Alias: $goal-achievement = http://terminology.hl7.org/CodeSystem/goal-achievement Alias: $goal-priority = http://terminology.hl7.org/CodeSystem/goal-priority Alias: $goal-category = http://terminology.hl7.org/CodeSystem/goal-category Instance: example-iv-4 InstanceOf: DiabBundle Title: "example-iv-4" Description: "Patient Summary: Patient Journey 4 (17.03.2025)" Usage: #example * identifier.system = "http://system-to-be-defined.com" * identifier.value = "63fef90a-be11-4ddf-aece-d77da15c4f13" * type = #document * timestamp = "2025-03-22T11:01:30+01:00" // Composition * entry[0].fullUrl = "urn:uuid:212fdc76-ccc3-40bf-8cdd-82f2ef88bd7b" * entry[=].resource = example-iv-4-composition // Patient * entry[+].fullUrl = "urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8" * entry[=].resource = example-iv-4-patient // Anton Testpatient // Author Device APS Generator * entry[+].fullUrl = "urn:uuid:75db30ee-7028-486c-929a-c5126837f474" * entry[=].resource = example-iv-4-author-device // APS Generator // Practitioner IV Diätologin // * entry[+].fullUrl = "urn:uuid:75db30ee-7028-486c-929a-c5126837f472" // * entry[=].resource = example-iv-4-practitioner-iv // IV Diätologin // Practitioner Hausärztin * entry[+].fullUrl = "urn:uuid:75db30ee-7028-486c-929a-c5126837f473" * entry[=].resource = example-iv-4-practitioner-1 // Dr. Hanna Hausärztin // Medizinische Fallkoordination * entry[+].fullUrl = "urn:uuid:75db30ee-7028-486c-929a-c5126837f477" * entry[=].resource = example-iv-4-careteam-fallkoordination // DGKP Roman Nutrix //Careplan careteam * entry[+].fullUrl = "urn:uuid:75db30ee-5555-486c-929a-c5126837f473" * entry[=].resource = example-iv-4-careplan-diabetes-careteam // Organisation * entry[+].fullUrl = "urn:uuid:f6266e6a-f63d-4673-b2de-3dff11e619d6" * entry[=].resource = example-iv-4-organization // Zentrale Anwendung APS // Medication Summary * entry[+].fullUrl = "urn:uuid:acac4c94-a752-4cf5-9a6b-0d84237d5076" * entry[=].resource = example-iv-4-medication-summary-1 // RAMIPRIL 1A TBL 5MG * entry[+].fullUrl = "urn:uuid:acac4c94-a752-4cf5-9a6b-0d84237d5011" * entry[=].resource = example-iv-4-medication-summary-2 // METFORMIN HEX FTBL 500MG // Allergies and Intolerances * entry[+].fullUrl = "urn:uuid:768eb9cb-00f3-4ab1-bfc2-ff835cb3b89b" * entry[=].resource = example-iv-4-allergy-1 // Benzylpenicillin-Natrium // Problem List * entry[+].fullUrl = "urn:uuid:9d1c0b74-20c1-4603-a95a-71e6a1dc8fde" * entry[=].resource = example-iv-4-problem-1 // Arterielle Hypertonie * entry[+].fullUrl = "urn:uuid:8d3a18fb-3610-4bfb-9aa4-1169cc6dd2dd" * entry[=].resource = example-iv-4-problem-2 // Adipositas * entry[+].fullUrl = "urn:uuid:a3a9be59-ec61-4cab-92a9-9cbab6aec437" * entry[=].resource = example-iv-4-problem-3 // Diabetes Diagnose // Problem List - Family history * entry[+].fullUrl = "urn:uuid:e66d8ac1-a124-4e94-be22-969c9b117ce5" * entry[=].resource = example-iv-4-problem-4 // Familienanamnese: Vorzeitige koronare Herzerkrankung * entry[+].fullUrl = "urn:uuid:e66d8ac1-a124-4e94-be22-969c9b117ce6" * entry[=].resource = example-iv-4-problem-5 // Familienanamnese: Diabetes mellitus in der Familien // History of Procedures Hüftersatz * entry[+].fullUrl = "urn:uuid:75c46c35-8f4e-4232-b026-5672c60d076a" * entry[=].resource = example-iv-4-procedure-history-1 // Totalersatz des linken Hüftgelenks // Medical Devices Hüftimplantat * entry[+].fullUrl = "urn:uuid:490dab5c-271e-4736-8a6b-5f6f089d0a11" * entry[=].resource = example-iv-4-medical-deviceUse-Hueftprothese * entry[+].fullUrl = "urn:uuid:490dab5c-271e-4736-8a6b-5f6f089d0a22" * entry[=].resource = example-iv-4-medical-device-Hueftprothese // Impfungen (Immunization) * entry[+].fullUrl = "urn:uuid:590dab5c-271e-4736-8a6b-d04fd2a04607" * entry[=].resource = example-iv-4-Immunization-1 // Diphtherie-Pertussis-Poliomyelitis-Tetanus // Diagnostic Results * entry[+].fullUrl = "urn:uuid:725bcf71-22e6-473b-a879-49a4b63cd654" * entry[=].resource = example-iv-4-diagnostic-result-1 // Blutzuckerwert * entry[+].fullUrl = "urn:uuid:aeff2319-2cc2-4fba-9541-7a4de3d20f91" * entry[=].resource = example-iv-4-diagnostic-result-2 // HbA1c Wert * entry[+].fullUrl = "urn:uuid:d16dce15-bc5a-48a5-910e-6ac039785a2a" * entry[=].resource = example-iv-4-diagnostic-result-3 // Kreatininwert // // Urindiagnostik // * entry[+].fullUrl = "urn:uuid:4fe4b16a-14cb-4fd6-9da6-02c4b3797fdc" // * entry[=].resource = example-iv-4-diagnostic-result-8 // * entry[+].fullUrl = "urn:uuid:24ff8632-0ccd-4279-88b2-325fdd936ecb" // * entry[=].resource = example-iv-4-diagnostic-result-9 // * entry[+].fullUrl = "urn:uuid:8c11ad58-94ec-469c-ba4d-bfba9063067d" // * entry[=].resource = example-iv-4-diagnostic-result-10 // * entry[+].fullUrl = "urn:uuid:8c7f9e94-b834-474e-818c-bbd6c3ce3e17" // * entry[=].resource = example-iv-4-diagnostic-result-11 // * entry[+].fullUrl = "urn:uuid:e6e05f94-92be-4ae3-bf49-b0b7d4a62b35" // * entry[=].resource = example-iv-4-diagnostic-result-12 // * entry[+].fullUrl = "urn:uuid:33e09da2-5f43-4046-b2eb-cf190031826b" // * entry[=].resource = example-iv-4-diagnostic-result-13 // * entry[+].fullUrl = "urn:uuid:b675680e-9469-41b1-adc1-093904e3a1d2" // * entry[=].resource = example-iv-4-diagnostic-result-14 // Diagnostic Results - Performer * entry[+].fullUrl = "urn:uuid:82f802a7-56a9-49b4-a675-95da08f0d7a6" * entry[=].resource = example-iv-4-diagnostic-result-performer-1 // Diagnostic Results - Specimen * entry[+].fullUrl = "urn:uuid:e3567418-073e-4fd7-af4e-5fd7ee4785f7" * entry[=].resource = example-iv-4-diagnostic-specimen-1 //Blutprobe // Vitalparameter (Vital Signs) * entry[+].fullUrl = "urn:uuid:74c5e186-d765-4c93-a624-c9b0746e8142" * entry[=].resource = example-iv-4-vital-sign-1 * entry[+].fullUrl = "urn:uuid:428259da-e0f7-4780-b1e3-c177515edd37" * entry[=].resource = example-iv-4-vital-sign-2 * entry[+].fullUrl = "urn:uuid:daf9c15d-14d4-429c-b658-6842fdff67d8" * entry[=].resource = example-iv-4-vital-sign-3 * entry[+].fullUrl = "urn:uuid:8248cc70-65a2-4d37-ae14-a3ef2abf8f32" * entry[=].resource = example-iv-4-vital-sign-4 * entry[+].fullUrl = "urn:uuid:4d3f7ac4-fd0a-49af-a56b-303a2dbe67d1" * entry[=].resource = example-iv-4-vital-sign-5 // Past History of Illness * entry[+].fullUrl = "urn:uuid:82301518-66ca-4b4c-821d-087adf643cc4" * entry[=].resource = example-iv-4-illness-history-1 // Masernerkrankung in der Kindheit // Careplan Default -> Vorhandener Task scheint nun im Careplan Diabetes auf // * entry[+].fullUrl = "urn:uuid:39cd75da-2456-46a9-a703-89d8b65ae639" // * entry[=].resource = example-iv-4-careplan-default // Careplan Diabetes * entry[+].fullUrl = "urn:uuid:39cd75da-2456-46a9-a703-89d8b65ae333" * entry[=].resource = example-iv-4-careplan-diabetes-1 // Careplan Diabetes - Augenuntersuchung - Task * entry[+].fullUrl = "urn:uuid:39cd75da-1111-46a9-a703-89d8b65ae111" * entry[=].resource = example-iv-4-careplan-task-eye-exam // Careplan Diabetes - Augenuntersuchung - Termin -> mit Task ersetzt // * entry[+].fullUrl = "urn:uuid:39cd75da-1111-46a9-a703-89d8b65ae333" // * entry[=].resource = example-iv-4-careplan-appointment-eye-exam // Careplan Diabetes - Schulung - Task * entry[+].fullUrl = "urn:uuid:39cd75da-2456-46a9-a703-89d8b65ae62c" * entry[=].resource = example-iv-4-careplan-task-nutrition-training // Careplan Diabetes - Schulung - Termin -> mit Task ersetzt // * entry[+].fullUrl = "urn:uuid:39cd75da-2456-46a9-a703-89d8b65ae63b" // * entry[=].resource = example-iv-4-careplan-appointment-nutrition-training // Task Laboruntersuchung // vom Default Careplan * entry[+].fullUrl = "urn:uuid:39cd75da-2456-46a9-a703-89d8b65a1234" * entry[=].resource = example-iv-4-careplan-task-labor-1 // abgeschlossene Laboruntersuchung // Careplan Diabetes - Anforderung neue Laboruntersuchung * entry[+].fullUrl = "urn:uuid:39cd75da-2456-46a9-a703-89d8b65ae699" * entry[=].resource = example-iv-4-careplan-task-labor-2 // Careplan Diabetes - Anforderung neue Laboruntersuchung -> mit Task ersetzt //* entry[+].fullUrl = "urn:uuid:39cd75da-2456-46a9-a703-89d8b65ae631" //* entry[=].resource = example-iv-4-careplan-servicerequest-labor // // Careplan Zielwerte Goals * entry[+].fullUrl = "urn:uuid:39cd75da-4444-46a9-a703-89d8b65ae777" * entry[=].resource = example-iv-4-careplan-diabetes-hba1c-zielwert * entry[+].fullUrl = "urn:uuid:39cd75da-9999-46a9-a703-89d8b65ae333" * entry[=].resource = example-iv-4-careplan-diabetes-exercise // Careplan outcome // //* entry[+].fullUrl = "urn:uuid:39cd75da-3333-46a9-a703-89d8b65ae555" // // * entry[=].resource = example-iv-4-careplan-diabetes-hba1c-outcome // Social History * entry[+].fullUrl = "urn:uuid:d0a5bbf1-6d01-4d44-bac5-05f12c98411e" * entry[=].resource = example-iv-4-social-history-1 // Ehemaliger Raucher * entry[+].fullUrl = "urn:uuid:d0a5bbf1-6d01-4d44-bac5-05f12c984112" * entry[=].resource = example-iv-4-social-history-2 // Alkoholische Getränke pro Tag, 1-2 Gläser Wein/Bier * entry[+].fullUrl = "urn:uuid:9add5c32-1ded-43d6-b163-c3fe13f94984" * entry[=].resource = example-iv-4-social-history-3 // Körperliche Aktivität 2,5h/Wo Instance: example-iv-4-composition InstanceOf: DiabComposition Usage: #inline // * language = #de-AT * status = #final * type = $cs-loinc#60591-5 "Patient Summary" * subject = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" * date = "2025-03-22T11:01:30+01:00" * author = Reference(urn:uuid:75db30ee-7028-486c-929a-c5126837f474) "APS Generator" * title = "Patient Summary" * custodian = Reference(urn:uuid:f6266e6a-f63d-4673-b2de-3dff11e619d6) "Zentrale Anwendung APS" * extension[countryOfAffiliation].valueString = "AT" // Medikationsliste (Medication Summary) * section[sectionMedications].title = "Medikationsliste" // Medikationsplan * section[sectionMedications].code = $cs-loinc#10160-0 "Medikationsanamnese" * section[sectionMedications].text.status = #empty * section[sectionMedications].text.div = "

