RIVO-Noord Zorgviewer Implementation Guide
1.23.0 - CI build

RIVO-Noord Zorgviewer Implementation Guide, published by RIVO-NN HL7NL. This guide is not an authorized publication; it is the continuous build for version 1.23.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/RIVO-Noord/zorgviewer-ig/ and changes regularly. See the Directory of published versions

## Resource Profile: TreatmentDirective

Official URL: http://fhir.hl7.nl/zorgviewer/StructureDefinition/TreatmentDirective | Version: 1.23.0
Active as of 2026-03-30 | Computable Name: TreatmentDirective

Advanced Care Planning (ACP) Behandelaanwijzingen (Consent)

> 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.

> - N.B. "Geverifieerd" en "Geverifieerd bij" wel gewenst vanuit FMS, maar niet beschikbaar in alle huidige configuraties en "echte" voorbeeld data.
> - Op dit moment zijn alleen de ACP Behandelwensen deel (de BehandelAanwijzing zib) in scope. Deze specificering van de zib BehandelAanwijzing is te vinden in dit profile.

### Zorginformatiebouwsteen

ZIB BehandelAanwijzing

### FMS Adequate Registratie

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

### 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.

### View Definition

ViewDefinition voor Behandelaanwijzingen

### UI Wireframe

Behandelaanwijzingen

>< | Bron | Datum | Behandeling | Behandeling toegestaan | Beperkingen | Geverifieerd bij | (status)
--- | --- | --- | --- | --- | --- | --- | ---
+ | Chipsoft | 30-9-2022 | Artificial respiration (procedure) | Ja, maar met beperkingen | Toelichting: Eerst overleg met echtgenote |  | active
| Categorie Treatment instructions
+ | Epic | 22-3-2022 | kunstmatige beademing (verrichting) | Ja, maar met beperkingen | Eerst overleg met echtgenote | patiënt (persoon) | active
| Categorie Advance Directive & Vastgelegd
+ | Nexus | 5-5-2023 | Kunstmatige beademing | Behandeling niet toegestaan en/of wenselijk |  |  | active
| Toelichting testje Categorie Behandelingsinstructies (artefact opnemen)

### Kolomdefinities

Kolom label | FHIR Path Expression | FHIR Type | Zib element | Toelichting of regels
Bron | `meta.extension('http://hl7.org/fhir/4.0/StructureDefinition/extension-Meta.source').valueUri` | `string` | nvt | Lookup adhv uri (AGB-Z of OID) `<adressering-base>/Organization?identifier=<.meta.tag.code>` en gebruik dan `Organization.name`
Datum | `period.start` | `dateTime` | BeginDatum | Kunnen vage datums zijn.
Behandeling | `extension('http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Treatment').valueCodeableConcept.coding[0].display` | `string` | Behandeling |
Behandeling toegestaan | `modifierExtension.where(url='http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-TreatmentPermitted').valueCodeableConcept.coding.display` | `string` | BehandelingToegestaan | Zie UI schets voor icon mapping. N.B. obv coding.code
Beperkingen | `except.extension('http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Restrictions').value` | `string` | Beperkingen |
Geverifieerd bij | `extension('http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Verification').extension('VerifiedWith').valueCodeableConcept.text.join(' & ')` | `string` | GeverifieerdBij |
UITKLAPVELD
+Toelichting | `extension.where(url='http://nictiz.nl/fhir/StructureDefinition/Comment').valueString` | `string` | Toelichting |
+Categorie | `category.coding.display.join(' & ')` | `string` | nvt |
MARKERING
(status) | `status` | `code` | nvt |

### User-Interface Mockup

! 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:

### 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.

Usages:

- Examples for this Profile: Consent/190c12af-49d4-4553-8009-c816ab622a3e
- CapabilityStatements using this Profile: Ontsluiten Bronsysteem

You can also check for usages in the FHIR IG Statistics

Changes since version 1.22.0:

- New Content

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Consent | C | 0..* | Zib TreatmentDirective | TreatmentDirective Constraints: ppc-1, hcim-treatmentdirective-1
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  |  |  | Content/Rules for all slices
extension:verification | S | 0..1 | (Complex) | Verification URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Verification Constraints: ext-1
Slices for extension |  | 1..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
extension:Verified |  | 1..1 | Extension | Verified
extension |  | 0..0 |  | Additional Content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "Verified"
Slices for valueBoolean |  |  |  | Content/Rules for all slices
valueBoolean:valueBoolean |  | 0..1 | boolean | Verified
extension:VerifiedWith | S | 0..1 | Extension | Extension
extension |  | 0..0 |  | Additional Content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "VerifiedWith"
Slices for valueCodeableConcept |  |  |  | Content/Rules for all slices
valueCodeableConcept: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
extension |  | 0..0 |  | Additional Content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "VerificationDate"
Slices for valueDateTime |  |  |  | Content/Rules for all slices
valueDateTime:valueDateTime |  | 0..1 | dateTime | VerificationDate
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Verification"
extension:comment | S | 0..1 | string | Comment URL: http://nictiz.nl/fhir/StructureDefinition/Comment Constraints: ext-1
extension:treatment | S | 0..1 | (Complex) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Treatment Constraints: ext-1
extension |  | 0..0 |  | 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] |  |  |  | Content/Rules for all slices
value[x]:valueCodeableConcept | S | 0..1 | CodeableConcept | Treatment Binding: ACP behandelingen waardelijst (extensible): The medical treatment to which the treatment instruction applies.
extension:additionalSources |  | 0..* | (Complex) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources Constraints: ext-1
extension |  | 0..0 |  | Additional Content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources"
Slices for modifierExtension | ?! | 1..* | Extension | Extensions that cannot be ignored Slice: Unordered, Open by value:url
modifierExtension:treatmentPermitted | ?!S | 1..1 | (Complex) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-TreatmentPermitted Constraints: ext-1
extension |  | 0..0 |  | 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] |  |  |  | Content/Rules for all slices
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 | S Σ | 0..1 | Period | Period that this consent applies
start | S Σ C | 0..1 | dateTime | StartDate
except | Σ | 0..* | BackboneElement | Additional rule - addition or removal of permissions
Slices for extension |  |  |  | Content/Rules for all slices
extension:restrictions | S | 0..1 | string | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Restrictions Constraints: ext-1
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 | Status | Usage | ValueSet | Version | Source
Consent.extension:verification.​extension:VerifiedWith.​valueCodeableConcept:valueCodeableConcept | Base | extensible | GeverifieerdBijCodelijst | 📦2017-12-31T00:00:00 | Nictiz FHIR NL STU3 Zib2017 v2.3
Consent.extension:treatment.​value[x]:valueCodeableConcept | Base | extensible | ACP behandelingen waardelijst | 📦1.23.0 | This IG
Consent.modifierExtension:treatmentPermitted.​value[x]:valueCodeableConcept | Base | extensible | BehandelingToegestaanCodelijst | 📦2017-12-31T00:00:00 | Nictiz FHIR NL STU3 Zib2017 v2.3
Consent.status | Base | required | ConsentState | 📦3.0.2 | FHIR Std.
Consent.category | Base | example | Consent Category Codes | 📦3.0.2 | FHIR Std.
Consent.except.type | Base | required | ConsentExceptType | 📦3.0.2 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
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 | Consent.extension:verification, Consent.extension:comment, Consent.extension:treatment, Consent.extension:additionalSources, Consent.modifierExtension:treatmentPermitted, Consent.except.extension:restrictions | 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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
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:comment | S | 0..1 | Comment | Comment
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 | Optional Extensions Element
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 | Status | Usage | ValueSet | Version | Source
Consent.extension:treatment.​valueCodeableConcept:valueCodeableConcept | Base | extensible | ACP behandelingen waardelijst | 📦1.23.0 | This IG

