Dit Profiel is het resultaat van de vergelijking tussen de zib2017 FHIR Profiel en de implementaties in Epic, Chipsoft, Topicus en Nexus. De elementen die in ieder geval in alle output beschikbaar zullen zijn. Voornamelijk bedoeld voor houvast van een client en voor validatie van output.

Zorginformatiebouwsteen

ZIB BehandelAanwijzing

FMS Adequate Registratie

Als bron voor de must-support flags is gebruikt: Fit-gap analyse behandelaanwijzing

N.B. "Geverifieerd" en "Geverifieerd bij" wel gewenst, maar niet beschikbaar in de huidige configuraties en "echte" voorbeeld data.

Behandelgrenzen van de Advance Care Planning (ACP)

Synoniem = Proactieve zorgplanning

Eerder in datasets onder het kopje Advanced Care Planning (ACP) is uitgelegd waar het formulier en de dataset uit bestaat. Vanuit de landelijke organisatie rondom palliatieve zorg is er een aanvulling nodig van de BehandelingCodelijst, komende uit de zib BehandelAanwijzing. Toegevoegd zijn drie nieuwe categorieen met SNOMED CT codering. Deze lijst kun je vinden op ACP TreatmentCodelist pagina.

Op dit moment zijn alleen de Behandelwensen deel (de BehandelAanwijzing zib) in scope. Deze specificering van de zib BehandelAanwijzing is te vinden in dit resource profile.

View Definition

• ViewDefinition voor Behandelaanwijzingen

User-Interface guidance

! Belangrijk dat de UI Schets van Behandelaanwijzing en de UI Schets van Wilsverklaring in één scherm te tonen.

Een schets van het scherm met labels en sortering informatie:

Kolom definities:

Gerelateerde Mapping

Voor implementatie in VIPLive, die zib 2020 gebasseerd is, zijn mappings gedefinieerd tussen de 2017 zib versie en de 2020 zib versie. Deze mappings zijn voorgelegd aan het Nictiz zib-centrum en zij hebben deze voorlopig geaccepteerd terwijl zij verder werken aan de officiele transformaties.

• equal betekent 100% gelijk
• equivalent betekent ongeveer gelijk

• ConceptMap Behandelaanwijzing 2017 en Behandelaanwijzing2 2020

Request

1. Opvragen (search) behandelaanwijzingen

   GET <ontsluiten-bronsysteem-base>/Consent?patient=<fhir_patient_id>&category=http://snomed.info/sct|11291000146105

Bronsysteem herkennen

De Zorgviewer-backend of Ontsluiten bronsysteem MOET na bevragen van het bronsysteem aan elk resultaat resource een meta-tag toevoegen met de AGB, OID of URA identifier van de zorgaanbieder (zie Organization voor voorbeelden). Dit wordt vervolgens gebruikt in de "Bron" kolom in de Zorgviewer-frontend. N.B. We gebruiken hier een pre-adopt van de FHIR R4 Meta.source.

Toevoegen aan elke response, dus per resource (bij een read) of per Bundle (bij een search):

"meta": {
    "extension": [ {
        "url": "http://hl7.org/fhir/4.0/StructureDefinition/extension-Meta.source",
        "valueUri": "urn:oid:2.16.840.1.113883.2.4.3.8"
    } ]
}

Alternatief: Elke entry van een search response Bundle bevat een referentie naar de bijbehorende Patient (<resource>.subject|patient). Elke patient heeft een Patient.managingOrganization en in de gerefereerde Organization.identifier staat vervolgens o.a. de OID van het bronsysyeem. Of je gebruikt de identifiers om een volledige Organization op te zoeken in het adresboek en zie inhoud hier.