Ramipril 5 mg 1-0-0-0, Start 15.06.2016

Metformin 500 mg 1-0-0-0, Start 22.03.2025

" * section[sectionMedications].entry[medicationStatement][0] = Reference(urn:uuid:acac4c94-a752-4cf5-9a6b-0d84237d5076) "RAMIPRIL 1A TBL 5MG" * section[sectionMedications].entry[medicationStatement][+] = Reference(urn:uuid:acac4c94-a752-4cf5-9a6b-0d84237d5011) "METFORMIN HEX FTBL 500MG" // Allergien und Intoleranzen (Allergies and Intolerances) * section[sectionAllergies].title = "Allergien und Intoleranzen" * section[sectionAllergies].code = $cs-loinc#48765-2 "Allergien und unerwünschte Wirkungen" * section[sectionAllergies].text.status = #empty * section[sectionAllergies].text.div = "

Allergie gegen Benzylpenicillin-Natrium.

" * section[sectionAllergies].entry[allergyOrIntolerance][0] = Reference(urn:uuid:768eb9cb-00f3-4ab1-bfc2-ff835cb3b89b) "Allergie gegen Benzylpenicillin-Natrium" // Gesundheitsprobleme und Risiken (Problems) * section[sectionProblems].title = "Gesundheitsprobleme und Risiken" * section[sectionProblems].code = $cs-loinc#11450-4 "Problemliste" * section[sectionProblems].text.status = #empty * section[sectionProblems].text.div = "

Diabettes mellitus Typ 2

Arterielle Hypertonie

Adipositas

Familienanamnese: Vorzeitige koronare Herzerkrankung, Diabetes mellitus

" * section[sectionProblems].entry[problem][0] = Reference(urn:uuid:9d1c0b74-20c1-4603-a95a-71e6a1dc8fde) "Arterielle Hypertonie" * section[sectionProblems].entry[problem][+] = Reference(urn:uuid:8d3a18fb-3610-4bfb-9aa4-1169cc6dd2dd) "Adipositas" * section[sectionProblems].entry[problem][+] = Reference(urn:uuid:a3a9be59-ec61-4cab-92a9-9cbab6aec437) "Diabetes mellitus Typ 2" // Problems - Family history * section[sectionProblems].entry[problem][+] = Reference(urn:uuid:e66d8ac1-a124-4e94-be22-969c9b117ce5) "Familienanamnese: Vorzeitige koronare Herzerkrankung" * section[sectionProblems].entry[problem][+] = Reference(urn:uuid:e66d8ac1-a124-4e94-be22-969c9b117ce6) "Familienanamnese: Diabetes mellitus in der Familie" // Eingriffe und Therapien (History of Procedures) * section[sectionProceduresHx].title = "Eingriffe und Therapien" * section[sectionProceduresHx].code = $cs-loinc#47519-4 "Anamnese der Prozeduren oder Maßnahmen" * section[sectionProceduresHx].text.status = #empty * section[sectionProceduresHx].text.div = "

Totalersatz des linken Hüftgelenks

" * section[sectionProceduresHx].entry[procedure][0] = Reference(urn:uuid:75c46c35-8f4e-4232-b026-5672c60d076a) "Totalersatz des linken Hüftgelenks" // * section[sectionProceduresHx].text.div = "

Narrativer Text muss generiert werden.

