linked in actionTaken. Note that "status" is only as current as the plan was most recently updated.
                            The unknown code is not to be used to convey other statuses. The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the activity.

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

                            Codes that reflect the current state of a care plan activity within its overall life cycle.

                            Typecode
                            Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the activity should not be treated as valid
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Requirements

                            Indicates progress against the plan, whether the activity is still relevant for the plan.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            140. CarePlan.activity.detail.statusReason
                            Definition

                            Provides reason why the activity isn't yet started, is on hold, was cancelled, etc.

                            ShortReason for current status
                            Comments

                            Will generally not be present if status is "complete". Be sure to prompt to update this (or at least remove the existing value) if the status is changed.

                            Control0..1
                            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()))
                            142. CarePlan.activity.detail.doNotPerform
                            Definition

                            If true, indicates that the described activity is one that must NOT be engaged in when following the plan. If false, or missing, indicates that the described activity is one that should be engaged in when following the plan.

                            ShortIf true, activity is prohibiting action
                            Comments

                            This element is labeled as a modifier because it marks an activity as an activity that is not to be performed.

                            Control0..1
                            This element is affected by the following invariants: ele-1
                            Typeboolean
                            Is Modifiertrue because If true this element negates the specified action. For example, instead of a request for a procedure, it is a request for the procedure to not occur.
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Requirements

                            Captures intention to not do something that may have been previously typical.

                            Meaning if MissingIf missing indicates that the described activity is one that should be engaged in when following the plan.
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            144. CarePlan.activity.detail.scheduled[x]
                            Definition

                            The period, timing or frequency upon which the described activity is to occur.

                            ShortWhen activity is to occur
                            Control0..1
                            This element is affected by the following invariants: ele-1
                            TypeChoice of: Timing, Period, string
                            [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
                            Requirements

                            Allows prompting for activities and detection of missed planned activities.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            146. CarePlan.activity.detail.location
                            Definition

                            Identifies the facility where the activity will occur; e.g. home, hospital, specific clinic, etc.

                            ShortWhere it should happen
                            Comments

                            May reference a specific clinical location or may identify a type of location.

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

                            Helps in planning of activity.

                            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')))
                            148. CarePlan.activity.detail.performer
                            Definition

                            Identifies who's expected to be involved in the activity.

                            ShortWho will be responsible?
                            Comments

                            A performer MAY also be a participant in the care plan.

                            Control0..*
                            This element is affected by the following invariants: ele-1
                            TypeReference(Practitioner, PractitionerRole, Organization, RelatedPerson, Patient, CareTeam, HealthcareService, Device)
                            Requirements

                            Helps in planning of activity.

                            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')))
                            150. CarePlan.activity.detail.product[x]
                            Definition

                            Identifies the food, drug or other product to be consumed or supplied in the activity.

                            ShortWhat is to be administered/supplied
                            Control0..1
                            This element is affected by the following invariants: ele-1
                            BindingFor example codes, see SNOMEDCTMedicationCodes
                            (example to http://hl7.org/fhir/ValueSet/medication-codes)

                            A product supplied or administered as part of a care plan activity.

                            TypeChoice of: CodeableConcept, Reference(Medication, Substance)
                            [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()))
                            152. CarePlan.activity.detail.dailyAmount
                            Definition

                            Identifies the quantity expected to be consumed in a given day.

                            ShortHow to consume/day?
                            Comments

                            The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                            Control0..1
                            This element is affected by the following invariants: ele-1
                            TypeQuantity(SimpleQuantity)
                            Is Modifierfalse
                            Requirements

                            Allows rough dose checking.

                            Alternate Namesdaily dose
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                            sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
                            154. CarePlan.activity.detail.quantity
                            Definition

                            Identifies the quantity expected to be supplied, administered or consumed by the subject.

                            ShortHow much to administer/supply/consume
                            Comments

                            The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                            Control0..1
                            This element is affected by the following invariants: ele-1
                            TypeQuantity(SimpleQuantity)
                            Is Modifierfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                            sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
                            156. CarePlan.activity.detail.description
                            Definition

                            This provides a textual description of constraints on the intended activity occurrence, including relation to other activities. It may also include objectives, pre-conditions and end-conditions. Finally, it may convey specifics about the activity such as body site, method, route, etc.

                            ShortExtra info describing activity to perform
                            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()))
                            158. CarePlan.activity:obds
                            Slice Nameobds
                            Definition

                            Standard tumor board recommendation using oBDS 19.1 therapy type categorization

                            ShortStandard oBDS therapy recommendation with category only
                            Control0..*
                            This element is affected by the following invariants: ele-1
                            TypeBackboneElement
                            Requirements

                            Allows systems to prompt for performance of planned activities, and validate plans against best practice.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            cpl-3: Provide a reference or detail, not both (detail.empty() or reference.empty())
                            160. CarePlan.activity:obds.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.
                            162. CarePlan.activity:obds.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 CarePlan.activity.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 164. CarePlan.activity:obds.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())
                              166. CarePlan.activity:obds.outcomeCodeableConcept
                              Definition

                              Identifies the outcome at the point when the status of the activity is assessed. For example, the outcome of an education activity could be patient understands (or not).

                              ShortResults of the activity
                              Comments

                              Note that this should not duplicate the activity status (e.g. completed or in progress).

                              Control0..*
                              This element is affected by the following invariants: ele-1
                              BindingFor example codes, see CarePlanActivityOutcome
                              (example to http://hl7.org/fhir/ValueSet/care-plan-activity-outcome)

                              Identifies the results of the activity.

                              TypeCodeableConcept
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              168. CarePlan.activity:obds.outcomeReference
                              Definition

                              Details of the outcome or action resulting from the activity. The reference to an "event" resource, such as Procedure or Encounter or Observation, is the result/outcome of the activity itself. The activity can be conveyed using CarePlan.activity.detail OR using the CarePlan.activity.reference (a reference to a “request” resource).

                              ShortAppointment, Encounter, Procedure, etc.
                              Comments

                              The activity outcome is independent of the outcome of the related goal(s). For example, if the goal is to achieve a target body weight of 150 lbs and an activity is defined to diet, then the activity outcome could be calories consumed whereas the goal outcome is an observation for the actual body weight measured.

