{
  "resourceType" : "Bundle",
  "id" : "BundleCRCPalliativ",
  "language" : "en",
  "type" : "transaction",
  "entry" : [{
    "fullUrl" : "http://example.org/fhir/Patient/PatientinCRC",
    "resource" : {
      "resourceType" : "Patient",
      "id" : "PatientinCRC",
      "language" : "en",
      "text" : {
        "status" : "generated"
      },
      "name" : [{
        "family" : "Musterfrau",
        "given" : ["Erika"]
      }],
      "gender" : "female",
      "birthDate" : "1961-09-12"
    },
    "request" : {
      "method" : "POST",
      "url" : "Patient"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/Practitioner/OnkologinCRC",
    "resource" : {
      "resourceType" : "Practitioner",
      "id" : "OnkologinCRC",
      "language" : "en",
      "text" : {
        "status" : "generated"
      },
      "name" : [{
        "family" : "Musterarzt",
        "given" : ["Petra"]
      }]
    },
    "request" : {
      "method" : "POST",
      "url" : "Practitioner"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/Organization/TumorzentrumCRC",
    "resource" : {
      "resourceType" : "Organization",
      "id" : "TumorzentrumCRC",
      "language" : "en",
      "text" : {
        "status" : "generated"
      },
      "name" : "Onkologisches Zentrum Musterklinik"
    },
    "request" : {
      "method" : "POST",
      "url" : "Organization"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/CareTeam/TumorboardCRC",
    "resource" : {
      "resourceType" : "CareTeam",
      "id" : "TumorboardCRC",
      "language" : "en",
      "text" : {
        "status" : "generated"
      },
      "status" : "active",
      "name" : "Interdisziplinäres Tumorboard Kolorektales Karzinom",
      "subject" : {
        "reference" : "Patient/PatientinCRC"
      },
      "participant" : [{
        "member" : {
          "reference" : "Practitioner/OnkologinCRC"
        }
      }],
      "managingOrganization" : [{
        "reference" : "Organization/TumorzentrumCRC"
      }]
    },
    "request" : {
      "method" : "POST",
      "url" : "CareTeam"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/Condition/ConditionCRC",
    "resource" : {
      "resourceType" : "Condition",
      "id" : "ConditionCRC",
      "meta" : {
        "profile" : ["https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-condition"]
      },
      "language" : "en",
      "text" : {
        "status" : "extensions"
      },
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/condition-assertedDate",
        "valueDateTime" : "2026-01-20"
      }],
      "clinicalStatus" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
          "code" : "active"
        }]
      },
      "verificationStatus" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status",
          "code" : "confirmed"
        }]
      },
      "category" : [{
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/condition-category",
          "code" : "encounter-diagnosis"
        }]
      }],
      "code" : {
        "coding" : [{
          "system" : "http://fhir.de/CodeSystem/bfarm/icd-10-gm",
          "version" : "2026",
          "code" : "C18.9",
          "display" : "Bösartige Neubildung: Kolon, nicht näher bezeichnet"
        }],
        "text" : "Metastasiertes Kolonkarzinom (mCRC) mit Lebermetastasen"
      },
      "subject" : {
        "reference" : "Patient/PatientinCRC"
      },
      "onsetDateTime" : "2026-01-20",
      "recordedDate" : "2026-01-20"
    },
    "request" : {
      "method" : "POST",
      "url" : "Condition"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/CarePlan/DiagnostikCarePlanCRC",
    "resource" : {
      "resourceType" : "CarePlan",
      "id" : "DiagnostikCarePlanCRC",
      "meta" : {
        "profile" : ["https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-diagnostic-care-plan"]
      },
      "language" : "en",
      "text" : {
        "status" : "extensions"
      },
      "extension" : [{
        "url" : "https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-careplan-custodian",
        "valueReference" : {
          "reference" : "Organization/TumorzentrumCRC"
        }
      }],
      "status" : "completed",
      "intent" : "plan",
      "category" : [{
        "text" : "Tumordiagnostik"
      }],
      "subject" : {
        "reference" : "Patient/PatientinCRC"
      },
      "period" : {
        "start" : "2026-01-05",
        "end" : "2026-01-20"
      },
      "careTeam" : [{
        "reference" : "CareTeam/TumorboardCRC"