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from Zib TreatmentDirective

Name	Flags	Card.	Type	Description & Constraints
Consent		0..*	Zib TreatmentDirective	TreatmentDirective
Slices for extension				Content/Rules for all slices
extension:verification	S	0..1	Zib TreatmentDirective Verification	Verification
Slices for extension				Content/Rules for all slices
extension:VerifiedWith	S	0..1	Extension	Extension
Slices for valueCodeableConcept				Content/Rules for all slices
valueCodeableConcept:valueCodeableConcept	S	0..1	CodeableConcept	Value of extension
extension:treatment	S	0..1	Zib TreatmentDirective Treatment	Optional Extensions Element
Slices for valueCodeableConcept				Content/Rules for all slices
valueCodeableConcept:valueCodeableConcept	S	0..1	CodeableConcept	Treatment Binding: ACP behandelingen waardelijst (extensible): The medical treatment to which the treatment instruction applies.
Slices for modifierExtension				Content/Rules for all slices
modifierExtension:treatmentPermitted	S	1..1	Zib TreatmentDirective TreatmentPermitted	Extension
period	S	0..1	Period	Period that this consent applies
start	S	0..1	dateTime	StartDate
except
Slices for extension				Content/Rules for all slices
extension:restrictions	S	0..1	Zib TreatmentDirective Restrictions	Optional Extensions Element
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Consent.extension:treatment.valueCodeableConcept:valueCodeableConcept	extensible	ACPTreatmentCodelist http://hl7.nl/fhir/zorgviewer/ValueSet/ACPTreatmentCodelist from this IG

Name	Flags	Card.	Type	Description & Constraints
Consent	C	0..*	Zib TreatmentDirective	TreatmentDirective ppc-1: Either a Policy or PolicyRule hcim-treatmentdirective-1: extension.additionalSources may only be used for AdvanceDirective references in addition to first reference in .source[x]
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension				Content/Rules for all slices
verification	S	0..1	(Complex)	Verification URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Verification
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:Verified		1..1	Extension	Verified
url		1..1	uri	"Verified"
Slices for value[x]		0..1	boolean	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueBoolean		0..1	boolean	Verified
extension:VerifiedWith	S	0..1	Extension	Extension
url		1..1	uri	"VerifiedWith"
Slices for value[x]		0..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept	S	0..1	CodeableConcept	Value of extension Binding: GeverifieerdBijCodelijst (extensible): The person with whom the treatment instruction was discussed and verified.
extension:VerificationDate		0..1	Extension	VerificationDate
url		1..1	uri	"VerificationDate"
Slices for value[x]		0..1	dateTime	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueDateTime		0..1	dateTime	VerificationDate
url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Verification"
comment		0..1	string	Comment URL: http://nictiz.nl/fhir/StructureDefinition/Comment
treatment	S	0..1	(Complex)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Treatment
url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Treatment"
Slices for value[x]		0..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept	S	0..1	CodeableConcept	Treatment Binding: ACP behandelingen waardelijst (extensible): The medical treatment to which the treatment instruction applies.
additionalSources		0..*	(Complex)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources
url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources"
Slices for modifierExtension	?!	1..*	Extension	Extension Slice: Unordered, Open by value:url
modifierExtension:treatmentPermitted	?!S	1..1	Zib TreatmentDirective TreatmentPermitted	Extension
url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-TreatmentPermitted"
Slices for value[x]		0..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept		0..1	CodeableConcept	TreatmentPermitted Binding: BehandelingToegestaanCodelijst (extensible): Indication of permission for the treatment, no permission for the treatment, or permission for the treatment with constraints.
status	?!Σ	1..1	code	draft | proposed | active | rejected | inactive | entered-in-error Binding: ConsentState (required): Indicates the state of the consent
category	Σ	1..*	CodeableConcept	Classification of the consent statement - for indexing/retrieval Binding: Consent Category Codes (example): A classification of the type of consents found in a consent statement
Slices for coding	Σ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code
coding:treatmentDirective	Σ	1..1	Coding	Code defined by a terminology system
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 11291000146105
patient	Σ	1..1	Reference(nl-core-patient)	Who the consent applies to
period	SΣ	0..1	Period	Period that this consent applies
start	SΣC	0..1	dateTime	StartDate
except	Σ	0..*	BackboneElement	Additional rule - addition or removal of permissions
Slices for extension				Content/Rules for all slices
restrictions	S	0..1	string	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Restrictions
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
type	Σ	1..1	code	deny | permit Binding: ConsentExceptType (required): How an exception statement is applied, such as adding additional consent or removing consent
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Consent.extension:verification.extension:VerifiedWith.value[x]:valueCodeableConcept	extensible	GeverifieerdBijCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.2.1.4--20171231000000
Consent.extension:treatment.value[x]:valueCodeableConcept	extensible	ACPTreatmentCodelist http://hl7.nl/fhir/zorgviewer/ValueSet/ACPTreatmentCodelist from this IG
Consent.modifierExtension:treatmentPermitted.value[x]:valueCodeableConcept	extensible	BehandelingToegestaanCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.2.1.2--20171231000000
Consent.status	required	ConsentState http://hl7.org/fhir/ValueSet/consent-state-codes from the FHIR Standard
Consent.category	example	Consent Category Codes http://hl7.org/fhir/ValueSet/consent-category from the FHIR Standard
Consent.except.type	required	ConsentExceptType http://hl7.org/fhir/ValueSet/consent-except-type from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-1	error	Consent	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
dom-2	error	Consent	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Consent	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource : contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4	error	Consent	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()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
hcim-treatmentdirective-1	error	Consent	extension.additionalSources may only be used for AdvanceDirective references in addition to first reference in .source[x] : extension.where(url = 'http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources').empty() or source.exists()
ppc-1	error	Consent	Either a Policy or PolicyRule : policy.exists() or policyRule.exists()

