Implementierungsleitfaden Therapieziele Onkologie
1.0.0-ballot - Ballot
Germany
Implementierungsleitfaden Therapieziele Onkologie - Local Development build (v1.0.0-ballot) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
{
"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"
}
}
]
}