" // * section[sectionProceduresHx].emptyReason = $cs-list-empty-reason#nilknown // Implantate, medizinische Geräte und Heilbehelfe (Medical Devices) * section[sectionMedicalDevices].title = "Implantate, medizinische Geräte und Heilbehelfe" * section[sectionMedicalDevices].code = $cs-loinc#46264-8 "Anamnese zum Einsatz von Medizinprodukten" * section[sectionMedicalDevices].text.status = #empty // * section[sectionMedicalDevices].text.div = "

Keine Implantate

" // * section[sectionMedicalDevices].emptyReason = $cs-list-empty-reason#nilknown * section[sectionMedicalDevices].text.div = "

Hüftprothese

" * section[sectionMedicalDevices].entry[deviceStatement][0] = Reference(urn:uuid:490dab5c-271e-4736-8a6b-5f6f089d0a11) "Hüftprothese" // Impfungen (Immunization) * section[sectionImmunizations].title = "Impfungen" * section[sectionImmunizations].code = $cs-loinc#11369-6 "Impfungen" * section[sectionImmunizations].text.status = #empty * section[sectionImmunizations].text.div = "

Impfung gegen Diphtherie-Pertussis-Poliomyelitis-Tetanus

" * section[sectionImmunizations].entry[immunization][0] = Reference(urn:uuid:590dab5c-271e-4736-8a6b-d04fd2a04607) "Diphtherie-Pertussis-Poliomyelitis-Tetanus" // Diagnostische Resultate (Results) * section[sectionResults].title = "Diagnostische Resultate" * section[sectionResults].code = $cs-loinc#30954-2 "Relevante diagnostische Tests oder Labordaten" * section[sectionResults].text.status = #empty * section[sectionResults].text.div = "

Glucose im kapillaren Blut 1h postprandial

Hemoglobin A1c/Hemoglobin im Blut: 8.1 %

Kreatinin in Serum: 1.2 mg/dL

" * section[sectionResults].entry[resultsObservationLaboratoryPathology][0] = Reference(urn:uuid:725bcf71-22e6-473b-a879-49a4b63cd654) "Glucose im kapillaren Blut 1h postprandial" * section[sectionResults].entry[resultsObservationLaboratoryPathology][+] = Reference(urn:uuid:aeff2319-2cc2-4fba-9541-7a4de3d20f91) "Hemoglobin A1c/Hemoglobin.total in Blood" * section[sectionResults].entry[resultsObservationLaboratoryPathology][+] = Reference(urn:uuid:d16dce15-bc5a-48a5-910e-6ac039785a2a) "Kreatinin in Serum" // * section[sectionResults].entry[resultsObservationLaboratoryPathology][+] = Reference(urn:uuid:4fe4b16a-14cb-4fd6-9da6-02c4b3797fdc) "Urindiagnostik" // Vitalparameter (Vital Signs) * section[sectionVitalSigns].title = "Vitalparameter" * section[sectionVitalSigns].code = $cs-loinc#8716-3 "Vitalparameter" * section[sectionVitalSigns].text.status = #empty * section[sectionVitalSigns].text.div = "

Körpergröße: 173 cm

Körpergewicht: 90 kg

BMI: 30.07 (high)

Blutdruck 180 / 80

Herzfrequenz 100

" * section[sectionVitalSigns].entry[vitalSign][0] = Reference(urn:uuid:74c5e186-d765-4c93-a624-c9b0746e8142) "Körpergröße: 173 cm" * section[sectionVitalSigns].entry[vitalSign][+] = Reference(urn:uuid:428259da-e0f7-4780-b1e3-c177515edd37) "Körpergewicht: 90 kg" * section[sectionVitalSigns].entry[vitalSign][+] = Reference(urn:uuid:daf9c15d-14d4-429c-b658-6842fdff67d8) "BMI: 30.07" * section[sectionVitalSigns].entry[vitalSign][+] = Reference(urn:uuid:8248cc70-65a2-4d37-ae14-a3ef2abf8f32) "Blutdruck 180 / 80" * section[sectionVitalSigns].entry[vitalSign][+] = Reference(urn:uuid:4d3f7ac4-fd0a-49af-a56b-303a2dbe67d1) "Herzfrequenz 100" // Vergangene Gesundheitsprobleme und Risiken (History of Past Illness) * section[sectionPastIllnessHx].title = "Vergangene Gesundheitsprobleme und Risiken" * section[sectionPastIllnessHx].code = $cs-loinc#11348-0 "Vergangene Gesundheitsprobleme und Risiken" * section[sectionPastIllnessHx].text.status = #empty * section[sectionPastIllnessHx].text.div = "

Masernerkrankung in der Kindheit.

" * section[sectionPastIllnessHx].entry[pastProblem][0] = Reference(urn:uuid:82301518-66ca-4b4c-821d-087adf643cc4) "Vergangene Masernerkrankung" // Behandlungsplan (Care Plan) * section[sectionPlanOfCare].title = "Behandlungsplan" * section[sectionPlanOfCare].code = $cs-loinc#18776-5 "Behandlungsplan - Notiz" * section[sectionPlanOfCare].text.status = #empty * section[sectionPlanOfCare].text.div = "

Behandlungsplan Diabetes: Patientenschulung und Ernährungsberatung, Augenuntersuchung, Laboruntersuchung, Zielvereinbarungen

" //* section[sectionPlanOfCare].entry[carePlan][0] = Reference(urn:uuid:39cd75da-2456-46a9-a703-89d8b65ae639) "Behandlungsplan Vorsorge" // nur 1 Behandlungsplan * section[sectionPlanOfCare].entry[carePlan][0] = Reference(urn:uuid:39cd75da-2456-46a9-a703-89d8b65ae333) "Behandlungsplan Diabetes" // Lebensstil (Social History) * section[sectionSocialHistory].title = "Lebensstil, soziale Umstände und Verhalten" * section[sectionSocialHistory].code = $cs-loinc#29762-2 "Sozialanamnese" * section[sectionSocialHistory].text.status = #empty * section[sectionSocialHistory].text.div = "