Name	Flags	Card.	Type	Description & Constraints
Consent	C	0..*	Zib TreatmentDirective	TreatmentDirective ppc-1: Either a Policy or PolicyRule hcim-treatmentdirective-1: extension.additionalSources may only be used for AdvanceDirective references in addition to first reference in .source[x]
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: Common Languages (extensible): A human language. Additional Bindings Purpose All Languages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
verification	S	0..1	(Complex)	Verification URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Verification
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:Verified		1..1	Extension	Verified
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"Verified"
Slices for value[x]		0..1	boolean	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueBoolean		0..1	boolean	Verified
extension:VerifiedWith	S	0..1	Extension	Extension
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"VerifiedWith"
Slices for value[x]		0..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept	S	0..1	CodeableConcept	Value of extension Binding: GeverifieerdBijCodelijst (extensible): The person with whom the treatment instruction was discussed and verified.
extension:VerificationDate		0..1	Extension	VerificationDate
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"VerificationDate"
Slices for value[x]		0..1	dateTime	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueDateTime		0..1	dateTime	VerificationDate
url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Verification"
comment		0..1	string	Comment URL: http://nictiz.nl/fhir/StructureDefinition/Comment
treatment	S	0..1	(Complex)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Treatment
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Treatment"
Slices for value[x]		0..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept	S	0..1	CodeableConcept	Treatment Binding: ACP behandelingen waardelijst (extensible): The medical treatment to which the treatment instruction applies.
additionalSources		0..*	(Complex)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources"
value[x]		0..1		AdvanceDirective
valueAttachment			Attachment
valueIdentifier			Identifier
valueReference			Reference(HCIM AdvanceDirective | DocumentReference | Contract | QuestionnaireResponse)
Slices for modifierExtension	?!	1..*	Extension	Extension Slice: Unordered, Open by value:url
modifierExtension:treatmentPermitted	?!S	1..1	Zib TreatmentDirective TreatmentPermitted	Extension
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-TreatmentPermitted"
Slices for value[x]		0..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept		0..1	CodeableConcept	TreatmentPermitted Binding: BehandelingToegestaanCodelijst (extensible): Indication of permission for the treatment, no permission for the treatment, or permission for the treatment with constraints.
identifier	Σ	0..1	Identifier	Identifier for this record (external references) Example General: {"system":"urn:ietf:rfc:3986","value":"Local eCMS identifier"}
status	?!Σ	1..1	code	draft | proposed | active | rejected | inactive | entered-in-error Binding: ConsentState (required): Indicates the state of the consent
category	Σ	1..*	CodeableConcept	Classification of the consent statement - for indexing/retrieval Binding: Consent Category Codes (example): A classification of the type of consents found in a consent statement
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code
coding:treatmentDirective	Σ	1..1	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 11291000146105
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
patient	Σ	1..1	Reference(nl-core-patient)	Who the consent applies to
period	SΣ	0..1	Period	Period that this consent applies
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
start	SΣC	0..1	dateTime	StartDate
end	ΣC	0..1	dateTime	EndDate
dateTime	Σ	0..1	dateTime	When this Consent was created or indexed
consentingParty	Σ	0..*	Reference(nl-core-relatedperson | nl-core-organization | nl-core-patient | nl-core-practitioner)	Who is agreeing to the policy and exceptions
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
actor	Σ	0..*	BackboneElement	Who|what controlled by this consent (or group, by role)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
role		1..1	CodeableConcept	How the actor is involved Binding: SecurityRoleType (extensible): How an actor is involved in the consent considerations
reference		1..1	Reference(Device | Group | CareTeam | nl-core-organization | nl-core-patient | nl-core-practitioner | nl-core-relatedperson)	Resource for the actor (or group, by role)
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
action	Σ	0..*	CodeableConcept	Actions controlled by this consent Binding: Consent Action Codes (example): Detailed codes for the consent action.
organization	Σ	0..*	Reference(nl-core-organization)	Custodian of the consent
source[x]	Σ	0..1		AdvanceDirective
sourceAttachment			Attachment
sourceIdentifier			Identifier
sourceReference			Reference(HCIM AdvanceDirective | DocumentReference | Contract | QuestionnaireResponse)
policy		0..*	BackboneElement	Policies covered by this consent
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
authority	C	0..1	uri	Enforcement source for policy
uri	C	0..1	uri	Specific policy covered by this consent Example General Dutch Law: http://wetten.overheid.nl/
policyRule	ΣC	0..1	uri	Policy that this consents to
securityLabel	Σ	0..*	Coding	Security Labels that define affected resources Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
purpose	Σ	0..*	Coding	Context of activities for which the agreement is made Binding: PurposeOfUse (extensible): What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels
dataPeriod	Σ	0..1	Period	Timeframe for data controlled by this consent