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Consent | C | 0..* | Zib TreatmentDirective | TreatmentDirective Constraints: ppc-1, hcim-treatmentdirective-1
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 This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
extension:verification | S | 0..1 | (Complex) | Verification URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Verification Constraints: ext-1
id |  | 0..1 | string | xml:id (or equivalent in JSON)
Slices for extension |  | 1..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
extension:Verified |  | 1..1 | Extension | Verified
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..0 |  | Additional Content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "Verified"
Slices for valueBoolean |  |  |  | Content/Rules for all slices
valueBoolean:valueBoolean |  | 0..1 | boolean | Verified
extension:VerifiedWith | S | 0..1 | Extension | Extension
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..0 |  | Additional Content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "VerifiedWith"
Slices for valueCodeableConcept |  |  |  | Content/Rules for all slices
valueCodeableConcept: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..0 |  | Additional Content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "VerificationDate"
Slices for valueDateTime |  |  |  | Content/Rules for all slices
valueDateTime:valueDateTime |  | 0..1 | dateTime | VerificationDate
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Verification"
extension:comment | S | 0..1 | string | Comment URL: http://nictiz.nl/fhir/StructureDefinition/Comment Constraints: ext-1
extension:treatment | S | 0..1 | (Complex) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Treatment Constraints: ext-1
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..0 |  | 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] |  |  |  | Content/Rules for all slices
value[x]:valueCodeableConcept | S | 0..1 | CodeableConcept | Treatment Binding: ACP behandelingen waardelijst (extensible): The medical treatment to which the treatment instruction applies.
extension:additionalSources |  | 0..* | (Complex) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources Constraints: ext-1
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..0 |  | 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 | Extensions that cannot be ignored Slice: Unordered, Open by value:url
modifierExtension:treatmentPermitted | ?!S | 1..1 | (Complex) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-TreatmentPermitted Constraints: ext-1
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..0 |  | 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] |  |  |  | Content/Rules for all slices
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 | S Σ | 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 | S Σ C | 0..1 | dateTime | StartDate
end | Σ C | 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 | Additional Content defined by implementations Slice: Unordered, Open by value:url
extension:practitionerRole |  | 0..1 | Reference(nl-core-practitionerrole) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference Constraints: ext-1
reference | Σ C | 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 | Additional Content defined by implementations Slice: Unordered, Open by value:url
extension:practitionerRole |  | 0..1 | Reference(nl-core-practitionerrole) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference Constraints: ext-1
reference | Σ C | 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 | Σ C | 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 | Additional Content defined by implementations Slice: Unordered, Open by value:url
extension:restrictions | S | 0..1 | string | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Restrictions Constraints: ext-1
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 | Additional Content defined by implementations Slice: Unordered, Open by value:url
extension:practitionerRole |  | 0..1 | Reference(nl-core-practitionerrole) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference Constraints: ext-1
reference | Σ C | 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 | Status | Usage | ValueSet | Version | Source
Consent.language | Base | extensible | Common Languages | 📦3.0.2 | FHIR Std.
Consent.extension:verification.​extension:VerifiedWith.​valueCodeableConcept:valueCodeableConcept | Base | extensible | GeverifieerdBijCodelijst | 📦2017-12-31T00:00:00 | Nictiz FHIR NL STU3 Zib2017 v2.3
Consent.extension:treatment.​value[x]:valueCodeableConcept | Base | extensible | ACP behandelingen waardelijst | 📦1.23.0 | This IG
Consent.modifierExtension:treatmentPermitted.​value[x]:valueCodeableConcept | Base | extensible | BehandelingToegestaanCodelijst | 📦2017-12-31T00:00:00 | Nictiz FHIR NL STU3 Zib2017 v2.3
Consent.status | Base | required | ConsentState | 📦3.0.2 | FHIR Std.
Consent.category | Base | example | Consent Category Codes | 📦3.0.2 | FHIR Std.
Consent.actor.role | Base | extensible | SecurityRoleType | 📦1.8.0 | FHIR Std.
Consent.action | Base | example | Consent Action Codes | 📦3.0.2 | FHIR Std.
Consent.securityLabel | Base | extensible | All Security Labels | 📦3.0.2 | FHIR Std.
Consent.purpose | Base | extensible | PurposeOfUse | 📦2014-03-26 | FHIR Std.
Consent.data.meaning | Base | required | ConsentDataMeaning | 📦3.0.2 | FHIR Std.
Consent.except.type | Base | required | ConsentExceptType | 📦3.0.2 | FHIR Std.
Consent.except.actor.​role | Base | extensible | SecurityRoleType | 📦1.8.0 | FHIR Std.
Consent.except.action | Base | example | Consent Action Codes | 📦3.0.2 | FHIR Std.
Consent.except.securityLabel | Base | extensible | All Security Labels | 📦3.0.2 | FHIR Std.
Consent.except.purpose | Base | extensible | PurposeOfUse | 📦2014-03-26 | FHIR Std.
Consent.except.class | Base | extensible | Consent Content Class | 📦3.0.2 | FHIR Std.
Consent.except.code | Base | example | Consent Content Codes | 📦3.0.2 | FHIR Std.
Consent.except.data.​meaning | Base | required | ConsentDataMeaning | 📦3.0.2 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
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 | Consent.extension:verification, Consent.extension:comment, Consent.extension:treatment, Consent.extension:additionalSources, Consent.modifierExtension:treatmentPermitted, Consent.consentingParty.extension:practitionerRole, Consent.actor.reference.extension:practitionerRole, Consent.except.extension:restrictions, Consent.except.actor.reference.extension:practitionerRole | 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: 10 elements