Ehemaliger Raucher, Person

Alkoholische Getränke pro Tag, 1-2 Gläser Wein/Bier

Körperliche Aktivität 2,5h/Wo

" * section[sectionSocialHistory].entry[smokingTobaccoUse][0] = Reference(urn:uuid:d0a5bbf1-6d01-4d44-bac5-05f12c98411e) "Ehemalig rauchende Person" * section[sectionSocialHistory].entry[alcoholUse][+] = Reference(urn:uuid:d0a5bbf1-6d01-4d44-bac5-05f12c984112) "Alkoholische Getränke pro Tag, 1-2 Gläser Wein/Bier" * section[sectionSocialHistory].entry[+] = Reference(urn:uuid:9add5c32-1ded-43d6-b163-c3fe13f94984) "Körperliche Aktivität" //**********************************************************************************/ // Problems Instance: example-iv-4-problem-1 InstanceOf: AtApsCondition Usage: #inline * clinicalStatus = $cs-condition-clinical#active "Active" * verificationStatus = $cs-condition-ver-status#confirmed "Confirmed" * category.coding[0] = $cs-condition-category#problem-list-item "Problem List Item" * code = $cs-sct#38341003 "Arterielle Hypertonie" * subject = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" * recordedDate = "2016-11-01T08:30:00+01:00" * asserter = Reference(urn:uuid:75db30ee-7028-486c-929a-c5126837f473) "Dr. Hanna Hausärztin" Instance: example-iv-4-problem-2 InstanceOf: AtApsCondition Usage: #inline * clinicalStatus = $cs-condition-clinical#active "Active" * verificationStatus = $cs-condition-ver-status#confirmed "Confirmed" * category.coding[0] = $cs-condition-category#problem-list-item "Problem List Item" * code = $cs-sct#443371000124107 "Adipositas" * subject = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" * recordedDate = "2016-11-01T08:30:00+01:00" * asserter = Reference(urn:uuid:75db30ee-7028-486c-929a-c5126837f473) "Dr. Hanna Hausärztin" Instance: example-iv-4-problem-3 InstanceOf: AtApsCondition Usage: #inline * clinicalStatus = $cs-condition-clinical#active "Active" * verificationStatus = $cs-condition-ver-status#confirmed "Confirmed" * category.coding[0] = $cs-condition-category#problem-list-item "Problem List Item" * code = $cs-sct#44054006 "Diabetes mellitus Typ 2" * subject = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" * recordedDate = "2025-03-22T08:00:00+01:00" * asserter = Reference(urn:uuid:75db30ee-7028-486c-929a-c5126837f473) "Dr. Hanna Hausärztin" // Problems - Family history Instance: example-iv-4-problem-4 InstanceOf: AtApsCondition Usage: #inline * clinicalStatus = $cs-condition-clinical#active "Active" * verificationStatus = $cs-condition-ver-status#confirmed "Confirmed" * category.coding[0] = $cs-condition-category#problem-list-item "Problem List Item" * code = $cs-sct#134439009 "Familienanamnese: vorzeitige koronare Herzkrankheit" * recordedDate = "2022-02-08T08:30:00+01:00" * subject = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" * asserter = Reference(urn:uuid:75db30ee-7028-486c-929a-c5126837f473) "Dr. Hanna Hausärztin" Instance: example-iv-4-problem-5 InstanceOf: AtApsCondition Usage: #inline * clinicalStatus = $cs-condition-clinical#active "Active" * verificationStatus = $cs-condition-ver-status#confirmed "Confirmed" * category.coding[0] = $cs-condition-category#problem-list-item "Problem List Item" * code = $cs-sct#160303001 "Familienanamnese: Diabetes mellitus in der Familie" * subject = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" * recordedDate = "2022-02-08T08:30:00+01:00" * asserter = Reference(urn:uuid:75db30ee-7028-486c-929a-c5126837f473) "Dr. Hanna Hausärztin" // Careplan Diabetes *************************************** Instance: example-iv-4-careplan-diabetes-1 InstanceOf: DiabCareplan Usage: #inline * text.status = #additional * text.div = "
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Behandlungsplan Diabetes

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" // * identifier.value = "12345" // * instantiatesUri = "https://www.sozialministerium.at/2025/Behandlungsplan-bei-Diabetes-mellitus-Typ-II" * status = #active * intent = #plan * category.coding[0] = $cs-loinc#18776-5 "Behandlungsplan" //Plan of care note * category.text = "Behandlungsplan Diabetes" * title = "Behandlungsplan Diabetes" * description = "Dokumentiert ausstehende Untersuchungen, Schulungen, klinische Ziele für die laufende Betreuung des Patienten." * subject = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" * created = "2025-03-22T08:00:00+01:00" * author = Reference(urn:uuid:75db30ee-7028-486c-929a-c5126837f473) "Dr. Hanna Hausärztin" * careTeam = Reference(urn:uuid:75db30ee-5555-486c-929a-c5126837f473) "Careteam von Dr. IV Ärztin" * goal[0] = Reference(urn:uuid:39cd75da-4444-46a9-a703-89d8b65ae777) "Ziel Hba1c" * goal[+] = Reference(urn:uuid:39cd75da-9999-46a9-a703-89d8b65ae333) "Ziel Bewegung" * addresses = Reference(urn:uuid:a3a9be59-ec61-4cab-92a9-9cbab6aec437) "Diabetes mellitus Typ 2" * activity[0].reference = Reference(urn:uuid:39cd75da-1111-46a9-a703-89d8b65ae111) "Task Augenuntersuchung" //* activity[0].reference = Reference(urn:uuid:39cd75da-1111-46a9-a703-89d8b65ae333) "Termin für Augenuntersuchung" // Alt: Appointment * activity[+].reference = Reference(urn:uuid:39cd75da-2456-46a9-a703-89d8b65ae62c) "Task Patientenschulung und Ernährungsberatung" //* activity[+].reference = Reference(urn:uuid:39cd75da-2456-46a9-a703-89d8b65ae63b) "Termin für Patientenschulung und Ernährungsberatung" // Alt: Appointment * activity[+].reference = Reference(urn:uuid:39cd75da-2456-46a9-a703-89d8b65ae699) "Angeforderte Laboruntersuchung" // neue Laboruntersuchung //* activity[+].reference = Reference(urn:uuid:39cd75da-2456-46a9-a703-89d8b65ae631) "Angeforderte Laboruntersuchung" // Alt: ServiceRequest * activity[+].reference = Reference(urn:uuid:39cd75da-2456-46a9-a703-89d8b65a1234) "Abgeschlossene Laboruntersuchung" // vom Standard Behanldungsplan //* activity[+].outcomeReference = Reference(urn:uuid:39cd75da-3333-46a9-a703-89d8b65ae555) "Zielwerte Hba1c" // Careplan careteam Instance: example-iv-4-careplan-diabetes-careteam InstanceOf: CareTeam Usage: #inline * name = "Careteam von Dr. IV Ärztin" * subject = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" * participant[0].role = $cs-sct#133932002 "Medizinische Fallführung" * participant[=].role.text = "Medizinische Fallführung" * participant[=].member = Reference(urn:uuid:75db30ee-7028-486c-929a-c5126837f473) "Dr. Hanna Hausärztin" * participant[+].role = $cs-sct#133932002 "Fallkoordination " * participant[=].role.text = "Fallkoordination " * participant[=].member = Reference(urn:uuid:75db30ee-7028-486c-929a-c5126837f477) "DGKP Roman Nutrix" // * participant[+].role = $cs-sct#62247001 "Family medicine specialist" // * participant[=].role.text = "Hausärztin" // * participant[=].member = Reference(urn:uuid:75db30ee-7028-486c-929a-c5126837f473) "Dr. Hanna Hausärztin" // * participant[+].role = $cs-sct#11911009 "Nephrologist" // * participant[=].role.text = "Nephrologist" // * participant[=].member = Reference(Practitioner/cc-prac-jones-vince) // * participant[+].role = $cs-sct#159033005 "Dietician" // * participant[=].role.text = "Dietician" // * participant[=].member = Reference(Practitioner/cc-prac-gonzalez-maria) // * participant[+].role = $cs-sct#106328005 "Social worker" // * participant[=].role.text = "Renal Social Worker" // * participant[=].member = Reference(Practitioner/cc-prac-johnson-sam) // * participant[+].role = $cs-sct#159011008 "Retail pharmacist" // * participant[=].role.text = "Community Pharmacist" // * participant[=].member = Reference(Practitioner/cc-prac-walkowski-ellen) // * participant[+].role = $cs-sct#224535009 "Registered nurse" // * participant[=].role.text = "Registered Nurse" // * participant[=].member = Reference(Practitioner/cc-prac-smith-julie) // ********************************************************** // Careplan Task Augenutersuchung Instance: example-iv-4-careplan-task-eye-exam InstanceOf: Task Usage: #inline * text.status = #additional * text.div = "
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Offene augenärztliche Kontrolle auf diabetische Retinopathie

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" * status = #requested * intent = #plan * priority = #routine * code.coding[0] = $cs-sct#722161008 "Untersuchung der diabetischen Netzhaut" // Task Type * code.coding[0].display = "Augenärztliche Kontrolle auf diabetische Retinopathie" //* description = "Augenärztliche Kontrolle auf diabetische Retinopathie" // * executionPeriod.start = "2025-03-20T08:00:00+00:00" // Datum der Auftragserteilung // * executionPeriod.end = 2025-03-17T08:30:00+01:00 // Datum der Erledigung * authoredOn = "2025-03-22T08:00:00+01:00" // * lastModified = 2025-03-17T08:30:00+01:00 // * for = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" * requester = Reference(urn:uuid:75db30ee-7028-486c-929a-c5126837f473) "Dr. Hanna Hausärztin" * performerType = $cs-sct#422234006 "Ophthalmologe" * owner = Reference(urn:uuid:75db30ee-7028-486c-929a-c5126837f473) "Dr. Hanna Hausärztin" * reasonReference = Reference(urn:uuid:a3a9be59-ec61-4cab-92a9-9cbab6aec437) "Diabetes mellitus Typ 2" * restriction.recipient = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" // Careplan Task Nutrition Training Instance: example-iv-4-careplan-task-nutrition-training InstanceOf: Task Usage: #inline * text.status = #additional * text.div = "
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Offene Patientenschulung und Ernährungsberatung bei Diabetes mellitus Typ II