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

                              Links plan to resulting actions.

                              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')))
                              170. CarePlan.activity:obds.progress
                              Definition

                              Notes about the adherence/status/progress of the activity.

                              ShortComments about the activity status/progress
                              Comments

                              This element should NOT be used to describe the activity to be performed - that occurs either within the resource pointed to by activity.detail.reference or in activity.detail.description.

                              Control0..*
                              This element is affected by the following invariants: ele-1
                              TypeAnnotation
                              Requirements

                              Can be used to capture information about adherence, progress, concerns, etc.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              172. CarePlan.activity:obds.reference
                              Definition

                              The details of the proposed activity represented in a specific resource.

                              ShortActivity details defined in specific resource
                              Comments

                              Standard extension exists (resource-pertainsToGoal) that allows goals to be referenced from any of the referenced resources in CarePlan.activity.reference.
                              The goal should be visible when the resource referenced by CarePlan.activity.reference is viewed independently from the CarePlan. Requests that are pointed to by a CarePlan using this element should not point to this CarePlan using the "basedOn" element. i.e. Requests that are part of a CarePlan are not "based on" the CarePlan.

                              Control0..0
                              This element is affected by the following invariants: ele-1, cpl-3
                              TypeReference(Appointment, CommunicationRequest, DeviceRequest, MedicationRequest, NutritionOrder, Task, ServiceRequest, VisionPrescription, RequestGroup)
                              Requirements

                              Details in a form consistent with other applications and contexts of use.

                              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')))
                              174. CarePlan.activity:obds.detail
                              Definition

                              A simple summary of a planned activity suitable for a general care plan system (e.g. form driven) that doesn't know about specific resources such as procedure etc.

                              ShortIn-line definition of activity
                              Control1..1
                              This element is affected by the following invariants: ele-1, cpl-3
                              TypeBackboneElement
                              Must Supporttrue
                              Requirements

                              Details in a simple form for generic care plan systems.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              tumorkonferenz-empfehlung-entscheidung-patient: Therapieabweichung aufgrund Patientenwunsch: Bei nichtangetretener oder abgebrochener Therapie ist anzugeben, ob dies dem Patientenwunsch entspricht oder ggfs. andere Gründe hat (status = 'cancelled' or status = 'stopped' implies statusReason.exists())
                              176. CarePlan.activity:obds.detail.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.
                              178. CarePlan.activity:obds.detail.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 CarePlan.activity.detail.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 180. CarePlan.activity:obds.detail.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())
                                182. CarePlan.activity:obds.detail.kind
                                Definition

                                A description of the kind of resource the in-line definition of a care plan activity is representing. The CarePlan.activity.detail is an in-line definition when a resource is not referenced using CarePlan.activity.reference. For example, a MedicationRequest, a ServiceRequest, or a CommunicationRequest.

                                ShortAppointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | Task | ServiceRequest | VisionPrescription
                                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 CarePlanActivityKind
                                (required to http://hl7.org/fhir/ValueSet/care-plan-activity-kind|4.0.1)

                                Resource types defined as part of FHIR that can be represented as in-line definitions of a care plan activity.

                                Typecode
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Requirements

                                May determine what types of extensions are permitted.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                184. CarePlan.activity:obds.detail.instantiatesCanonical
                                Definition

                                The URL pointing to a FHIR-defined protocol, guideline, questionnaire or other definition that is adhered to in whole or in part by this CarePlan activity.

                                ShortInstantiates FHIR protocol or definition
                                Comments

                                see Canonical References

                                Control0..*
                                This element is affected by the following invariants: ele-1
                                Typecanonical(PlanDefinition, ActivityDefinition, Questionnaire, Measure, OperationDefinition)
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Requirements

                                Allows Questionnaires that the patient (or practitioner) should fill in to fulfill the care plan activity.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                186. CarePlan.activity:obds.detail.instantiatesUri
                                Definition

                                The URL pointing to an externally maintained protocol, guideline, questionnaire or other definition that is adhered to in whole or in part by this CarePlan activity.

                                ShortInstantiates external protocol or definition
                                Comments

                                This might be an HTML page, PDF, etc. or could just be a non-resolvable URI 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
                                Requirements

                                Allows Questionnaires that the patient (or practitioner) should fill in to fulfill the care plan activity.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                188. CarePlan.activity:obds.detail.code
                                Definition

                                Detailed description of the type of planned activity; e.g. what lab test, what procedure, what kind of encounter.

                                ShortDetail type of activity
                                Comments

                                Tends to be less relevant for activities involving particular products. Codes should not convey negation - use "prohibited" instead.

                                Control1..1
                                This element is affected by the following invariants: ele-1
                                BindingThe codes SHALL be taken from MII VS Onkologie Therapieempfehlung Typ
                                (required to https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/ValueSet/mii-vs-onko-therapieempfehlung-typ)

                                Detailed description of the type of activity; e.g. What lab test, what procedure, what kind of encounter.

                                TypeCodeableConcept
                                Must Supporttrue
                                Requirements

                                Allows matching performed to planned as well as validation against protocols.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                190. CarePlan.activity:obds.detail.code.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.
                                192. CarePlan.activity:obds.detail.code.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 CarePlan.activity.detail.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 194. CarePlan.activity:obds.detail.code.coding
                                  Definition

                                  Typ der Therapieempfehlung der Tumorkonferenz gemäß 19.1 oBDS 2021.

                                  ShortTyp der Therapieempfehlung
                                  Comments

                                  Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

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

                                  Allows for alternative encodings within a code system, and translations to other code systems.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  196. CarePlan.activity:obds.detail.code.coding.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.
                                  198. CarePlan.activity:obds.detail.code.coding.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 CarePlan.activity.detail.code.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 200. CarePlan.activity:obds.detail.code.coding.system
                                    Definition

                                    The identification of the code system that defines the meaning of the symbol in the code.