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Consent | C | 0..* | Zib TreatmentDirective | TreatmentDirective Constraints: ppc-1, hcim-treatmentdirective-1
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  |  |  | Content/Rules for all slices
extension:verification | S | 0..1 | (Complex) | Verification URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Verification Constraints: ext-1
Slices for extension |  | 1..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
extension:Verified |  | 1..1 | Extension | Verified
extension |  | 0..0 |  | Additional Content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "Verified"
Slices for valueBoolean |  |  |  | Content/Rules for all slices
valueBoolean:valueBoolean |  | 0..1 | boolean | Verified
extension:VerifiedWith | S | 0..1 | Extension | Extension
extension |  | 0..0 |  | Additional Content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "VerifiedWith"
Slices for valueCodeableConcept |  |  |  | Content/Rules for all slices
valueCodeableConcept: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
extension |  | 0..0 |  | Additional Content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "VerificationDate"
Slices for valueDateTime |  |  |  | Content/Rules for all slices
valueDateTime:valueDateTime |  | 0..1 | dateTime | VerificationDate
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Verification"
extension:comment | S | 0..1 | string | Comment URL: http://nictiz.nl/fhir/StructureDefinition/Comment Constraints: ext-1
extension:treatment | S | 0..1 | (Complex) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Treatment Constraints: ext-1
extension |  | 0..0 |  | 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] |  |  |  | Content/Rules for all slices
value[x]:valueCodeableConcept | S | 0..1 | CodeableConcept | Treatment Binding: ACP behandelingen waardelijst (extensible): The medical treatment to which the treatment instruction applies.
extension:additionalSources |  | 0..* | (Complex) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources Constraints: ext-1
extension |  | 0..0 |  | Additional Content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources"
Slices for modifierExtension | ?! | 1..* | Extension | Extensions that cannot be ignored Slice: Unordered, Open by value:url
modifierExtension:treatmentPermitted | ?!S | 1..1 | (Complex) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-TreatmentPermitted Constraints: ext-1
extension |  | 0..0 |  | 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] |  |  |  | Content/Rules for all slices
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 | S Σ | 0..1 | Period | Period that this consent applies
start | S Σ C | 0..1 | dateTime | StartDate
except | Σ | 0..* | BackboneElement | Additional rule - addition or removal of permissions
Slices for extension |  |  |  | Content/Rules for all slices
extension:restrictions | S | 0..1 | string | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Restrictions Constraints: ext-1
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 | Status | Usage | ValueSet | Version | Source
Consent.extension:verification.​extension:VerifiedWith.​valueCodeableConcept:valueCodeableConcept | Base | extensible | GeverifieerdBijCodelijst | 📦2017-12-31T00:00:00 | Nictiz FHIR NL STU3 Zib2017 v2.3
Consent.extension:treatment.​value[x]:valueCodeableConcept | Base | extensible | ACP behandelingen waardelijst | 📦1.23.0 | This IG
Consent.modifierExtension:treatmentPermitted.​value[x]:valueCodeableConcept | Base | extensible | BehandelingToegestaanCodelijst | 📦2017-12-31T00:00:00 | Nictiz FHIR NL STU3 Zib2017 v2.3
Consent.status | Base | required | ConsentState | 📦3.0.2 | FHIR Std.
Consent.category | Base | example | Consent Category Codes | 📦3.0.2 | FHIR Std.
Consent.except.type | Base | required | ConsentExceptType | 📦3.0.2 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
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 | Consent.extension:verification, Consent.extension:comment, Consent.extension:treatment, Consent.extension:additionalSources, Consent.modifierExtension:treatmentPermitted, Consent.except.extension:restrictions | 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 Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
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:comment | S | 0..1 | Comment | Comment
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 | Optional Extensions Element
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 | Status | Usage | ValueSet | Version | Source
Consent.extension:treatment.​valueCodeableConcept:valueCodeableConcept | Base | extensible | ACP behandelingen waardelijst | 📦1.23.0 | This IG