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" * status = #requested * intent = #plan * priority = #routine * code.coding[0] = $cs-sct#428274007 "Patientenschulung und Ernährungsberatung bei Diabetes mellitus Typ II" // Task Type * code.coding[0].display = "Patientenschulung und Ernährungsberatung bei Diabetes mellitus Typ II" //* description = "Diese Schulung beinhaltet detaillierte Ernährungsinformationten für Diabetes mellitus Typ II Patienten" // * executionPeriod.start = "2025-03-20T08:00:00+00:00" // Datum der Auftragserteilung // * executionPeriod.end = 2025-03-17T08:30:00+01:00 // Datum der Erledigung * authoredOn = "2025-03-22T08:00:00+01:00" //* lastModified = 2025-03-17T08:30:00+01:00 // * for = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" * requester = Reference(urn:uuid:75db30ee-7028-486c-929a-c5126837f473) "Dr. Hanna Hausärztin" * performerType = $cs-sct#768827000 "Nutritionist" * owner = Reference(urn:uuid:75db30ee-7028-486c-929a-c5126837f473) "Dr. Hanna Hausärztin" // evtl. Laborarzt // *owner = Reference(urn:uuid:75db30ee-7028-486c-929a-c5126837f472) "Dr. IV Diätologin" * reasonReference = Reference(urn:uuid:a3a9be59-ec61-4cab-92a9-9cbab6aec437) "Diabetes mellitus Typ 2" * restriction.recipient = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" //* input[0].type = TODO Goal //* input[0].value = TODO Gol //* output[0].type = TODO Dokument oder Valueset //* output[0].value = TODO Dokument oder Valueset // Diabetes Careplan angeforderte Laboruntersuchung Instance: example-iv-4-careplan-task-labor-1 InstanceOf: Task Usage: #inline * text.status = #additional * text.div = "
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Offene Laboruntersuchung

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" * status = #completed * intent = #order * priority = #urgent * code.coding[0] = $cs-sct#15220000 "Laboruntersuchung" * code.text = "Laboruntersuchung" * description = "Abklärung mögl. Diabetes II" // * executionPeriod.start = 2025-03-17T08:00:00+01:00 // Datum der Auftragserteilung // * executionPeriod.end = 2025-03-17T08:30:00+01:00 // Datum der Erledigung * authoredOn = 2025-03-14T08:00:00+01:00 * lastModified = 2025-03-17T08:30:00+01:00 // * for = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" * requester = Reference(urn:uuid:75db30ee-7028-486c-929a-c5126837f473) "Dr. Hanna Hausärztin" * performerType = $cs-sct#61246008 "Laborfacharzt" * owner = Reference(urn:uuid:75db30ee-7028-486c-929a-c5126837f473) "Dr. Hanna Hausärztin" // evtl. Laborarzt //* focus = Reference(urn:uuid:39cd75da-2456-46a9-a703-89d8b65ae639) "Vorsorgeuntersuchungsprogramm" * restriction.recipient = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" // Diabetes Careplan angeforderte Laboruntersuchung Instance: example-iv-4-careplan-task-labor-2 InstanceOf: Task Usage: #inline * text.status = #additional * text.div = "
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Abgeschlossene Laboruntersuchung