                                    ShortIdentity of the terminology system
                                    Comments

                                    The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                                    Control1..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
                                    Must Supporttrue
                                    Summarytrue
                                    Requirements

                                    Need to be unambiguous about the source of the definition of the symbol.

                                    Pattern Valuehttps://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapie-typ
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    202. CarePlan.activity:obds.detail.code.coding.version
                                    Definition

                                    The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                    ShortVersion of the system - if relevant
                                    Comments

                                    Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                    NoteThis is a business version Id, not a resource version Id (see discussion)
                                    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()))
                                    204. CarePlan.activity:obds.detail.code.coding.code
                                    Definition

                                    A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                    ShortSymbol in syntax defined by the system
                                    Comments

                                    Note that FHIR strings SHALL NOT exceed 1MB in size

                                    Control1..1
                                    This element is affected by the following invariants: ele-1
                                    Typecode
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Must Supporttrue
                                    Summarytrue
                                    Requirements

                                    Need to refer to a particular code in the system.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    206. CarePlan.activity:obds.detail.code.coding.display
                                    Definition

                                    A representation of the meaning of the code in the system, following the rules of the system.

                                    ShortRepresentation defined by the 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
                                    Requirements

                                    Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    208. CarePlan.activity:obds.detail.code.coding.userSelected
                                    Definition

                                    Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                    ShortIf this coding was chosen directly by the user
                                    Comments

                                    Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                                    Control0..1
                                    This element is affected by the following invariants: ele-1
                                    Typeboolean
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    Requirements

                                    This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    210. CarePlan.activity:obds.detail.code.text
                                    Definition

                                    A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                    ShortPlain text representation of the concept
                                    Comments

                                    Very often the text is the same as a displayName of one of the codings.

                                    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
                                    Requirements

                                    The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    212. CarePlan.activity:obds.detail.reasonCode
                                    Definition

                                    Provides the rationale that drove the inclusion of this particular activity as part of the plan or the reason why the activity was prohibited.

                                    ShortWhy activity should be done or why activity was prohibited
                                    Comments

                                    This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonCondition instead.

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

                                    Identifies why a care plan activity is needed. Can include any health condition codes as well as such concepts as "general wellness", prophylaxis, surgical preparation, etc.

                                    TypeCodeableConcept
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    214. CarePlan.activity:obds.detail.reasonReference
                                    Definition

                                    Indicates another resource, such as the health condition(s), whose existence justifies this request and drove the inclusion of this particular activity as part of the plan.

                                    ShortWhy activity is needed
                                    Comments

                                    Conditions can be identified at the activity level that are not identified as reasons for the overall plan.

                                    Control0..*
                                    This element is affected by the following invariants: ele-1
                                    TypeReference(Condition, Observation, DiagnosticReport, DocumentReference)
                                    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')))
                                    216. CarePlan.activity:obds.detail.goal
                                    Definition

                                    Internal reference that identifies the goals that this activity is intended to contribute towards meeting.

                                    ShortGoals this activity relates to
                                    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(Goal)
                                    Requirements

                                    So that participants know the link explicitly.

                                    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')))
                                    218. CarePlan.activity:obds.detail.status
                                    Definition

                                    Status der Therapieempfehlung nach HL7 FHIR CarePlanActivityStatus | not-started | scheduled | in-progress | on-hold | completed | cancelled | stopped | unknown | entered-in-error |

                                    ShortStatus der Therapieempfehlung
                                    Comments

                                    Some aspects of status can be inferred based on the resources linked in actionTaken. Note that "status" is only as current as the plan was most recently updated.
                                    The unknown code is not to be used to convey other statuses. The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the activity.

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

                                    Codes that reflect the current state of a care plan activity within its overall life cycle.

                                    Typecode
                                    Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the activity should not be treated as valid
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Must Supporttrue
                                    Requirements

                                    Indicates progress against the plan, whether the activity is still relevant for the plan.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    220. CarePlan.activity:obds.detail.statusReason
                                    Definition

                                    wenn Therapieabweichung - z.B. status = cancelled - Aussage ob dies durch Patientenwunsch erfolgt ist gemäß 19.2 oBDS 2021.

                                    ShortTherapieabweichung aufgrund Patientenwunsch der Therapieempfehlung
                                    Comments

                                    Will generally not be present if status is "complete". Be sure to prompt to update this (or at least remove the existing value) if the status is changed.

                                    Control0..1
                                    This element is affected by the following invariants: ele-1
                                    BindingThe codes SHALL be taken from MII VS Onkologie Therapieabweichung
                                    (required to https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/ValueSet/mii-vs-onko-therapieabweichung)
                                    TypeCodeableConcept
                                    Must Supporttrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    222. CarePlan.activity:obds.detail.statusReason.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.
                                    224. CarePlan.activity:obds.detail.statusReason.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 CarePlan.activity.detail.statusReason.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 226. CarePlan.activity:obds.detail.statusReason.coding
                                      Definition

                                      A reference to a code defined by a terminology system.

                                      ShortCode defined by a terminology system
                                      Comments

                                      Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                      Control0..*
                                      This element is affected by the following invariants: ele-1
                                      TypeCoding
                                      Must Supporttrue
                                      Summarytrue
                                      Requirements

                                      Allows for alternative encodings within a code system, and translations to other code systems.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      228. CarePlan.activity:obds.detail.statusReason.coding.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.
                                      230. CarePlan.activity:obds.detail.statusReason.coding.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 CarePlan.activity.detail.statusReason.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 232. CarePlan.activity:obds.detail.statusReason.coding.system
                                        Definition

                                        The identification of the code system that defines the meaning of the symbol in the code.

                                        ShortIdentity of the terminology system
                                        Comments

                                        The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                                        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
                                        Requirements

                                        Need to be unambiguous about the source of the definition of the symbol.