      }],
      "addresses" : [{
        "reference" : "Condition/ConditionCRC"
      }],
      "activity" : [{
        "outcomeReference" : [{
          "reference" : "DiagnosticReport/DiagnosticReportHistologieCRC"
        }],
        "reference" : {
          "reference" : "ServiceRequest/ServiceRequestKoloskopieCRC"
        }
      }]
    },
    "request" : {
      "method" : "POST",
      "url" : "CarePlan"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/ServiceRequest/ServiceRequestKoloskopieCRC",
    "resource" : {
      "resourceType" : "ServiceRequest",
      "id" : "ServiceRequestKoloskopieCRC",
      "language" : "en",
      "text" : {
        "status" : "generated"
      },
      "status" : "completed",
      "intent" : "order",
      "code" : {
        "coding" : [{
          "system" : "http://snomed.info/sct",
          "code" : "73761001",
          "display" : "Colonoscopy"
        }],
        "text" : "Koloskopie mit Biopsieentnahme"
      },
      "subject" : {
        "reference" : "Patient/PatientinCRC"
      }
    },
    "request" : {
      "method" : "POST",
      "url" : "ServiceRequest"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/DiagnosticReport/DiagnosticReportHistologieCRC",
    "resource" : {
      "resourceType" : "DiagnosticReport",
      "id" : "DiagnosticReportHistologieCRC",
      "language" : "en",
      "text" : {
        "status" : "generated"
      },
      "status" : "final",
      "code" : {
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "60568-3",
          "display" : "Pathology Synoptic report"
        }],
        "text" : "Histopathologie Kolonbiopsie"
      },
      "subject" : {
        "reference" : "Patient/PatientinCRC"
      },
      "effectiveDateTime" : "2026-01-18",
      "conclusion" : "Adenokarzinom des Kolons (C18.9), ICD-O-3 M8140/3."
    },
    "request" : {
      "method" : "POST",
      "url" : "DiagnosticReport"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/EpisodeOfCare/TherapielinieCRCErstlinie",
    "resource" : {
      "resourceType" : "EpisodeOfCare",
      "id" : "TherapielinieCRCErstlinie",
      "meta" : {
        "profile" : ["https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-therapy-line"]
      },
      "language" : "en",
      "text" : {
        "status" : "extensions"
      },
      "extension" : [{
        "extension" : [{
          "url" : "hauptintention",
          "valueCodeableConcept" : {
            "coding" : [{
              "system" : "http://snomed.info/sct",
              "code" : "363676003",
              "display" : "Palliative intent"
            }]
          }
        },
        {
          "url" : "phase",
          "valueCodeableConcept" : {
            "coding" : [{
              "system" : "http://snomed.info/sct",
              "code" : "450827009",
              "display" : "Induction chemotherapy"
            }]
          }
        }],
        "url" : "https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-therapy-intent"
      },
      {
        "extension" : [{
          "url" : "setting",
          "valueCodeableConcept" : {
            "coding" : [{
              "system" : "https://bih-cei.de/fhir/therapieziele-onkologie/CodeSystem/enlist-lot-setting",
              "code" : "aLoT",
              "display" : "aLoT — fortgeschrittenes Setting"
            }]
          }
        },
        {
          "url" : "line",
          "valuePositiveInt" : 1
        },
        {
          "url" : "modification",
          "valueUnsignedInt" : 0
        },
        {
          "url" : "notation",
          "valueString" : "aLoT 1.0"
        }],
        "url" : "https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/enlist-lot"
      },
      {
        "url" : "https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/enlist-countable",
        "valueCodeableConcept" : {
          "coding" : [{
            "system" : "https://bih-cei.de/fhir/therapieziele-onkologie/CodeSystem/enlist-countable",
            "code" : "counted",
            "display" : "Zählt in der LoT-Zählung"
          }]
        }
      }],
      "status" : "active",
      "type" : [{
        "coding" : [{
          "system" : "http://snomed.info/sct",
          "code" : "315601005",
          "display" : "Ambulatory chemotherapy"
        }]
      }],
      "diagnosis" : [{
        "condition" : {
          "reference" : "Condition/ConditionCRC"
        },
        "role" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/diagnosis-role",