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" * status = #requested * intent = #order * priority = #routine * code.coding[0] = $cs-sct#15220000 "Laboruntersuchung" * code.text = "Laboruntersuchung" //* description = "Kontrolle HbA1c" // * executionPeriod.start = 2025-03-17T08:00:00+01:00 // Datum der Auftragserteilung // * executionPeriod.end = 2025-03-17T08:30:00+01:00 // Datum der Erledigung * authoredOn = 2025-03-22T08:00:00+01:00 //* lastModified = 2025-03-18T08:30:00+01:00 // * for = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" * requester = Reference(urn:uuid:75db30ee-7028-486c-929a-c5126837f473) "Dr. Hanna Hausärztin" * performerType = $cs-sct#61246008 "Laborfacharzt" * owner = Reference(urn:uuid:75db30ee-7028-486c-929a-c5126837f473) "Dr. Hanna Hausärztin" // evtl. Laborarzt //* focus = Reference(urn:uuid:39cd75da-2456-46a9-a703-89d8b65ae639) "Vorsorgeuntersuchungsprogramm" * reasonReference = Reference(urn:uuid:a3a9be59-ec61-4cab-92a9-9cbab6aec437) "Diabetes mellitus Typ 2" * restriction.recipient = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" // Diabetes Careplan Zielwerte HbA1c Instance: example-iv-4-careplan-diabetes-hba1c-zielwert InstanceOf: Goal Usage: #inline * lifecycleStatus = #proposed // * achievementStatus = $goal-achievement#in-progress "In Progress" //todo unklar // * achievementStatus.text = "In Progress" //todo unklar * category.coding[0] = $goal-category#dietary "Diät" * category.coding[+] = $goal-category#behavioral "Verhalten" * priority = $goal-priority#high-priority "hoch" //* priority.text = "hoch" * description.text = "Hämoglobin A1c stabilisieren" * subject = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" * startDate = "2025-03-22" * target.measure = $cs-loinc#4548-4 "Hämoglobin A1c total im Blut" * target.measure.text = "Hämoglobin A1c total im Blut" * target.detailQuantity.comparator = #< * target.detailQuantity = 6.0 '%' "%" * expressedBy = Reference(urn:uuid:75db30ee-7028-486c-929a-c5126837f473) "Dr. Hanna Hausärztin" * addresses = Reference(urn:uuid:a3a9be59-ec61-4cab-92a9-9cbab6aec437) "Diabetes mellitus Typ 2" //* note.text = "Überwachen Sie regelmäßig den HbA1c-Wert, um das Gesamtziel von 6,0 zu erreichen." // Diabetes Careplan Ziel Bewegung Instance: example-iv-4-careplan-diabetes-exercise InstanceOf: Goal Usage: #inline * lifecycleStatus = #proposed // * achievementStatus = $goal-achievement#in-progress "In Progress" // * achievementStatus.text = "In Progress" * category.coding[0] = $goal-category#behavioral "Verhalten" * priority = $goal-priority#high-priority "hoch" //* priority.text = "hoch" * description.text = "Mindestens 30 Minuten pro Tag Sport treiben" * subject = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" * startDate = "2025-03-22" * target.measure = $cs-sct#226029000 "Bewegung" * target.measure.text = "Bewegung" * expressedBy = Reference(urn:uuid:75db30ee-7028-486c-929a-c5126837f473) "Dr. Hanna Hausärztin" * addresses = Reference(urn:uuid:a3a9be59-ec61-4cab-92a9-9cbab6aec437) "Diabetes mellitus Typ 2" // ********************************************************** // Medication Summary Instance: example-iv-4-medication-summary-1 InstanceOf: AtApsMedicationStatement Usage: #inline * status = #active * medicationCodeableConcept = $cs-asp-liste#2450888 "RAMIPRIL 1A TBL 5MG" * subject = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" * effectivePeriod.start = "2016-11-02T11:00:05+02:00" * dosage.text = "S:1-0-0-0" * dosage.sequence = 1 // * dosage.timing.repeat.when = $cs-event-timing#NIGHT "Night" // * dosage.timing.repeat.dayOfWeek = #fri * dosage.route = $cs-sct#26643006 "Orale Einnahme" * dosage.doseAndRate.doseQuantity = 2 $cs-elga-medikationmengenart#{TAB} "Tablet" Instance: example-iv-4-medication-summary-2 InstanceOf: AtApsMedicationStatement Usage: #inline * status = #active * medicationCodeableConcept = $cs-asp-liste#1294446 "METFORMIN HEX FTBL 500MG" * subject = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" * effectivePeriod.start = "2025-07-15T08:00:00+01:00" * dosage.text = "S:1-0-0-0" * dosage.sequence = 1 // * dosage.timing.repeat.when = $cs-event-timing#NIGHT "Night" // * dosage.timing.repeat.dayOfWeek = #fri * dosage.route = $cs-sct#26643006 "Orale Einnahme" * dosage.doseAndRate.doseQuantity = 2 $cs-elga-medikationmengenart#{TAB} "Tablet" // Allergies and Intolerances Instance: example-iv-4-allergy-1 InstanceOf: AtApsAllergyIntolerance // DiabAllergyIntolerance Usage: #inline * clinicalStatus = $cs-allergyintolerance-clinical#active "Active" * criticality = #high * code = $cs-sct#89055006 "Benzylpenicillin-Natrium" * patient = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" * asserter = Reference(urn:uuid:75db30ee-7028-486c-929a-c5126837f473) "Dr. Hausärztin" // History of Procedures Instance: example-iv-4-procedure-history-1 InstanceOf: AtApsProcedure Usage: #inline * status = #completed * code = $cs-sct#770606008 "Totalersatz des linken Hüftgelenks" * subject = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" * performedDateTime = "2020-12-23T08:30:00+01:00" * focalDevice.manipulated = Reference(urn:uuid:490dab5c-271e-4736-8a6b-5f6f089d0a22) "Hüftprothese" // Medical Devices Instance: example-iv-4-medical-deviceUse-Hueftprothese InstanceOf: AtApsDeviceUseStatement Usage: #inline * status = #active * subject = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" * device = Reference(urn:uuid:490dab5c-271e-4736-8a6b-5f6f089d0a22) "Hüftprothese" * device.display = "Implantat: Hüftprothese" // * timingDateTime.extension.url = "http://hl7.org/fhir/StructureDefinition/data-absent-reason" // * timingDateTime.extension.valueCode = #unknown * timingPeriod.start = "2020-12-23T08:30:00+01:00" * bodySite = $cs-sct#362905007 "Gesamtes linkes Hüftgelenk" * bodySite.coding[0].display = "Gesamtes linkes Hüftgelenk" Instance: example-iv-4-medical-device-Hueftprothese InstanceOf: AtApsDevice Usage: #inline * type = $cs-sct#67270000 "Hüftprothese" * patient = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" * deviceName.name = "Hüftprothese" * deviceName.type = #other * version.value = "123456" // Instance: example-iv-4-deviceUse-Insulinpumpe // InstanceOf: AtApsDeviceUseStatement // Usage: #inline // * status = #active // * subject = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" // * device = Reference(urn:uuid:a1a80313-a757-4062-b0d7-d04fd2a04602) "Insulinpumpe" // * device.display = "Verwendetes Gerät: Insulinpumpe" // * timingDateTime.extension.url = "http://hl7.org/fhir/StructureDefinition/data-absent-reason" // * timingDateTime.extension.valueCode = #unknown // Instance: example-iv-4-device-Insulinpumpe // InstanceOf: AtApsDevice // Usage: #inline // * type = $cs-sct#69805005 "Insulin pump" // * patient = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" // * deviceName.name = "Insulinpumpe" // * deviceName.type = #other // * version.value = "Insulin pump" Instance: example-iv-4-Immunization-1 InstanceOf: AtApsImmunization Usage: #inline * status = #completed * vaccineCode.coding[0] = $vs-eimpf-impfstoffe#2457324 "BOOSTRIX POLIO FSPR 0,5ML" // * vaccineCode.text = "Diphtherie-Pertussis-Poliomyelitis-Tetanus" * patient = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" * performer.actor = Reference(urn:uuid:75db30ee-7028-486c-929a-c5126837f473) "Dr. Hanna Hausärztin" * vaccineCode = $vs-eimpf-impfstoffe#2457324 "BOOSTRIX POLIO FSPR 0,5ML" * occurrenceDateTime = "2025-01-08T14:31:30+00:00" //* primarySource = true * route = $vs-eimpf-medikationartanwendung#IM "Intramuskulär" * protocolApplied[0].series = "Standardimpfserie" * protocolApplied[0].doseNumberPositiveInt = 1 * protocolApplied[0].targetDisease[0] = $vs-eimpf-immunizationtarget#397430003 "Diphtheria" * protocolApplied[0].targetDisease[+] = $vs-eimpf-immunizationtarget#27836007 "Pertussis" * protocolApplied[0].targetDisease[+] = $vs-eimpf-immunizationtarget#398102009 "Poliomyelitis" * protocolApplied[0].targetDisease[+] = $vs-eimpf-immunizationtarget#76902006 "Tetanus" // Diagnostic Results // Diagnostic Results - Performer Instance: example-iv-4-diagnostic-result-performer-1 InstanceOf: AtApsOrganization Usage: #inline // * identifier.system = "urn:ietf:rfc:3986" // * identifier.value = "urn:oid:1.2.40.0.34.99.4613" // * identifier.assigner.display = "Bundesministerium für Gesundheit" * name = "Amadeus Spital - Labor" * telecom[0].system = #phone * telecom[=].value = "+43.1.3453446.0" * telecom[+].system = #fax * telecom[=].value = "+43.1.3453446.4674" * telecom[+].system = #email * telecom[=].value = "info@amadeusspital.at" * telecom[+].system = #url * telecom[=].value = "https://www.amadeusspital.at" * address.line = "Währinger Gürtel 18-20" * address.city = "Wien" * address.postalCode = "1090" * address.country = "AUT" // Diagnostic Results - Specimen - Blut Instance: example-iv-4-diagnostic-specimen-1 InstanceOf: AtApsSpecimen Usage: #inline * subject = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" * status = $cs-specimen-status#unavailable "Unavailable" * type = $cs-sct#119297000 "Blutprobe" // Diagnostic Results Blut Instance: example-iv-4-diagnostic-result-1 InstanceOf: AtApsObservationResultsLaboratoryPathology Usage: #inline * status = #final * category = $cs-observation-category#laboratory "Laboratory" * code = $cs-loinc#32016-8 "Glucose im kapillaren Blut 1h postprandial" * subject = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" * effectiveDateTime = "2025-03-14T08:00:00+01:00" * performer = Reference(urn:uuid:75db30ee-7028-486c-929a-c5126837f473) "Dr. Hanna Hausärztin" * valueQuantity = 250 'mg/dL' "mg/dL" * specimen = Reference(urn:uuid:e3567418-073e-4fd7-af4e-5fd7ee4785f7) "Blutprobe" Instance: example-iv-4-diagnostic-result-2 InstanceOf: AtApsObservationResultsLaboratoryPathology Usage: #inline * status = #final * category = $cs-observation-category#laboratory "Laboratory" * code = $cs-loinc#4548-4 "Hemoglobin A1c/Hemoglobin.total in Blood" * subject = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) * effectiveDateTime = "2025-03-17T09:30:00+01:00" * performer = Reference(urn:uuid:82f802a7-56a9-49b4-a675-95da08f0d7a6) "Amadeus Spital - Labor" * valueQuantity = 8.1 '%' "%" * specimen = Reference(urn:uuid:e3567418-073e-4fd7-af4e-5fd7ee4785f7) "Blutprobe" Instance: example-iv-4-diagnostic-result-3 InstanceOf: AtApsObservationResultsLaboratoryPathology Usage: #inline * status = #final * category = $cs-observation-category#laboratory "Laboratory" * code = $cs-loinc#2160-0 "Kreatinin in Serum" * subject = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) * effectiveDateTime = "2025-03-17T09:30:00+01:00" * performer = Reference(urn:uuid:82f802a7-56a9-49b4-a675-95da08f0d7a6) "Amadeus Spital - Labor" * valueQuantity = 1.2 'mg/dL' "mg/dL" * specimen = Reference(urn:uuid:e3567418-073e-4fd7-af4e-5fd7ee4785f7) "Blutprobe" // // Diagnostic Results - Specimen Urin // Instance: example-iv-4-diagnostic-specimen-2 // InstanceOf: AtApsSpecimen // Usage: #inline // * subject = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" // * status = $cs-specimen-status#available "Available" // * type = $cs-sct#122575003 "Urine specimen" // // Diagnostic Results - Urindiagnostik // Instance: example-iv-4-diagnostic-result-8 // InstanceOf: AtApsObservationResultsLaboratoryPathology // Usage: #inline // * status = #final // * category = $cs-observation-category#laboratory "Laboratory" // * code = $cs-elga-laborparameterergaenzung#1400 "Urindiagnostik" // * subject = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" // * effectiveDateTime = "2025-02-08T07:56:06+01:00" // * performer = Reference(urn:uuid:82f802a7-56a9-49b4-a675-95da08f0d7a6) "Amadeus Spital - Labor" // * hasMember[0] = Reference(urn:uuid:24ff8632-0ccd-4279-88b2-325fdd936ecb) "Leukocytes in Urine" // * hasMember[+] = Reference(urn:uuid:8c11ad58-94ec-469c-ba4d-bfba9063067d) "Protein in Urine" // * hasMember[+] = Reference(urn:uuid:8c7f9e94-b834-474e-818c-bbd6c3ce3e17) "Glucose in Urine" // * hasMember[+] = Reference(urn:uuid:e6e05f94-92be-4ae3-bf49-b0b7d4a62b35) "Blood in Urine by Visual" // * hasMember[+] = Reference(urn:uuid:33e09da2-5f43-4046-b2eb-cf190031826b) "Nitrite in Urine" // * hasMember[+] = Reference(urn:uuid:b675680e-9469-41b1-adc1-093904e3a1d2) "Urobilinogen in Urine" // * specimen = Reference(urn:uuid:ee1e26a1-caba-45f7-928e-d93fc1a47da9) "Urine specimen" // Instance: example-iv-4-diagnostic-result-9 // InstanceOf: AtApsObservationResultsLaboratoryPathology // Usage: #inline // * status = #final // * category = $cs-observation-category#laboratory "Laboratory" // * code = $cs-loinc#33052-2 "Leukocytes [Presence] in Urine" // * subject = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" // * effectiveDateTime = "2025-02-13T14:31:30+00:00" // * performer = Reference(urn:uuid:82f802a7-56a9-49b4-a675-95da08f0d7a6) "Amadeus Spital - Labor" // * valueCodeableConcept = $cs-sct#260415000 "Not detected (qualifier value)" // * specimen = Reference(urn:uuid:ee1e26a1-caba-45f7-928e-d93fc1a47da9) "Urine specimen (example-iv-4-diagnostic-specimen-2)" // Instance: example-iv-4-diagnostic-result-10 // InstanceOf: AtApsObservationResultsLaboratoryPathology // Usage: #inline // * status = #final // * category = $cs-observation-category#laboratory "Laboratory" // * code = $cs-loinc#2887-8 "Protein [Presence] in Urine" // * subject = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" // * effectiveDateTime = "2025-02-13T14:31:30+00:00" // * performer = Reference(urn:uuid:82f802a7-56a9-49b4-a675-95da08f0d7a6) "Amadeus Spital - Labor" // * valueCodeableConcept = $cs-sct#260415000 "Not detected (qualifier value)" // * specimen = Reference(urn:uuid:ee1e26a1-caba-45f7-928e-d93fc1a47da9) "Urine specimen (example-iv-4-diagnostic-specimen-2)" // Instance: example-iv-4-diagnostic-result-11 // InstanceOf: AtApsObservationResultsLaboratoryPathology // Usage: #inline // * status = #final // * category = $cs-observation-category#laboratory "Laboratory" // * code = $cs-loinc#2349-9 "Glucose [Presence] in Urine" // * subject = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" // * effectiveDateTime = "2025-02-13T14:31:30+00:00" // * performer = Reference(urn:uuid:82f802a7-56a9-49b4-a675-95da08f0d7a6) "Amadeus Spital - Labor" // * valueCodeableConcept = $cs-sct#260415000 "Not detected (qualifier value)" // * specimen = Reference(urn:uuid:ee1e26a1-caba-45f7-928e-d93fc1a47da9) "Urine specimen (example-iv-4-diagnostic-specimen-2)" // Instance: example-iv-4-diagnostic-result-12 // InstanceOf: AtApsObservationResultsLaboratoryPathology // Usage: #inline // * status = #final // * category = $cs-observation-category#laboratory "Laboratory" // * code = $cs-loinc#53963-5 "Blood [Presence] in Urine by Visual" // * subject = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" // * effectiveDateTime = "2025-02-13T14:31:30+00:00" // * performer = Reference(urn:uuid:82f802a7-56a9-49b4-a675-95da08f0d7a6) "Amadeus Spital - Labor" // * valueCodeableConcept = $cs-sct#260415000 "Not detected (qualifier value)" // * specimen = Reference(urn:uuid:ee1e26a1-caba-45f7-928e-d93fc1a47da9) "Urine specimen (example-iv-4-diagnostic-specimen-2)" // Instance: example-iv-4-diagnostic-result-13 // InstanceOf: AtApsObservationResultsLaboratoryPathology // Usage: #inline // * status = #final // * category = $cs-observation-category#laboratory "Laboratory" // * code = $cs-loinc#32710-6 "Nitrite [Presence] in Urine" // * subject = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" // * effectiveDateTime = "2025-02-13T14:31:30+00:00" // * performer = Reference(urn:uuid:82f802a7-56a9-49b4-a675-95da08f0d7a6) "Amadeus Spital - Labor" // * valueCodeableConcept = $cs-sct#260415000 "Not detected (qualifier value)" // * specimen = Reference(urn:uuid:ee1e26a1-caba-45f7-928e-d93fc1a47da9) "Urine specimen (example-iv-4-diagnostic-specimen-2)" // Instance: example-iv-4-diagnostic-result-14 // InstanceOf: AtApsObservationResultsLaboratoryPathology // Usage: #inline // * status = #final // * category = $cs-observation-category#laboratory "Laboratory" // * code = $cs-loinc#13658-0 "Urobilinogen [Presence] in Urine" // * subject = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" // * effectiveDateTime = "2025-02-13T14:31:30+00:00" // * performer = Reference(urn:uuid:82f802a7-56a9-49b4-a675-95da08f0d7a6) "Amadeus Spital - Labor" // * valueCodeableConcept = $cs-sct#260415000 "Not detected (qualifier value)" // * specimen = Reference(urn:uuid:ee1e26a1-caba-45f7-928e-d93fc1a47da9) "Urine specimen (example-iv-4-diagnostic-specimen-2)" // Vitalparameter (Vital Signs) Instance: example-iv-4-vital-sign-1 InstanceOf: AtApsObservationVitalSigns Usage: #inline * status = #final * category[VSCat] = $cs-observation-category#vital-signs "Vital Signs" * code = $cs-loinc#8302-2 "Körpergröße" * subject = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" * performer = Reference(urn:uuid:75db30ee-7028-486c-929a-c5126837f473) "Dr. Hanna Hausärztin" * effectiveDateTime = "2020-02-15T08:00:00+01:00" * valueQuantity = 173 'cm' "cm" Instance: example-iv-4-vital-sign-2 InstanceOf: AtApsObservationVitalSigns Usage: #inline * status = #final * category[VSCat] = $cs-observation-category#vital-signs "Vital Signs" * code = $cs-loinc#29463-7 "Körpergewicht" * subject = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" * performer = Reference(urn:uuid:75db30ee-7028-486c-929a-c5126837f473) "Dr. Hanna Hausärztin" * effectiveDateTime = "2020-02-15T08:00:00+01:00" * valueQuantity = 90 'kg' "kg" Instance: example-iv-4-vital-sign-3 InstanceOf: AtApsObservationVitalSigns Usage: #inline * status = #final * category[VSCat] = $cs-observation-category#vital-signs "Vital Signs" * code = $cs-loinc#39156-5 "Body Mass Index (BMI) [Verhältnis]" * subject = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" * performer = Reference(urn:uuid:75db30ee-7028-486c-929a-c5126837f473) "Dr. Hanna Hausärztin" * effectiveDateTime = "2020-02-15T08:00:00+01:00" * valueQuantity = 30.07 'kg/m2' "kg/m2" // * interpretation = $cs-v3-ObservationInterpretation#H "High" Instance: example-iv-4-vital-sign-4 InstanceOf: AtApsObservationVitalSigns Usage: #inline * status = #final * category[VSCat] = $cs-observation-category#vital-signs "Vital Signs" * code = $cs-loinc#85354-9 "Blood pressure panel with all children optional" * subject = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" * performer = Reference(urn:uuid:75db30ee-7028-486c-929a-c5126837f473) "Dr. Hanna Hausärztin" * effectiveDateTime = "2025-03-14T08:00:00+01:00" * component[0].code = $cs-loinc#8480-6 "Systolischer Blutdruck" * component[=].code.text = "Systolischer Blutdruck" * component[=].valueQuantity = 180 'mm[Hg]' "mm[Hg]" * component[+].code = $cs-loinc#8462-4 "Diastolischer Blutdruck" * component[=].code.text = "Diastolischer Blutdruck" * component[=].valueQuantity = 80 'mm[Hg]' "mm[Hg]" Instance: example-iv-4-vital-sign-5 InstanceOf: AtApsObservationVitalSigns Usage: #inline * status = #final * category[VSCat] = $cs-observation-category#vital-signs "Vital Signs" * code = $cs-loinc#8867-4 "Herzfrequenz" * subject = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" * performer = Reference(urn:uuid:75db30ee-7028-486c-929a-c5126837f473) "Dr. Hanna Hausärztin" * effectiveDateTime = "2025-03-14T08:00:00+01:00" * valueQuantity = 100 '/min' "/min" // Past History of Illness Instance: example-iv-4-illness-history-1 InstanceOf: AtApsCondition Usage: #inline * clinicalStatus = $cs-condition-clinical#resolved "Resolved" * verificationStatus = $cs-condition-ver-status#confirmed "Confirmed" * category.coding[0] = $cs-condition-category#problem-list-item "Problem List Item" * code = $cs-sct#14189004 "Masern" * subject = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" * asserter = Reference(urn:uuid:75db30ee-7028-486c-929a-c5126837f473) "Dr. Hanna Hausärztin" * recordedDate = "1960-01-02" // Social History Instance: example-iv-4-social-history-1 InstanceOf: AtApsObservationTobaccoUse Usage: #inline * status = #final * category[0] = $cs-observation-category#social-history "Lebensstil" * code = $cs-loinc#72166-2 "Raucherstatus" * subject = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" * performer = Reference(urn:uuid:75db30ee-7028-486c-929a-c5126837f473) "Dr. Hanna Hausärztin" * effectiveDateTime = "2025-03-14T08:00:00+01:00" * valueCodeableConcept = $cs-sct#8517006 "Ehemalig rauchende Person" Instance: example-iv-4-social-history-2 InstanceOf: AtApsObservationAlcoholUse Usage: #inline * status = #final * category[0] = $cs-observation-category#social-history "Lebensstil" * code = $cs-loinc#74013-4 "Alcoholic drinks per day" * code.coding.display = "Alkoholische Getränke pro Tag, 1-2 Gläser Wein/Bier" * subject = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" * performer = Reference(urn:uuid:75db30ee-7028-486c-929a-c5126837f473) "Dr. Hanna Hausärztin" * effectiveDateTime = "2025-03-14T08:00:00+01:00" * valueQuantity = 2 '/d' "Gläser Wein pro Tag" Instance: example-iv-4-social-history-3 InstanceOf: AtApsObservation Usage: #inline * status = #final // * category.coding[0] = $cs-observation-category#social-history "Lebensstil" * category[0] = $cs-observation-category#social-history "Lebensstil" * code = $cs-sct#61686008 "Körperliche Aktivität" * subject = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" * performer = Reference(urn:uuid:75db30ee-7028-486c-929a-c5126837f473) "Dr. Hanna Hausärztin" * effectiveDateTime = "2025-03-14T08:00:00+01:00" * valueRatio.numerator = 2.5 'h' "Stunden" * valueRatio.numerator.comparator = #> * valueRatio.denominator = 1 'wk' "Woche" Instance: example-iv-4-organization InstanceOf: AtApsOrganization Usage: #inline * name = "Zentrale Anwendung APS, BMSGPK" * address.city = "Wien" * address.postalCode = "1010" * address.line = "Stubenring 1" // Arzt Instance: example-iv-4-practitioner-1 InstanceOf: AtApsPractitioner Usage: #inline // * identifier.system = "urn:ietf:rfc:3986" // * identifier.value = "urn:oid:1.2.40.0.10.99.1.2.3.4" // * identifier.assigner.display = "Bundesministerium für Gesundheit" * name.prefix[0] = "Dr." * name.family = "Hausärztin" * name.given[0] = "Hanna" * address.city = "Wien" * address.postalCode = "1200" * address.line = "Treustraße 38" // DGKP Instance: example-iv-4-careteam-fallkoordination InstanceOf: AtApsPractitioner Usage: #inline // * identifier.system = "urn:ietf:rfc:3986" // * identifier.value = "urn:oid:1.2.40.0.10.99.1.2.3.4" // * identifier.assigner.display = "Bundesministerium für Gesundheit" * name.prefix[0] = "DGKP" * name.family = "Nutrix" * name.given[0] = "Roman" * address.city = "Wien" * address.postalCode = "1010" * address.line = "Karlsplatz 1" // APS Generator Instance: example-iv-4-author-device InstanceOf: AtApsDevice Usage: #inline * patient = Reference(urn:uuid:0fed5ebe-ca8f-4ad1-aba4-ddad45bd6cc8) "Anton Testpatient" * type = $cs-sct#49062001 "Gerät" * text.status = #additional * text.div = "