                                        Pattern Valuehttps://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-therapieabweichung
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        234. CarePlan.activity:obds.detail.statusReason.coding.version
                                        Definition

                                        The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                        ShortVersion of the system - if relevant
                                        Comments

                                        Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                        NoteThis is a business version Id, not a resource version Id (see discussion)
                                        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()))
                                        236. CarePlan.activity:obds.detail.statusReason.coding.code
                                        Definition

                                        A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                        ShortSymbol in syntax defined by the system
                                        Comments

                                        Note that FHIR strings SHALL NOT exceed 1MB in size

                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        Typecode
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supporttrue
                                        Summarytrue
                                        Requirements

                                        Need to refer to a particular code in the system.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        238. CarePlan.activity:obds.detail.statusReason.coding.display
                                        Definition

                                        A representation of the meaning of the code in the system, following the rules of the system.

                                        ShortRepresentation defined by the 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
                                        Requirements

                                        Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        240. CarePlan.activity:obds.detail.statusReason.coding.userSelected
                                        Definition

                                        Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                        ShortIf this coding was chosen directly by the user
                                        Comments

                                        Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        Typeboolean
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Requirements

                                        This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        242. CarePlan.activity:obds.detail.statusReason.text
                                        Definition

                                        A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                        ShortPlain text representation of the concept
                                        Comments

                                        Very often the text is the same as a displayName of one of the codings.

                                        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
                                        Requirements

                                        The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        244. CarePlan.activity:obds.detail.doNotPerform
                                        Definition

                                        If true, indicates that the described activity is one that must NOT be engaged in when following the plan. If false, or missing, indicates that the described activity is one that should be engaged in when following the plan.

                                        ShortIf true, activity is prohibiting action
                                        Comments

                                        This element is labeled as a modifier because it marks an activity as an activity that is not to be performed.

                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        Typeboolean
                                        Is Modifiertrue because If true this element negates the specified action. For example, instead of a request for a procedure, it is a request for the procedure to not occur.
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Requirements

                                        Captures intention to not do something that may have been previously typical.

                                        Meaning if MissingIf missing indicates that the described activity is one that should be engaged in when following the plan.
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        246. CarePlan.activity:obds.detail.scheduled[x]
                                        Definition

                                        The period, timing or frequency upon which the described activity is to occur.

                                        ShortWhen activity is to occur
                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        TypeChoice of: Timing, Period, string
                                        [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
                                        Requirements

                                        Allows prompting for activities and detection of missed planned activities.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        248. CarePlan.activity:obds.detail.location
                                        Definition

                                        Identifies the facility where the activity will occur; e.g. home, hospital, specific clinic, etc.

                                        ShortWhere it should happen
                                        Comments

                                        May reference a specific clinical location or may identify a type of location.

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

                                        Helps in planning of activity.

                                        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')))
                                        250. CarePlan.activity:obds.detail.performer
                                        Definition

                                        Identifies who's expected to be involved in the activity.

                                        ShortWho will be responsible?
                                        Comments

                                        A performer MAY also be a participant in the care plan.

                                        Control0..*
                                        This element is affected by the following invariants: ele-1
                                        TypeReference(Practitioner, PractitionerRole, Organization, RelatedPerson, Patient, CareTeam, HealthcareService, Device)
                                        Requirements

                                        Helps in planning of activity.

                                        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')))
                                        252. CarePlan.activity:obds.detail.product[x]
                                        Definition

                                        Identifies the food, drug or other product to be consumed or supplied in the activity.

                                        ShortWhat is to be administered/supplied
                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        BindingFor example codes, see SNOMEDCTMedicationCodes
                                        (example to http://hl7.org/fhir/ValueSet/medication-codes)

                                        A product supplied or administered as part of a care plan activity.

                                        TypeChoice of: CodeableConcept, Reference(Medication, Substance)
                                        [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()))
                                        254. CarePlan.activity:obds.detail.dailyAmount
                                        Definition

                                        Identifies the quantity expected to be consumed in a given day.

                                        ShortHow to consume/day?
                                        Comments

                                        The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        TypeQuantity(SimpleQuantity)
                                        Is Modifierfalse
                                        Requirements

                                        Allows rough dose checking.

                                        Alternate Namesdaily dose
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                        sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
                                        256. CarePlan.activity:obds.detail.quantity
                                        Definition

                                        Identifies the quantity expected to be supplied, administered or consumed by the subject.

                                        ShortHow much to administer/supply/consume
                                        Comments

                                        The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        TypeQuantity(SimpleQuantity)
                                        Is Modifierfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                        sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
                                        258. CarePlan.activity:obds.detail.description
                                        Definition

                                        This provides a textual description of constraints on the intended activity occurrence, including relation to other activities. It may also include objectives, pre-conditions and end-conditions. Finally, it may convey specifics about the activity such as body site, method, route, etc.

                                        ShortExtra info describing activity to perform
                                        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()))
                                        260. CarePlan.activity:extended
                                        Slice Nameextended
                                        Definition

                                        Detailed molecular tumor board recommendation using RequestGroup for structured multi-agent protocols and specific medication choices

                                        ShortExtended molecular tumor board recommendation with detailed protocols
                                        Control0..*
                                        This element is affected by the following invariants: ele-1
                                        TypeBackboneElement
                                        Requirements

                                        Allows systems to prompt for performance of planned activities, and validate plans against best practice.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        cpl-3: Provide a reference or detail, not both (detail.empty() or reference.empty())
                                        262. CarePlan.activity:extended.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.
                                        264. CarePlan.activity:extended.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 CarePlan.activity.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • value @ url
                                        • 266. CarePlan.activity:extended.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())
                                          268. CarePlan.activity:extended.outcomeCodeableConcept
                                          Definition

                                          Identifies the outcome at the point when the status of the activity is assessed. For example, the outcome of an education activity could be patient understands (or not).

                                          ShortResults of the activity
                                          Comments

                                          Note that this should not duplicate the activity status (e.g. completed or in progress).

                                          Control0..*
                                          This element is affected by the following invariants: ele-1
                                          BindingFor example codes, see CarePlanActivityOutcome
                                          (example to http://hl7.org/fhir/ValueSet/care-plan-activity-outcome)

                                          Identifies the results of the activity.

                                          TypeCodeableConcept
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          270. CarePlan.activity:extended.outcomeReference
                                          Definition

                                          Details of the outcome or action resulting from the activity. The reference to an "event" resource, such as Procedure or Encounter or Observation, is the result/outcome of the activity itself. The activity can be conveyed using CarePlan.activity.detail OR using the CarePlan.activity.reference (a reference to a “request” resource).