            "code" : "CC",
            "display" : "Chief complaint"
          }]
        },
        "rank" : 1
      }],
      "patient" : {
        "reference" : "Patient/PatientinCRC"
      },
      "managingOrganization" : {
        "reference" : "Organization/TumorzentrumCRC"
      },
      "period" : {
        "start" : "2026-02-10"
      },
      "careManager" : {
        "reference" : "Practitioner/OnkologinCRC"
      },
      "team" : [{
        "reference" : "CareTeam/TumorboardCRC"
      }]
    },
    "request" : {
      "method" : "POST",
      "url" : "EpisodeOfCare"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/Goal/TherapiezielCRCLebensverlaengerung",
    "resource" : {
      "resourceType" : "Goal",
      "id" : "TherapiezielCRCLebensverlaengerung",
      "meta" : {
        "profile" : ["https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-therapy-goal"]
      },
      "language" : "en",
      "text" : {
        "status" : "extensions"
      },
      "extension" : [{
        "extension" : [{
          "url" : "hauptintention",
          "valueCodeableConcept" : {
            "coding" : [{
              "system" : "http://snomed.info/sct",
              "code" : "363676003",
              "display" : "Palliative intent"
            }]
          }
        },
        {
          "url" : "phase",
          "valueCodeableConcept" : {
            "coding" : [{
              "system" : "http://snomed.info/sct",
              "code" : "450827009",
              "display" : "Induction chemotherapy"
            }]
          }
        }],
        "url" : "https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-therapy-intent"
      },
      {
        "extension" : [{
          "url" : "individual",
          "valueReference" : {
            "reference" : "Patient/PatientinCRC"
          }
        },
        {
          "url" : "status",
          "valueCode" : "agree"
        },
        {
          "url" : "priority",
          "valueCodeableConcept" : {
            "coding" : [{
              "system" : "http://terminology.hl7.org/CodeSystem/goal-priority",
              "code" : "high-priority",
              "display" : "High Priority"
            }]
          }
        }],
        "url" : "http://hl7.org/fhir/StructureDefinition/goal-acceptance"
      },
      {
        "extension" : [{
          "url" : "type",
          "valueCodeableConcept" : {
            "coding" : [{
              "system" : "http://terminology.hl7.org/CodeSystem/goal-relationship-type",
              "code" : "replacement",
              "display" : "Replacement"
            }]
          }
        },
        {
          "url" : "target",
          "valueReference" : {
            "reference" : "Goal/TherapiezielCRCKurativAbgelehnt"
          }
        }],
        "url" : "http://hl7.org/fhir/StructureDefinition/goal-relationship"
      },
      {
        "extension" : [{
          "url" : "type",
          "valueCodeableConcept" : {
            "coding" : [{
              "system" : "http://terminology.hl7.org/CodeSystem/goal-relationship-type",
              "code" : "successor",
              "display" : "Successor"
            }]
          }
        },
        {
          "url" : "target",
          "valueReference" : {
            "reference" : "Goal/TherapiezielCRCErhaltung"
          }
        }],
        "url" : "http://hl7.org/fhir/StructureDefinition/goal-relationship"
      }],
      "lifecycleStatus" : "active",
      "achievementStatus" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/goal-achievement",
          "code" : "in-progress",
          "display" : "In Progress"
        }]
      },
      "category" : [{
        "coding" : [{
          "system" : "https://bih-cei.de/fhir/therapieziele-onkologie/CodeSystem/onko-therapy-goal-type",
          "code" : "lebensverlaengerung",
          "display" : "Lebensverlängerung"
        }]
      },
      {
        "coding" : [{
          "system" : "https://bih-cei.de/fhir/therapieziele-onkologie/CodeSystem/onko-therapy-goal-type",
          "code" : "symptomkontrolle",
          "display" : "Symptomkontrolle / Palliation"
        }]
      }],
      "priority" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/goal-priority",
          "code" : "high-priority",
          "display" : "High Priority"
        }]
      },
      "description" : {
        "text" : "Verlängerung des Gesamtüberlebens und Kontrolle tumorbedingter Symptome unter palliativer Systemtherapie."