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Consent | C | 0..* | Zib TreatmentDirective | TreatmentDirective Constraints: ppc-1, hcim-treatmentdirective-1
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 This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
extension:verification | S | 0..1 | (Complex) | Verification URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Verification Constraints: ext-1
id |  | 0..1 | string | xml:id (or equivalent in JSON)
Slices for extension |  | 1..* | Extension | Additional Content defined by implementations Slice: Unordered, Open by value:url
extension:Verified |  | 1..1 | Extension | Verified
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..0 |  | Additional Content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "Verified"
Slices for valueBoolean |  |  |  | Content/Rules for all slices
valueBoolean:valueBoolean |  | 0..1 | boolean | Verified
extension:VerifiedWith | S | 0..1 | Extension | Extension
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..0 |  | Additional Content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "VerifiedWith"
Slices for valueCodeableConcept |  |  |  | Content/Rules for all slices
valueCodeableConcept: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..0 |  | Additional Content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "VerificationDate"
Slices for valueDateTime |  |  |  | Content/Rules for all slices
valueDateTime:valueDateTime |  | 0..1 | dateTime | VerificationDate
url |  | 1..1 | uri | "http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Verification"
extension:comment | S | 0..1 | string | Comment URL: http://nictiz.nl/fhir/StructureDefinition/Comment Constraints: ext-1
extension:treatment | S | 0..1 | (Complex) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Treatment Constraints: ext-1
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..0 |  | 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] |  |  |  | Content/Rules for all slices
value[x]:valueCodeableConcept | S | 0..1 | CodeableConcept | Treatment Binding: ACP behandelingen waardelijst (extensible): The medical treatment to which the treatment instruction applies.
extension:additionalSources |  | 0..* | (Complex) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/consent-additionalSources Constraints: ext-1
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..0 |  | 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 | Extensions that cannot be ignored Slice: Unordered, Open by value:url
modifierExtension:treatmentPermitted | ?!S | 1..1 | (Complex) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-TreatmentPermitted Constraints: ext-1
id |  | 0..1 | string | xml:id (or equivalent in JSON)
extension |  | 0..0 |  | 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] |  |  |  | Content/Rules for all slices
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 | S Σ | 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 | S Σ C | 0..1 | dateTime | StartDate
end | Σ C | 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 | Additional Content defined by implementations Slice: Unordered, Open by value:url
extension:practitionerRole |  | 0..1 | Reference(nl-core-practitionerrole) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference Constraints: ext-1
reference | Σ C | 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 | Additional Content defined by implementations Slice: Unordered, Open by value:url