                                          ShortAppointment, Encounter, Procedure, etc.
                                          Comments

                                          The activity outcome is independent of the outcome of the related goal(s). For example, if the goal is to achieve a target body weight of 150 lbs and an activity is defined to diet, then the activity outcome could be calories consumed whereas the goal outcome is an observation for the actual body weight measured.

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

                                          Links plan to resulting actions.

                                          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')))
                                          272. CarePlan.activity:extended.progress
                                          Definition

                                          Notes about the adherence/status/progress of the activity.

                                          ShortProgress notes for recommendation implementation
                                          Comments

                                          This element should NOT be used to describe the activity to be performed - that occurs either within the resource pointed to by activity.detail.reference or in activity.detail.description.

                                          Control0..*
                                          This element is affected by the following invariants: ele-1
                                          TypeAnnotation
                                          Must Supporttrue
                                          Requirements

                                          Can be used to capture information about adherence, progress, concerns, etc.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          274. CarePlan.activity:extended.reference
                                          Definition

                                          Reference to detailed therapy recommendations: RequestGroup for complex multi-agent protocols, MedicationRequest for specific medication orders, or ServiceRequest for therapy referrals (surgery, radiation, etc.)

                                          ShortDetailed therapy recommendation - RequestGroup, MedicationRequest, or ServiceRequest
                                          Comments

                                          Standard extension exists (resource-pertainsToGoal) that allows goals to be referenced from any of the referenced resources in CarePlan.activity.reference.
                                          The goal should be visible when the resource referenced by CarePlan.activity.reference is viewed independently from the CarePlan. Requests that are pointed to by a CarePlan using this element should not point to this CarePlan using the "basedOn" element. i.e. Requests that are part of a CarePlan are not "based on" the CarePlan.

                                          Control1..1
                                          This element is affected by the following invariants: ele-1, cpl-3
                                          TypeReference(MII PR Onkologie Therapieempfehlung Kombinationstherapie, MedicationRequest, ServiceRequest)
                                          Must Supporttrue
                                          Must Support TypesNo must-support rules about the choice of types/profiles
                                          Requirements

                                          Details in a form consistent with other applications and contexts of use.

                                          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')))
                                          276. CarePlan.activity:extended.detail
                                          Definition

                                          A simple summary of a planned activity suitable for a general care plan system (e.g. form driven) that doesn't know about specific resources such as procedure etc.

                                          ShortIn-line definition of activity
                                          Control0..0
                                          This element is affected by the following invariants: ele-1, cpl-3
                                          TypeBackboneElement
                                          Requirements

                                          Details in a simple form for generic care plan systems.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          298. CarePlan.activity:extended/Therapieempfehlung
                                          Slice Nameextended/Therapieempfehlung
                                          Definition

                                          Therapieempfehlung für eine medikamentöse Systemische Therapie

                                          ShortTherapieempfehlung Systemische Therapie
                                          Control0..*
                                          This element is affected by the following invariants: ele-1
                                          TypeBackboneElement
                                          Must Supporttrue
                                          Requirements

                                          Allows systems to prompt for performance of planned activities, and validate plans against best practice.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          cpl-3: Provide a reference or detail, not both (detail.empty() or reference.empty())
                                          300. CarePlan.activity:extended/Therapieempfehlung.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.
                                          302. CarePlan.activity:extended/Therapieempfehlung.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 CarePlan.activity.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                          • value @ url
                                          • 304. CarePlan.activity:extended/Therapieempfehlung.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())
                                            306. CarePlan.activity:extended/Therapieempfehlung.outcomeCodeableConcept
                                            Definition

                                            Identifies the outcome at the point when the status of the activity is assessed. For example, the outcome of an education activity could be patient understands (or not).

                                            ShortResults of the activity
                                            Comments

                                            Note that this should not duplicate the activity status (e.g. completed or in progress).

                                            Control0..*
                                            This element is affected by the following invariants: ele-1
                                            BindingFor example codes, see CarePlanActivityOutcome
                                            (example to http://hl7.org/fhir/ValueSet/care-plan-activity-outcome)

                                            Identifies the results of the activity.

                                            TypeCodeableConcept
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            308. CarePlan.activity:extended/Therapieempfehlung.outcomeReference
                                            Definition

                                            Details of the outcome or action resulting from the activity. The reference to an "event" resource, such as Procedure or Encounter or Observation, is the result/outcome of the activity itself. The activity can be conveyed using CarePlan.activity.detail OR using the CarePlan.activity.reference (a reference to a “request” resource).

                                            ShortAppointment, Encounter, Procedure, etc.
                                            Comments

                                            The activity outcome is independent of the outcome of the related goal(s). For example, if the goal is to achieve a target body weight of 150 lbs and an activity is defined to diet, then the activity outcome could be calories consumed whereas the goal outcome is an observation for the actual body weight measured.

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

                                            Links plan to resulting actions.

                                            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')))
                                            310. CarePlan.activity:extended/Therapieempfehlung.progress
                                            Definition

                                            Notes about the adherence/status/progress of the activity.

                                            ShortComments about the activity status/progress
                                            Comments

                                            This element should NOT be used to describe the activity to be performed - that occurs either within the resource pointed to by activity.detail.reference or in activity.detail.description.

                                            Control0..*
                                            This element is affected by the following invariants: ele-1
                                            TypeAnnotation
                                            Requirements

                                            Can be used to capture information about adherence, progress, concerns, etc.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            312. CarePlan.activity:extended/Therapieempfehlung.reference
                                            Definition

                                            The details of the proposed activity represented in a specific resource.

                                            ShortActivity details defined in specific resource
                                            Comments

                                            Standard extension exists (resource-pertainsToGoal) that allows goals to be referenced from any of the referenced resources in CarePlan.activity.reference.
                                            The goal should be visible when the resource referenced by CarePlan.activity.reference is viewed independently from the CarePlan. Requests that are pointed to by a CarePlan using this element should not point to this CarePlan using the "basedOn" element. i.e. Requests that are part of a CarePlan are not "based on" the CarePlan.