data	Σ	0..*	BackboneElement	Data controlled by this consent
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
meaning	Σ	1..1	code	instance | related | dependents | authoredby Binding: ConsentDataMeaning (required): How a resource reference is interpreted when testing consent restrictions
reference	Σ	1..1	Reference(Resource)	The actual data reference
except	Σ	0..*	BackboneElement	Additional rule - addition or removal of permissions
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
restrictions	S	0..1	string	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Restrictions
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
type	Σ	1..1	code	deny | permit Binding: ConsentExceptType (required): How an exception statement is applied, such as adding additional consent or removing consent
period	Σ	0..1	Period	Timeframe for this exception
actor	Σ	0..*	BackboneElement	Who|what controlled by this exception (or group, by role)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
role		1..1	CodeableConcept	How the actor is involved Binding: SecurityRoleType (extensible): How an actor is involved in the consent considerations
reference		1..1	Reference(Device | Group | CareTeam | nl-core-organization | nl-core-patient | nl-core-practitioner | nl-core-relatedperson)	Resource for the actor (or group, by role)
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
action	Σ	0..*	CodeableConcept	Actions controlled by this exception Binding: Consent Action Codes (example): Detailed codes for the consent action.
securityLabel	Σ	0..*	Coding	Security Labels that define affected resources Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
purpose	Σ	0..*	Coding	Context of activities covered by this exception Binding: PurposeOfUse (extensible): What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels
class	Σ	0..*	Coding	e.g. Resource Type, Profile, or CDA etc Binding: Consent Content Class (extensible): The class (type) of information a consent rule covers
code	Σ	0..*	Coding	e.g. LOINC or SNOMED CT code, etc in the content Binding: Consent Content Codes (example): If this code is found in an instance, then the exception applies
dataPeriod	Σ	0..1	Period	Timeframe for data controlled by this exception
data	Σ	0..*	BackboneElement	Data controlled by this exception
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
meaning	Σ	1..1	code	instance | related | dependents | authoredby Binding: ConsentDataMeaning (required): How a resource reference is interpreted when testing consent restrictions
reference	Σ	1..1	Reference(Resource)	The actual data reference
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Consent.language	extensible	Common Languages Additional Bindings Purpose All Languages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Consent.extension:verification.extension:VerifiedWith.value[x]:valueCodeableConcept	extensible	GeverifieerdBijCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.2.1.4--20171231000000
Consent.extension:treatment.value[x]:valueCodeableConcept	extensible	ACPTreatmentCodelist http://hl7.nl/fhir/zorgviewer/ValueSet/ACPTreatmentCodelist from this IG
Consent.modifierExtension:treatmentPermitted.value[x]:valueCodeableConcept	extensible	BehandelingToegestaanCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.2.1.2--20171231000000
Consent.status	required	ConsentState http://hl7.org/fhir/ValueSet/consent-state-codes from the FHIR Standard
Consent.category	example	Consent Category Codes http://hl7.org/fhir/ValueSet/consent-category from the FHIR Standard
Consent.actor.role	extensible	SecurityRoleType http://hl7.org/fhir/ValueSet/security-role-type from the FHIR Standard
Consent.action	example	Consent Action Codes http://hl7.org/fhir/ValueSet/consent-action from the FHIR Standard
Consent.securityLabel	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
Consent.purpose	extensible	PurposeOfUse http://hl7.org/fhir/ValueSet/v3-PurposeOfUse from the FHIR Standard
Consent.data.meaning	required	ConsentDataMeaning http://hl7.org/fhir/ValueSet/consent-data-meaning from the FHIR Standard
Consent.except.type	required	ConsentExceptType http://hl7.org/fhir/ValueSet/consent-except-type from the FHIR Standard
Consent.except.actor.role	extensible	SecurityRoleType http://hl7.org/fhir/ValueSet/security-role-type from the FHIR Standard
Consent.except.action	example	Consent Action Codes http://hl7.org/fhir/ValueSet/consent-action from the FHIR Standard
Consent.except.securityLabel	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
Consent.except.purpose	extensible	PurposeOfUse http://hl7.org/fhir/ValueSet/v3-PurposeOfUse from the FHIR Standard
Consent.except.class	extensible	Consent Content Class http://hl7.org/fhir/ValueSet/consent-content-class from the FHIR Standard
Consent.except.code	example	Consent Content Codes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/consent-content-code from the FHIR Standard
Consent.except.data.meaning	required	ConsentDataMeaning http://hl7.org/fhir/ValueSet/consent-data-meaning from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-1	error	Consent	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
dom-2	error	Consent	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Consent	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource : contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4	error	Consent	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()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
hcim-treatmentdirective-1	error	Consent	extension.additionalSources may only be used for AdvanceDirective references in addition to first reference in .source[x] : extension.where(url = 'http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources').empty() or source.exists()
ppc-1	error	Consent	Either a Policy or PolicyRule : policy.exists() or policyRule.exists()

