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