                                            Control1..1
                                            This element is affected by the following invariants: ele-1, cpl-3
                                            TypeReference(MII PR MTB Therapieempfehlung Systemische Therapie, MII PR MTB Therapieempfehlung Kombinationstherapie, MedicationRequest, RequestGroup)
                                            Must Supporttrue
                                            Must Support TypesNo must-support rules about the choice of types/profiles
                                            Requirements

                                            Details in a form consistent with other applications and contexts of use.

                                            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')))
                                            314. CarePlan.activity:extended/Therapieempfehlung.detail
                                            Definition

                                            A simple summary of a planned activity suitable for a general care plan system (e.g. form driven) that doesn't know about specific resources such as procedure etc.

                                            ShortIn-line definition of activity
                                            Control0..0
                                            This element is affected by the following invariants: ele-1, cpl-3
                                            TypeBackboneElement
                                            Requirements

                                            Details in a simple form for generic care plan systems.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            336. CarePlan.activity:extended/HumangenetischeBeratung
                                            Slice Nameextended/HumangenetischeBeratung
                                            Definition

                                            Auftrag zur erneuten Human-genetischen Beratung

                                            ShortEmpfehlung Human-genetische Beratung
                                            Control0..1
                                            This element is affected by the following invariants: ele-1
                                            TypeBackboneElement
                                            Must Supporttrue
                                            Requirements

                                            Allows systems to prompt for performance of planned activities, and validate plans against best practice.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            cpl-3: Provide a reference or detail, not both (detail.empty() or reference.empty())
                                            338. CarePlan.activity:extended/HumangenetischeBeratung.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.
                                            340. CarePlan.activity:extended/HumangenetischeBeratung.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 CarePlan.activity.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • value @ url
                                            • 342. CarePlan.activity:extended/HumangenetischeBeratung.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())
                                              344. CarePlan.activity:extended/HumangenetischeBeratung.outcomeCodeableConcept
                                              Definition

                                              Identifies the outcome at the point when the status of the activity is assessed. For example, the outcome of an education activity could be patient understands (or not).

                                              ShortResults of the activity
                                              Comments

                                              Note that this should not duplicate the activity status (e.g. completed or in progress).

                                              Control0..*
                                              This element is affected by the following invariants: ele-1
                                              BindingFor example codes, see CarePlanActivityOutcome
                                              (example to http://hl7.org/fhir/ValueSet/care-plan-activity-outcome)

                                              Identifies the results of the activity.

                                              TypeCodeableConcept
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              346. CarePlan.activity:extended/HumangenetischeBeratung.outcomeReference
                                              Definition

                                              Details of the outcome or action resulting from the activity. The reference to an "event" resource, such as Procedure or Encounter or Observation, is the result/outcome of the activity itself. The activity can be conveyed using CarePlan.activity.detail OR using the CarePlan.activity.reference (a reference to a “request” resource).

                                              ShortAppointment, Encounter, Procedure, etc.
                                              Comments

                                              The activity outcome is independent of the outcome of the related goal(s). For example, if the goal is to achieve a target body weight of 150 lbs and an activity is defined to diet, then the activity outcome could be calories consumed whereas the goal outcome is an observation for the actual body weight measured.

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

                                              Links plan to resulting actions.

                                              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')))
                                              348. CarePlan.activity:extended/HumangenetischeBeratung.progress
                                              Definition

                                              Notes about the adherence/status/progress of the activity.

                                              ShortComments about the activity status/progress
                                              Comments

                                              This element should NOT be used to describe the activity to be performed - that occurs either within the resource pointed to by activity.detail.reference or in activity.detail.description.

                                              Control0..*
                                              This element is affected by the following invariants: ele-1
                                              TypeAnnotation
                                              Requirements

                                              Can be used to capture information about adherence, progress, concerns, etc.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              350. CarePlan.activity:extended/HumangenetischeBeratung.reference
                                              Definition

                                              The details of the proposed activity represented in a specific resource.

                                              ShortActivity details defined in specific resource
                                              Comments

                                              Standard extension exists (resource-pertainsToGoal) that allows goals to be referenced from any of the referenced resources in CarePlan.activity.reference.
                                              The goal should be visible when the resource referenced by CarePlan.activity.reference is viewed independently from the CarePlan. Requests that are pointed to by a CarePlan using this element should not point to this CarePlan using the "basedOn" element. i.e. Requests that are part of a CarePlan are not "based on" the CarePlan.

                                              Control1..1
                                              This element is affected by the following invariants: ele-1, cpl-3
                                              TypeReference(MII PR MTB Human-genetische Beratung Auftrag)
                                              Must Supporttrue
                                              Requirements

                                              Details in a form consistent with other applications and contexts of use.

                                              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')))
                                              352. CarePlan.activity:extended/HumangenetischeBeratung.detail
                                              Definition

                                              A simple summary of a planned activity suitable for a general care plan system (e.g. form driven) that doesn't know about specific resources such as procedure etc.

                                              ShortIn-line definition of activity
                                              Control0..0
                                              This element is affected by the following invariants: ele-1, cpl-3
                                              TypeBackboneElement
                                              Requirements

                                              Details in a simple form for generic care plan systems.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              374. CarePlan.activity:extended/HistologieEvaluation
                                              Slice Nameextended/HistologieEvaluation
                                              Definition

                                              Auftrag zur erneuten Histologie-Evaluation

                                              ShortEmpfehlung Histologie-Evaluation
                                              Control0..1
                                              This element is affected by the following invariants: ele-1
                                              TypeBackboneElement
                                              Must Supporttrue
                                              Requirements

                                              Allows systems to prompt for performance of planned activities, and validate plans against best practice.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              cpl-3: Provide a reference or detail, not both (detail.empty() or reference.empty())
                                              376. CarePlan.activity:extended/HistologieEvaluation.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.
                                              378. CarePlan.activity:extended/HistologieEvaluation.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 CarePlan.activity.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • value @ url
                                              • 380. CarePlan.activity:extended/HistologieEvaluation.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())
                                                382. CarePlan.activity:extended/HistologieEvaluation.outcomeCodeableConcept
                                                Definition

                                                Identifies the outcome at the point when the status of the activity is assessed. For example, the outcome of an education activity could be patient understands (or not).