Differential View

This structure is derived from Zib TreatmentDirective

Name	Flags	Card.	Type	Description & Constraints
Consent		0..*	Zib TreatmentDirective	TreatmentDirective
Slices for extension				Content/Rules for all slices
extension:verification	S	0..1	Zib TreatmentDirective Verification	Verification
Slices for extension				Content/Rules for all slices
extension:VerifiedWith	S	0..1	Extension	Extension
Slices for valueCodeableConcept				Content/Rules for all slices
valueCodeableConcept:valueCodeableConcept	S	0..1	CodeableConcept	Value of extension
extension:treatment	S	0..1	Zib TreatmentDirective Treatment	Optional Extensions Element
Slices for valueCodeableConcept				Content/Rules for all slices
valueCodeableConcept:valueCodeableConcept	S	0..1	CodeableConcept	Treatment Binding: ACP behandelingen waardelijst (extensible): The medical treatment to which the treatment instruction applies.
Slices for modifierExtension				Content/Rules for all slices
modifierExtension:treatmentPermitted	S	1..1	Zib TreatmentDirective TreatmentPermitted	Extension
period	S	0..1	Period	Period that this consent applies
start	S	0..1	dateTime	StartDate
except
Slices for extension				Content/Rules for all slices
extension:restrictions	S	0..1	Zib TreatmentDirective Restrictions	Optional Extensions Element
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Consent.extension:treatment.valueCodeableConcept:valueCodeableConcept	extensible	ACPTreatmentCodelist http://hl7.nl/fhir/zorgviewer/ValueSet/ACPTreatmentCodelist from this IG

