@startuml references-mtb-improved

' Layout configuration for better readability
!pragma layout smetana
skinparam ranksep 60
skinparam nodesep 40
skinparam packageStyle rectangle
skinparam defaultTextAlignment center
skinparam wrapWidth 200
skinparam maxMessageSize 150

!$colors = {"CarePlan": "#6a6cf8", "Claim": "#f26f6f", "ClaimResponse": "#a4b1f7", "ClinicalImpression": "#69f683", "Condition": "#6d7198", "DiagnosticReport": "#fa92bb", "MedicationRequest": "#ba6bf9", "MedicationStatement": "#74f8dc", "Observation": "#fbca69", "Procedure": "#70a68c", "RequestGroup": "#fee0b0", "ResearchStudy": "#d96ac5", "ServiceRequest": "#a3c16d"}

legend top right
    |Color|Type|
    |<$colors.CarePlan>|CarePlan|
    |<$colors.Claim>|Claim|
    |<$colors.ClaimResponse>|ClaimResponse|
    |<$colors.ClinicalImpression>|ClinicalImpression|
    |<$colors.Condition>|Condition|
    |<$colors.DiagnosticReport>|DiagnosticReport|
    |<$colors.MedicationRequest>|MedicationRequest|
    |<$colors.MedicationStatement>|MedicationStatement|
    |<$colors.Observation>|Observation|
    |<$colors.Procedure>|Procedure|
    |<$colors.RequestGroup>|RequestGroup|
    |<$colors.ResearchStudy>|ResearchStudy|
    |<$colors.ServiceRequest>|ServiceRequest|
endlegend

' Core Episode Package - Center
package "Behandlungsepisode" as episode {
    object "MTB Behandlungsepisode" as Behandlungsepisode $colors.ClinicalImpression
    object "Diagnose Primärtumor" as Diagnose $colors.Condition
    object "Consent Given" as Consent $colors.Observation
    object "Systemische Vortherapie" as Vortherapie $colors.Procedure
    object "Tumorausbreitung" as Tumorausbreitung $colors.Observation
    object "WHO Grad Tumor ZNS" as WHOGrad $colors.Observation
    object "Oncotree" as Oncotree $colors.Observation
}

' Diagnostic Reports - Top
package "NGS-Bericht" as ngs {
    object "NGS Bericht" as NGSBericht $colors.DiagnosticReport
    object "Varianten & Biomarker" as Varianten $colors.Observation
    object "Genomic Study" as GenomicStudy $colors.Procedure
    object "Genomic Study Analysis" as GenomicAnalysis $colors.Procedure
    object "Therapeutische Implikation" as TherapImplikation $colors.Observation
    object "Diagnostische Implikation" as DiagImplikation $colors.Observation
}

package "Molekular-Pathologie" as molpath {
    object "Molecular Pathology Report" as MolPathReport $colors.DiagnosticReport
    object "Molekularpathologische Inhalte" as MolPathInhalte $colors.Observation
}

' Treatment Plan - Right
package "Therapieplan" as therapy {
    object "Therapieplan" as Therapieplan $colors.CarePlan
    object "Therapieempfehlung" as TherapEmpf $colors.MedicationRequest
    object "Therapieempfehlung Kombination" as TherapKombi $colors.RequestGroup
    object "Humangenetische Beratung" as HumanGen $colors.ServiceRequest
    object "Histologie Evaluation" as HistoEval $colors.ServiceRequest
    object "Biopsie Auftrag" as Biopsie $colors.ServiceRequest
    object "Studieneinschluss Anfrage" as StudienAnfrage $colors.ServiceRequest
    object "Studie" as Studie $colors.ResearchStudy
    object "Tumorzellgehalt" as Tumorzellgehalt $colors.Observation
}

' Follow-up - Bottom Right
package "Follow-Up" as followup {
    object "Follow-Up Clinical Impression" as FollowUpCI $colors.ClinicalImpression

    package "Systemtherapie" as systherapy {
        object "Systemische Therapie" as SysTherapie $colors.Procedure
        object "Response Befund" as Response $colors.Observation
    }

    package "Kostenübernahme" as cost {
        object "Antrag Kostenübernahme" as Antrag $colors.Claim
        object "Antwort Kostenübernahme" as Antwort $colors.ClaimResponse
    }
}

' Main flow relationships
Behandlungsepisode --> Diagnose : problem
Behandlungsepisode --> Consent : supportingInfo
Behandlungsepisode --> Vortherapie : supportingInfo
Behandlungsepisode --> Therapieplan : supportingInfo

' Diagnosis details
Diagnose --> WHOGrad : stage
Diagnose --> Oncotree : stage
Diagnose --> Tumorausbreitung : stage
TherapImplikation --> Diagnose : focus
DiagImplikation --> Diagnose : focus

' NGS connections
Behandlungsepisode --> NGSBericht : investigation
NGSBericht --> Varianten : result
NGSBericht --> GenomicStudy : extension
NGSBericht --> GenomicAnalysis : extension
NGSBericht --> TherapImplikation : result
NGSBericht --> DiagImplikation : result
GenomicStudy --> GenomicAnalysis : extension:genomic-study-analysis
Varianten --> TherapImplikation : derivedFrom
Varianten --> DiagImplikation : derivedFrom
TherapImplikation --> Diagnose : focus
DiagImplikation --> Diagnose : focus

' Molecular Pathology
Behandlungsepisode --> MolPathReport : investigation
MolPathReport --> MolPathInhalte : result

' Treatment plan details
Therapieplan --> Behandlungsepisode : supportingInfo
Therapieplan --> TherapEmpf : activity
Therapieplan --> TherapKombi : activity
Therapieplan --> HumanGen : activity
Therapieplan --> HistoEval : activity
Therapieplan --> Biopsie : activity
Therapieplan --> StudienAnfrage : activity

TherapKombi --> TherapEmpf : action.resource
TherapEmpf --> Diagnose : reasonReference
Vortherapie --> Therapieplan : basedOn

' Service requests
Biopsie --> Tumorzellgehalt : reasonReference
HistoEval --> Tumorzellgehalt : reasonReference
StudienAnfrage --> Diagnose : reasonReference
StudienAnfrage --> Studie : supportingInfo

' Follow-up
FollowUpCI --> Behandlungsepisode : previous
SysTherapie --> TherapEmpf : basedOn
Response --> SysTherapie : partOf
Response --> Diagnose : focus

' Cost claims
Antwort --> Antrag : request
Antrag --> Antrag : related.claim

@enduml