                                                ShortResults of the activity
                                                Comments

                                                Note that this should not duplicate the activity status (e.g. completed or in progress).

                                                Control0..*
                                                This element is affected by the following invariants: ele-1
                                                BindingFor example codes, see CarePlanActivityOutcome
                                                (example to http://hl7.org/fhir/ValueSet/care-plan-activity-outcome)

                                                Identifies the results of the activity.

                                                TypeCodeableConcept
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                384. CarePlan.activity:extended/HistologieEvaluation.outcomeReference
                                                Definition

                                                Details of the outcome or action resulting from the activity. The reference to an "event" resource, such as Procedure or Encounter or Observation, is the result/outcome of the activity itself. The activity can be conveyed using CarePlan.activity.detail OR using the CarePlan.activity.reference (a reference to a “request” resource).

                                                ShortAppointment, Encounter, Procedure, etc.
                                                Comments

                                                The activity outcome is independent of the outcome of the related goal(s). For example, if the goal is to achieve a target body weight of 150 lbs and an activity is defined to diet, then the activity outcome could be calories consumed whereas the goal outcome is an observation for the actual body weight measured.

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

                                                Links plan to resulting actions.

                                                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')))
                                                386. CarePlan.activity:extended/HistologieEvaluation.progress
                                                Definition

                                                Notes about the adherence/status/progress of the activity.

                                                ShortComments about the activity status/progress
                                                Comments

                                                This element should NOT be used to describe the activity to be performed - that occurs either within the resource pointed to by activity.detail.reference or in activity.detail.description.

                                                Control0..*
                                                This element is affected by the following invariants: ele-1
                                                TypeAnnotation
                                                Requirements

                                                Can be used to capture information about adherence, progress, concerns, etc.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                388. CarePlan.activity:extended/HistologieEvaluation.reference
                                                Definition

                                                The details of the proposed activity represented in a specific resource.

                                                ShortActivity details defined in specific resource
                                                Comments

                                                Standard extension exists (resource-pertainsToGoal) that allows goals to be referenced from any of the referenced resources in CarePlan.activity.reference.
                                                The goal should be visible when the resource referenced by CarePlan.activity.reference is viewed independently from the CarePlan. Requests that are pointed to by a CarePlan using this element should not point to this CarePlan using the "basedOn" element. i.e. Requests that are part of a CarePlan are not "based on" the CarePlan.

                                                Control1..1
                                                This element is affected by the following invariants: ele-1, cpl-3
                                                TypeReference(MII PR MTB Histologie-Evaluation Auftrag)
                                                Must Supporttrue
                                                Requirements

                                                Details in a form consistent with other applications and contexts of use.

                                                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')))
                                                390. CarePlan.activity:extended/HistologieEvaluation.detail
                                                Definition

                                                A simple summary of a planned activity suitable for a general care plan system (e.g. form driven) that doesn't know about specific resources such as procedure etc.

                                                ShortIn-line definition of activity
                                                Control0..0
                                                This element is affected by the following invariants: ele-1, cpl-3
                                                TypeBackboneElement
                                                Requirements

                                                Details in a simple form for generic care plan systems.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                412. CarePlan.activity:extended/Biopsie
                                                Slice Nameextended/Biopsie
                                                Definition

                                                Auftrag zur erneuten Biopsie

                                                ShortEmpfehlung Biopsie
                                                Control0..*
                                                This element is affected by the following invariants: ele-1
                                                TypeBackboneElement
                                                Must Supporttrue
                                                Requirements

                                                Allows systems to prompt for performance of planned activities, and validate plans against best practice.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                cpl-3: Provide a reference or detail, not both (detail.empty() or reference.empty())
                                                414. CarePlan.activity:extended/Biopsie.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.
                                                416. CarePlan.activity:extended/Biopsie.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 CarePlan.activity.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                • value @ url
                                                • 418. CarePlan.activity:extended/Biopsie.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())
                                                  420. CarePlan.activity:extended/Biopsie.outcomeCodeableConcept
                                                  Definition

                                                  Identifies the outcome at the point when the status of the activity is assessed. For example, the outcome of an education activity could be patient understands (or not).

                                                  ShortResults of the activity
                                                  Comments

                                                  Note that this should not duplicate the activity status (e.g. completed or in progress).

                                                  Control0..*
                                                  This element is affected by the following invariants: ele-1
                                                  BindingFor example codes, see CarePlanActivityOutcome
                                                  (example to http://hl7.org/fhir/ValueSet/care-plan-activity-outcome)

                                                  Identifies the results of the activity.

                                                  TypeCodeableConcept
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  422. CarePlan.activity:extended/Biopsie.outcomeReference
                                                  Definition

                                                  Details of the outcome or action resulting from the activity. The reference to an "event" resource, such as Procedure or Encounter or Observation, is the result/outcome of the activity itself. The activity can be conveyed using CarePlan.activity.detail OR using the CarePlan.activity.reference (a reference to a “request” resource).

                                                  ShortAppointment, Encounter, Procedure, etc.
                                                  Comments

                                                  The activity outcome is independent of the outcome of the related goal(s). For example, if the goal is to achieve a target body weight of 150 lbs and an activity is defined to diet, then the activity outcome could be calories consumed whereas the goal outcome is an observation for the actual body weight measured.

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

                                                  Links plan to resulting actions.

                                                  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')))
                                                  424. CarePlan.activity:extended/Biopsie.progress
                                                  Definition

                                                  Notes about the adherence/status/progress of the activity.

                                                  ShortComments about the activity status/progress
                                                  Comments

                                                  This element should NOT be used to describe the activity to be performed - that occurs either within the resource pointed to by activity.detail.reference or in activity.detail.description.

                                                  Control0..*
                                                  This element is affected by the following invariants: ele-1
                                                  TypeAnnotation
                                                  Requirements

                                                  Can be used to capture information about adherence, progress, concerns, etc.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  426. CarePlan.activity:extended/Biopsie.reference
                                                  Definition

                                                  The details of the proposed activity represented in a specific resource.