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Consent	C	0..*	Zib TreatmentDirective	TreatmentDirective ppc-1: Either a Policy or PolicyRule hcim-treatmentdirective-1: extension.additionalSources may only be used for AdvanceDirective references in addition to first reference in .source[x]
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension				Content/Rules for all slices
verification	S	0..1	(Complex)	Verification URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Verification
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:Verified		1..1	Extension	Verified
url		1..1	uri	"Verified"
Slices for value[x]		0..1	boolean	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueBoolean		0..1	boolean	Verified
extension:VerifiedWith	S	0..1	Extension	Extension
url		1..1	uri	"VerifiedWith"
Slices for value[x]		0..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept	S	0..1	CodeableConcept	Value of extension Binding: GeverifieerdBijCodelijst (extensible): The person with whom the treatment instruction was discussed and verified.
extension:VerificationDate		0..1	Extension	VerificationDate
url		1..1	uri	"VerificationDate"
Slices for value[x]		0..1	dateTime	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueDateTime		0..1	dateTime	VerificationDate
url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Verification"
comment		0..1	string	Comment URL: http://nictiz.nl/fhir/StructureDefinition/Comment
treatment	S	0..1	(Complex)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Treatment
url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Treatment"
Slices for value[x]		0..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept	S	0..1	CodeableConcept	Treatment Binding: ACP behandelingen waardelijst (extensible): The medical treatment to which the treatment instruction applies.
additionalSources		0..*	(Complex)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources
url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources"
Slices for modifierExtension	?!	1..*	Extension	Extension Slice: Unordered, Open by value:url
modifierExtension:treatmentPermitted	?!S	1..1	Zib TreatmentDirective TreatmentPermitted	Extension
url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-TreatmentPermitted"
Slices for value[x]		0..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept		0..1	CodeableConcept	TreatmentPermitted Binding: BehandelingToegestaanCodelijst (extensible): Indication of permission for the treatment, no permission for the treatment, or permission for the treatment with constraints.
status	?!Σ	1..1	code	draft | proposed | active | rejected | inactive | entered-in-error Binding: ConsentState (required): Indicates the state of the consent
category	Σ	1..*	CodeableConcept	Classification of the consent statement - for indexing/retrieval Binding: Consent Category Codes (example): A classification of the type of consents found in a consent statement
Slices for coding	Σ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code
coding:treatmentDirective	Σ	1..1	Coding	Code defined by a terminology system
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 11291000146105
patient	Σ	1..1	Reference(nl-core-patient)	Who the consent applies to
period	SΣ	0..1	Period	Period that this consent applies
start	SΣC	0..1	dateTime	StartDate
except	Σ	0..*	BackboneElement	Additional rule - addition or removal of permissions
Slices for extension				Content/Rules for all slices
restrictions	S	0..1	string	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Restrictions
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
type	Σ	1..1	code	deny | permit Binding: ConsentExceptType (required): How an exception statement is applied, such as adding additional consent or removing consent
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Consent.extension:verification.extension:VerifiedWith.value[x]:valueCodeableConcept	extensible	GeverifieerdBijCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.2.1.4--20171231000000
Consent.extension:treatment.value[x]:valueCodeableConcept	extensible	ACPTreatmentCodelist http://hl7.nl/fhir/zorgviewer/ValueSet/ACPTreatmentCodelist from this IG
Consent.modifierExtension:treatmentPermitted.value[x]:valueCodeableConcept	extensible	BehandelingToegestaanCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.2.1.2--20171231000000
Consent.status	required	ConsentState http://hl7.org/fhir/ValueSet/consent-state-codes from the FHIR Standard
Consent.category	example	Consent Category Codes http://hl7.org/fhir/ValueSet/consent-category from the FHIR Standard
Consent.except.type	required	ConsentExceptType http://hl7.org/fhir/ValueSet/consent-except-type from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-1	error	Consent	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
dom-2	error	Consent	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Consent	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource : contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4	error	Consent	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()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
hcim-treatmentdirective-1	error	Consent	extension.additionalSources may only be used for AdvanceDirective references in addition to first reference in .source[x] : extension.where(url = 'http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources').empty() or source.exists()
ppc-1	error	Consent	Either a Policy or PolicyRule : policy.exists() or policyRule.exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Consent	C	0..*	Zib TreatmentDirective	TreatmentDirective ppc-1: Either a Policy or PolicyRule hcim-treatmentdirective-1: extension.additionalSources may only be used for AdvanceDirective references in addition to first reference in .source[x]