Dieses Gerät erzeugt ein APS FHIR-Dokument.

" * deviceName.name = "APS Generator" * deviceName.type = #user-friendly-name * version.value = "1.0" // Practitioner Arzt Instance: example-iv-4-practitioner-iv InstanceOf: AtApsPractitioner Usage: #inline // * identifier.system = "urn:ietf:rfc:3986" // * identifier.value = "urn:oid:1.2.40.0.10.99.1.2.3.4" // * identifier.assigner.display = "Bundesministerium für Gesundheit" * name.prefix[0] = "Dr." * name.family = "IV Diätologin" * name.given[0] = "Melanie" * address.city = "Wien" * address.postalCode = "1020" * address.line = "Praterstern 5" // Patient Instance: example-iv-4-patient InstanceOf: AtApsPatient Usage: #inline * id = "001" * identifier[socialSecurityNumber].type = $cs-v2-0203#SS "Social Security number" * identifier[socialSecurityNumber].system = "urn:oid:1.2.40.0.10.1.4.3.1" * identifier[socialSecurityNumber].value = "1234121153" * identifier[socialSecurityNumber].assigner.display = "Dachverband der österreichischen Sozialversicherungsträger" * identifier[localPatientId].type = $cs-v2-0203#PI "Patient internal identifier" * identifier[localPatientId].system = "urn:oid:1.2.3.4.5" * identifier[localPatientId].value = "0002" * identifier[localPatientId].assigner.display = "Ein GDA in Österreich" * name.family = "Testpatient" * name.given[0] = "Anton" * gender = #male // 1..1 in AT Core * birthDate = "1953-11-12" // 1..1 in IPS * address.line = "Rotenturmstraße 14" * address.use = #home * address.city = "Wien" * address.postalCode = "1010" * address.country = "AUT" * maritalStatus = $cs-v3-MaritalStatus#M "Married"