                                                  ShortActivity details defined in specific resource
                                                  Comments

                                                  Standard extension exists (resource-pertainsToGoal) that allows goals to be referenced from any of the referenced resources in CarePlan.activity.reference.
                                                  The goal should be visible when the resource referenced by CarePlan.activity.reference is viewed independently from the CarePlan. Requests that are pointed to by a CarePlan using this element should not point to this CarePlan using the "basedOn" element. i.e. Requests that are part of a CarePlan are not "based on" the CarePlan.

                                                  Control1..1
                                                  This element is affected by the following invariants: ele-1, cpl-3
                                                  TypeReference(MII PR MTB Biopsie Auftrag)
                                                  Must Supporttrue
                                                  Requirements

                                                  Details in a form consistent with other applications and contexts of use.

                                                  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')))
                                                  428. CarePlan.activity:extended/Biopsie.detail
                                                  Definition

                                                  A simple summary of a planned activity suitable for a general care plan system (e.g. form driven) that doesn't know about specific resources such as procedure etc.

                                                  ShortIn-line definition of activity
                                                  Control0..0
                                                  This element is affected by the following invariants: ele-1, cpl-3
                                                  TypeBackboneElement
                                                  Requirements

                                                  Details in a simple form for generic care plan systems.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  450. CarePlan.activity:extended/Studieneinschlussempfehlung
                                                  Slice Nameextended/Studieneinschlussempfehlung
                                                  Definition

                                                  Anfrage zum Studieneinschluss

                                                  ShortStudieneinschlussempfehlung
                                                  Control0..*
                                                  This element is affected by the following invariants: ele-1
                                                  TypeBackboneElement
                                                  Must Supporttrue
                                                  Requirements

                                                  Allows systems to prompt for performance of planned activities, and validate plans against best practice.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  cpl-3: Provide a reference or detail, not both (detail.empty() or reference.empty())
                                                  452. CarePlan.activity:extended/Studieneinschlussempfehlung.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.
                                                  454. CarePlan.activity:extended/Studieneinschlussempfehlung.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 CarePlan.activity.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                  • value @ url
                                                  • 456. CarePlan.activity:extended/Studieneinschlussempfehlung.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())
                                                    458. CarePlan.activity:extended/Studieneinschlussempfehlung.outcomeCodeableConcept
                                                    Definition

                                                    Identifies the outcome at the point when the status of the activity is assessed. For example, the outcome of an education activity could be patient understands (or not).

                                                    ShortResults of the activity
                                                    Comments

                                                    Note that this should not duplicate the activity status (e.g. completed or in progress).

                                                    Control0..*
                                                    This element is affected by the following invariants: ele-1
                                                    BindingFor example codes, see CarePlanActivityOutcome
                                                    (example to http://hl7.org/fhir/ValueSet/care-plan-activity-outcome)

                                                    Identifies the results of the activity.

                                                    TypeCodeableConcept
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    460. CarePlan.activity:extended/Studieneinschlussempfehlung.outcomeReference
                                                    Definition

                                                    Details of the outcome or action resulting from the activity. The reference to an "event" resource, such as Procedure or Encounter or Observation, is the result/outcome of the activity itself. The activity can be conveyed using CarePlan.activity.detail OR using the CarePlan.activity.reference (a reference to a “request” resource).

                                                    ShortAppointment, Encounter, Procedure, etc.
                                                    Comments

                                                    The activity outcome is independent of the outcome of the related goal(s). For example, if the goal is to achieve a target body weight of 150 lbs and an activity is defined to diet, then the activity outcome could be calories consumed whereas the goal outcome is an observation for the actual body weight measured.

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

                                                    Links plan to resulting actions.

                                                    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')))
                                                    462. CarePlan.activity:extended/Studieneinschlussempfehlung.progress
                                                    Definition

                                                    Notes about the adherence/status/progress of the activity.

                                                    ShortComments about the activity status/progress
                                                    Comments

                                                    This element should NOT be used to describe the activity to be performed - that occurs either within the resource pointed to by activity.detail.reference or in activity.detail.description.

                                                    Control0..*
                                                    This element is affected by the following invariants: ele-1
                                                    TypeAnnotation
                                                    Requirements

                                                    Can be used to capture information about adherence, progress, concerns, etc.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    464. CarePlan.activity:extended/Studieneinschlussempfehlung.reference
                                                    Definition

                                                    The details of the proposed activity represented in a specific resource.

                                                    ShortActivity details defined in specific resource
                                                    Comments

                                                    Standard extension exists (resource-pertainsToGoal) that allows goals to be referenced from any of the referenced resources in CarePlan.activity.reference.
                                                    The goal should be visible when the resource referenced by CarePlan.activity.reference is viewed independently from the CarePlan. Requests that are pointed to by a CarePlan using this element should not point to this CarePlan using the "basedOn" element. i.e. Requests that are part of a CarePlan are not "based on" the CarePlan.

                                                    Control1..1
                                                    This element is affected by the following invariants: ele-1, cpl-3
                                                    TypeReference(MII PR MTB Studieneinschluss Anfrage)
                                                    Must Supporttrue
                                                    Requirements

                                                    Details in a form consistent with other applications and contexts of use.

                                                    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')))
                                                    466. CarePlan.activity:extended/Studieneinschlussempfehlung.detail
                                                    Definition

                                                    A simple summary of a planned activity suitable for a general care plan system (e.g. form driven) that doesn't know about specific resources such as procedure etc.

                                                    ShortIn-line definition of activity
                                                    Control0..0
                                                    This element is affected by the following invariants: ele-1, cpl-3
                                                    TypeBackboneElement
                                                    Requirements

                                                    Details in a simple form for generic care plan systems.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    488. CarePlan.note
                                                    Definition

                                                    General notes about the care plan not covered elsewhere.

                                                    ShortComments about the plan
                                                    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
                                                    Requirements

                                                    Used to capture information that applies to the plan as a whole that doesn't fit into discrete elements.

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