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: Common Languages (extensible): A human language. Additional Bindings Purpose All Languages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
verification	S	0..1	(Complex)	Verification URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Verification
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:Verified		1..1	Extension	Verified
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"Verified"
Slices for value[x]		0..1	boolean	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueBoolean		0..1	boolean	Verified
extension:VerifiedWith	S	0..1	Extension	Extension
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"VerifiedWith"
Slices for value[x]		0..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept	S	0..1	CodeableConcept	Value of extension Binding: GeverifieerdBijCodelijst (extensible): The person with whom the treatment instruction was discussed and verified.
extension:VerificationDate		0..1	Extension	VerificationDate
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"VerificationDate"
Slices for value[x]		0..1	dateTime	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueDateTime		0..1	dateTime	VerificationDate
url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Verification"
comment		0..1	string	Comment URL: http://nictiz.nl/fhir/StructureDefinition/Comment
treatment	S	0..1	(Complex)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Treatment
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Treatment"
Slices for value[x]		0..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept	S	0..1	CodeableConcept	Treatment Binding: ACP behandelingen waardelijst (extensible): The medical treatment to which the treatment instruction applies.
additionalSources		0..*	(Complex)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources"
value[x]		0..1		AdvanceDirective
valueAttachment			Attachment
valueIdentifier			Identifier
valueReference			Reference(HCIM AdvanceDirective | DocumentReference | Contract | QuestionnaireResponse)
Slices for modifierExtension	?!	1..*	Extension	Extension Slice: Unordered, Open by value:url
modifierExtension:treatmentPermitted	?!S	1..1	Zib TreatmentDirective TreatmentPermitted	Extension
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
url		1..1	uri	"http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-TreatmentPermitted"
Slices for value[x]		0..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept		0..1	CodeableConcept	TreatmentPermitted Binding: BehandelingToegestaanCodelijst (extensible): Indication of permission for the treatment, no permission for the treatment, or permission for the treatment with constraints.
identifier	Σ	0..1	Identifier	Identifier for this record (external references) Example General: {"system":"urn:ietf:rfc:3986","value":"Local eCMS identifier"}
status	?!Σ	1..1	code	draft | proposed | active | rejected | inactive | entered-in-error Binding: ConsentState (required): Indicates the state of the consent
category	Σ	1..*	CodeableConcept	Classification of the consent statement - for indexing/retrieval Binding: Consent Category Codes (example): A classification of the type of consents found in a consent statement
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code
coding:treatmentDirective	Σ	1..1	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 11291000146105
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
patient	Σ	1..1	Reference(nl-core-patient)	Who the consent applies to
period	SΣ	0..1	Period	Period that this consent applies
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
start	SΣC	0..1	dateTime	StartDate
end	ΣC	0..1	dateTime	EndDate
dateTime	Σ	0..1	dateTime	When this Consent was created or indexed
consentingParty	Σ	0..*	Reference(nl-core-relatedperson | nl-core-organization | nl-core-patient | nl-core-practitioner)	Who is agreeing to the policy and exceptions
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
actor	Σ	0..*	BackboneElement	Who|what controlled by this consent (or group, by role)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
role		1..1	CodeableConcept	How the actor is involved Binding: SecurityRoleType (extensible): How an actor is involved in the consent considerations
reference		1..1	Reference(Device | Group | CareTeam | nl-core-organization | nl-core-patient | nl-core-practitioner | nl-core-relatedperson)	Resource for the actor (or group, by role)
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
action	Σ	0..*	CodeableConcept	Actions controlled by this consent Binding: Consent Action Codes (example): Detailed codes for the consent action.
organization	Σ	0..*	Reference(nl-core-organization)	Custodian of the consent
source[x]	Σ	0..1		AdvanceDirective
sourceAttachment			Attachment
sourceIdentifier			Identifier
sourceReference			Reference(HCIM AdvanceDirective | DocumentReference | Contract | QuestionnaireResponse)
policy		0..*	BackboneElement	Policies covered by this consent
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
authority	C	0..1	uri	Enforcement source for policy
uri	C	0..1	uri	Specific policy covered by this consent Example General Dutch Law: http://wetten.overheid.nl/
policyRule	ΣC	0..1	uri	Policy that this consents to
securityLabel	Σ	0..*	Coding	Security Labels that define affected resources Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
purpose	Σ	0..*	Coding	Context of activities for which the agreement is made Binding: PurposeOfUse (extensible): What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels
dataPeriod	Σ	0..1	Period	Timeframe for data controlled by this consent
data	Σ	0..*	BackboneElement	Data controlled by this consent
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