      },
      "subject" : {
        "reference" : "Patient/PatientinCRC"
      },
      "startDate" : "2026-02-10",
      "target" : [{
        "measure" : {
          "coding" : [{
            "system" : "http://loinc.org",
            "code" : "21908-9",
            "display" : "Stage group.clinical Cancer"
          }]
        },
        "dueDate" : "2026-08-10"
      }],
      "expressedBy" : {
        "reference" : "Practitioner/OnkologinCRC"
      },
      "addresses" : [{
        "reference" : "Condition/ConditionCRC"
      }],
      "outcomeReference" : [{
        "reference" : "Observation/ObservationDiseaseStatusCRC"
      }]
    },
    "request" : {
      "method" : "POST",
      "url" : "Goal"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/Goal/TherapiezielCRCKurativAbgelehnt",
    "resource" : {
      "resourceType" : "Goal",
      "id" : "TherapiezielCRCKurativAbgelehnt",
      "meta" : {
        "profile" : ["https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-therapy-goal"]
      },
      "language" : "en",
      "text" : {
        "status" : "extensions"
      },
      "extension" : [{
        "extension" : [{
          "url" : "hauptintention",
          "valueCodeableConcept" : {
            "coding" : [{
              "system" : "http://snomed.info/sct",
              "code" : "373808002",
              "display" : "Curative - procedure intent"
            }]
          }
        }],
        "url" : "https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-therapy-intent"
      },
      {
        "url" : "http://hl7.org/fhir/StructureDefinition/goal-reasonRejected",
        "valueCodeableConcept" : {
          "text" : "Nicht resektable Fernmetastasierung — kuratives Ziel nicht erreichbar."
        }
      }],
      "lifecycleStatus" : "rejected",
      "category" : [{
        "coding" : [{
          "system" : "https://bih-cei.de/fhir/therapieziele-onkologie/CodeSystem/onko-therapy-goal-type",
          "code" : "heilung",
          "display" : "Heilung"
        }]
      }],
      "description" : {
        "text" : "Kurative Resektion des Primärtumors mit kurativer Absicht."
      },
      "subject" : {
        "reference" : "Patient/PatientinCRC"
      },
      "expressedBy" : {
        "reference" : "Practitioner/OnkologinCRC"
      },
      "addresses" : [{
        "reference" : "Condition/ConditionCRC"
      }]
    },
    "request" : {
      "method" : "POST",
      "url" : "Goal"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/Goal/TherapiezielCRCErhaltung",
    "resource" : {
      "resourceType" : "Goal",
      "id" : "TherapiezielCRCErhaltung",
      "meta" : {
        "profile" : ["https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-therapy-goal"]
      },
      "language" : "en",
      "text" : {
        "status" : "extensions"
      },
      "extension" : [{
        "extension" : [{
          "url" : "hauptintention",
          "valueCodeableConcept" : {
            "coding" : [{
              "system" : "http://snomed.info/sct",
              "code" : "363676003",
              "display" : "Palliative intent"
            }]
          }
        },
        {
          "url" : "phase",
          "valueCodeableConcept" : {
            "coding" : [{
              "system" : "http://snomed.info/sct",
              "code" : "1345242003",
              "display" : "Maintenance antineoplastic therapy"
            }]
          }
        }],
        "url" : "https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-therapy-intent"
      },
      {
        "extension" : [{
          "url" : "type",
          "valueCodeableConcept" : {
            "coding" : [{
              "system" : "http://terminology.hl7.org/CodeSystem/goal-relationship-type",
              "code" : "predecessor",
              "display" : "Predecessor"
            }]
          }
        },
        {
          "url" : "target",
          "valueReference" : {
            "reference" : "Goal/TherapiezielCRCLebensverlaengerung"
          }
        }],
        "url" : "http://hl7.org/fhir/StructureDefinition/goal-relationship"
      }],
      "lifecycleStatus" : "proposed",
      "category" : [{
        "coding" : [{
          "system" : "https://bih-cei.de/fhir/therapieziele-onkologie/CodeSystem/onko-therapy-goal-type",
          "code" : "lebensverlaengerung",
          "display" : "Lebensverlängerung"
        }]
      },
      {
        "coding" : [{
          "system" : "https://bih-cei.de/fhir/therapieziele-onkologie/CodeSystem/onko-therapy-goal-type",
          "code" : "lebensqualitaet",
          "display" : "Lebensqualität"
        }]
      }],
      "description" : {
        "text" : "Erhalt des Therapieansprechens bei reduzierter Toxizität (Erhaltungstherapie) nach erfolgreicher Induktion."