extension:practitionerRole |  | 0..1 | Reference(nl-core-practitionerrole) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference Constraints: ext-1
reference | Σ C | 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 | Σ C | 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 | Additional Content defined by implementations Slice: Unordered, Open by value:url
extension:restrictions | S | 0..1 | string | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentDirective-Restrictions Constraints: ext-1
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 | Additional Content defined by implementations Slice: Unordered, Open by value:url
extension:practitionerRole |  | 0..1 | Reference(nl-core-practitionerrole) | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference Constraints: ext-1
reference | Σ C | 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 | Status | Usage | ValueSet | Version | Source
Consent.language | Base | extensible | Common Languages | 📦3.0.2 | FHIR Std.
Consent.extension:verification.​extension:VerifiedWith.​valueCodeableConcept:valueCodeableConcept | Base | extensible | GeverifieerdBijCodelijst | 📦2017-12-31T00:00:00 | Nictiz FHIR NL STU3 Zib2017 v2.3
Consent.extension:treatment.​value[x]:valueCodeableConcept | Base | extensible | ACP behandelingen waardelijst | 📦1.23.0 | This IG
Consent.modifierExtension:treatmentPermitted.​value[x]:valueCodeableConcept | Base | extensible | BehandelingToegestaanCodelijst | 📦2017-12-31T00:00:00 | Nictiz FHIR NL STU3 Zib2017 v2.3
Consent.status | Base | required | ConsentState | 📦3.0.2 | FHIR Std.
Consent.category | Base | example | Consent Category Codes | 📦3.0.2 | FHIR Std.
Consent.actor.role | Base | extensible | SecurityRoleType | 📦1.8.0 | FHIR Std.
Consent.action | Base | example | Consent Action Codes | 📦3.0.2 | FHIR Std.
Consent.securityLabel | Base | extensible | All Security Labels | 📦3.0.2 | FHIR Std.
Consent.purpose | Base | extensible | PurposeOfUse | 📦2014-03-26 | FHIR Std.
Consent.data.meaning | Base | required | ConsentDataMeaning | 📦3.0.2 | FHIR Std.
Consent.except.type | Base | required | ConsentExceptType | 📦3.0.2 | FHIR Std.
Consent.except.actor.​role | Base | extensible | SecurityRoleType | 📦1.8.0 | FHIR Std.
Consent.except.action | Base | example | Consent Action Codes | 📦3.0.2 | FHIR Std.
Consent.except.securityLabel | Base | extensible | All Security Labels | 📦3.0.2 | FHIR Std.
Consent.except.purpose | Base | extensible | PurposeOfUse | 📦2014-03-26 | FHIR Std.
Consent.except.class | Base | extensible | Consent Content Class | 📦3.0.2 | FHIR Std.
Consent.except.code | Base | example | Consent Content Codes | 📦3.0.2 | FHIR Std.
Consent.except.data.​meaning | Base | required | ConsentDataMeaning | 📦3.0.2 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
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 | Consent.extension:verification, Consent.extension:comment, Consent.extension:treatment, Consent.extension:additionalSources, Consent.modifierExtension:treatmentPermitted, Consent.consentingParty.extension:practitionerRole, Consent.actor.reference.extension:practitionerRole, Consent.except.extension:restrictions, Consent.except.actor.reference.extension:practitionerRole | 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: 10 elements

Other representations of profile: CSV, Excel, Schematron