meaning	Σ	1..1	code	instance | related | dependents | authoredby Binding: ConsentDataMeaning (required): How a resource reference is interpreted when testing consent restrictions
reference	Σ	1..1	Reference(Resource)	The actual data reference
except	Σ	0..*	BackboneElement	Additional rule - addition or removal of permissions
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
restrictions	S	0..1	string	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Restrictions
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
type	Σ	1..1	code	deny | permit Binding: ConsentExceptType (required): How an exception statement is applied, such as adding additional consent or removing consent
period	Σ	0..1	Period	Timeframe for this exception
actor	Σ	0..*	BackboneElement	Who|what controlled by this exception (or group, by role)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
role		1..1	CodeableConcept	How the actor is involved Binding: SecurityRoleType (extensible): How an actor is involved in the consent considerations
reference		1..1	Reference(Device | Group | CareTeam | nl-core-organization | nl-core-patient | nl-core-practitioner | nl-core-relatedperson)	Resource for the actor (or group, by role)
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
action	Σ	0..*	CodeableConcept	Actions controlled by this exception Binding: Consent Action Codes (example): Detailed codes for the consent action.
securityLabel	Σ	0..*	Coding	Security Labels that define affected resources Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
purpose	Σ	0..*	Coding	Context of activities covered by this exception Binding: PurposeOfUse (extensible): What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels
class	Σ	0..*	Coding	e.g. Resource Type, Profile, or CDA etc Binding: Consent Content Class (extensible): The class (type) of information a consent rule covers
code	Σ	0..*	Coding	e.g. LOINC or SNOMED CT code, etc in the content Binding: Consent Content Codes (example): If this code is found in an instance, then the exception applies
dataPeriod	Σ	0..1	Period	Timeframe for data controlled by this exception
data	Σ	0..*	BackboneElement	Data controlled by this exception
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
meaning	Σ	1..1	code	instance | related | dependents | authoredby Binding: ConsentDataMeaning (required): How a resource reference is interpreted when testing consent restrictions
reference	Σ	1..1	Reference(Resource)	The actual data reference
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Consent.language	extensible	Common Languages Additional Bindings Purpose All Languages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Consent.extension:verification.extension:VerifiedWith.value[x]:valueCodeableConcept	extensible	GeverifieerdBijCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.2.1.4--20171231000000
Consent.extension:treatment.value[x]:valueCodeableConcept	extensible	ACPTreatmentCodelist http://hl7.nl/fhir/zorgviewer/ValueSet/ACPTreatmentCodelist from this IG
Consent.modifierExtension:treatmentPermitted.value[x]:valueCodeableConcept	extensible	BehandelingToegestaanCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.2.1.2--20171231000000
Consent.status	required	ConsentState http://hl7.org/fhir/ValueSet/consent-state-codes from the FHIR Standard
Consent.category	example	Consent Category Codes http://hl7.org/fhir/ValueSet/consent-category from the FHIR Standard
Consent.actor.role	extensible	SecurityRoleType http://hl7.org/fhir/ValueSet/security-role-type from the FHIR Standard
Consent.action	example	Consent Action Codes http://hl7.org/fhir/ValueSet/consent-action from the FHIR Standard
Consent.securityLabel	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
Consent.purpose	extensible	PurposeOfUse http://hl7.org/fhir/ValueSet/v3-PurposeOfUse from the FHIR Standard
Consent.data.meaning	required	ConsentDataMeaning http://hl7.org/fhir/ValueSet/consent-data-meaning from the FHIR Standard
Consent.except.type	required	ConsentExceptType http://hl7.org/fhir/ValueSet/consent-except-type from the FHIR Standard
Consent.except.actor.role	extensible	SecurityRoleType http://hl7.org/fhir/ValueSet/security-role-type from the FHIR Standard
Consent.except.action	example	Consent Action Codes http://hl7.org/fhir/ValueSet/consent-action from the FHIR Standard
Consent.except.securityLabel	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
Consent.except.purpose	extensible	PurposeOfUse http://hl7.org/fhir/ValueSet/v3-PurposeOfUse from the FHIR Standard
Consent.except.class	extensible	Consent Content Class http://hl7.org/fhir/ValueSet/consent-content-class from the FHIR Standard
Consent.except.code	example	Consent Content Codes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/consent-content-code from the FHIR Standard
Consent.except.data.meaning	required	ConsentDataMeaning http://hl7.org/fhir/ValueSet/consent-data-meaning from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-1	error	Consent	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
dom-2	error	Consent	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Consent	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource : contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4	error	Consent	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()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
hcim-treatmentdirective-1	error	Consent	extension.additionalSources may only be used for AdvanceDirective references in addition to first reference in .source[x] : extension.where(url = 'http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources').empty() or source.exists()
ppc-1	error	Consent	Either a Policy or PolicyRule : policy.exists() or policyRule.exists()

This structure is derived from Zib TreatmentDirective

Summary

Must-Support: 9 elements