      },
      "subject" : {
        "reference" : "Patient/PatientinCRC"
      },
      "expressedBy" : {
        "reference" : "Practitioner/OnkologinCRC"
      },
      "addresses" : [{
        "reference" : "Condition/ConditionCRC"
      }]
    },
    "request" : {
      "method" : "POST",
      "url" : "Goal"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/MedicationRequest/MedicationRequestFOLFOX",
    "resource" : {
      "resourceType" : "MedicationRequest",
      "id" : "MedicationRequestFOLFOX",
      "meta" : {
        "profile" : ["https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-tumorboard-medication-request"]
      },
      "language" : "en",
      "text" : {
        "status" : "generated"
      },
      "status" : "active",
      "intent" : "plan",
      "category" : [{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "85232-7",
          "display" : "Tumor board Consult note"
        }]
      }],
      "medicationCodeableConcept" : {
        "text" : "FOLFOX + Bevacizumab"
      },
      "subject" : {
        "reference" : "Patient/PatientinCRC"
      },
      "requester" : {
        "reference" : "Practitioner/OnkologinCRC"
      }
    },
    "request" : {
      "method" : "POST",
      "url" : "MedicationRequest"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/ServiceRequest/ServiceRequestPortCRC",
    "resource" : {
      "resourceType" : "ServiceRequest",
      "id" : "ServiceRequestPortCRC",
      "meta" : {
        "profile" : ["https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-tumorboard-service-request"]
      },
      "language" : "en",
      "text" : {
        "status" : "generated"
      },
      "status" : "active",
      "intent" : "plan",
      "category" : [{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "85232-7",
          "display" : "Tumor board Consult note"
        }]
      }],
      "code" : {
        "coding" : [{
          "system" : "http://snomed.info/sct",
          "code" : "1255694000",
          "display" : "Implantable venous access port injection"
        }],
        "text" : "Implantation eines Portkatheters für die systemische Therapie"
      },
      "subject" : {
        "reference" : "Patient/PatientinCRC"
      },
      "requester" : {
        "reference" : "Practitioner/OnkologinCRC"
      }
    },
    "request" : {
      "method" : "POST",
      "url" : "ServiceRequest"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/Observation/ObservationDiseaseStatusCRC",
    "resource" : {
      "resourceType" : "Observation",
      "id" : "ObservationDiseaseStatusCRC",
      "language" : "en",
      "text" : {
        "status" : "generated"
      },
      "status" : "final",
      "code" : {
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "97509-4",
          "display" : "Cancer disease progression"
        }]
      },
      "subject" : {
        "reference" : "Patient/PatientinCRC"
      },
      "effectiveDateTime" : "2026-05-15",
      "valueCodeableConcept" : {
        "coding" : [{
          "system" : "http://snomed.info/sct",
          "code" : "260415000",
          "display" : "Not detected"
        }]
      }
    },
    "request" : {
      "method" : "POST",
      "url" : "Observation"
    }
  },
  {
    "fullUrl" : "http://example.org/fhir/CarePlan/CarePlanCRCPalliativ",
    "resource" : {
      "resourceType" : "CarePlan",
      "id" : "CarePlanCRCPalliativ",
      "meta" : {
        "profile" : ["https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-care-plan"]
      },
      "language" : "en",
      "text" : {
        "status" : "extensions"
      },
      "extension" : [{
        "extension" : [{
          "url" : "hauptintention",
          "valueCodeableConcept" : {
            "coding" : [{
              "system" : "http://snomed.info/sct",
              "code" : "363676003",
              "display" : "Palliative intent"
            }]
          }
        }],
        "url" : "https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-therapy-intent"
      },
      {
        "url" : "https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-careplan-custodian",
        "valueReference" : {
          "reference" : "Organization/TumorzentrumCRC"
        }
      }],
      "status" : "active",
      "intent" : "plan",
      "category" : [{
        "coding" : [{
          "system" : "http://snomed.info/sct",
          "code" : "736252007",
          "display" : "Cancer care plan"
        }]
      }],
      "subject" : {
        "reference" : "Patient/PatientinCRC"
      },
      "period" : {
        "start" : "2026-02-10"
      },
      "author" : {
        "reference" : "Practitioner/OnkologinCRC"
      },
      "careTeam" : [{
        "reference" : "CareTeam/TumorboardCRC"
      }],
      "addresses" : [{
        "reference" : "Condition/ConditionCRC"
      }],
      "supportingInfo" : [{
        "reference" : "CarePlan/DiagnostikCarePlanCRC"
      }],
      "goal" : [{
        "reference" : "Goal/TherapiezielCRCLebensverlaengerung"
      }],
      "activity" : [{
        "outcomeReference" : [{
          "reference" : "Observation/ObservationDiseaseStatusCRC"
        }],
        "reference" : {
          "reference" : "MedicationRequest/MedicationRequestFOLFOX"
        }
      },
      {
        "reference" : {
          "reference" : "ServiceRequest/ServiceRequestPortCRC"
        }
      }]
    },
    "request" : {
      "method" : "POST",
      "url" : "CarePlan"
    }
  }]
}