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" : "BundleMammaNeoadjuvant",
"language" : "en",
"type" : "transaction",
"entry" : [
{
"fullUrl" : "http://example.org/fhir/Patient/PatientinMamma",
"resource" : {
"resourceType" : "Patient",
"id" : "PatientinMamma",
"language" : "en",
"text" : {
"status" : "generated"
},
"name" : [
{
"family" : "Baumann",
"given" : [
"Sabine"
]
}
],
"gender" : "female",
"birthDate" : "1977-06-24"
},
"request" : {
"method" : "POST",
"url" : "Patient"
}
},
{
"fullUrl" : "http://example.org/fhir/Practitioner/OnkologinMamma",
"resource" : {
"resourceType" : "Practitioner",
"id" : "OnkologinMamma",
"language" : "en",
"text" : {
"status" : "generated"
},
"name" : [
{
"family" : "Musterarzt",
"given" : [
"Katrin"
]
}
]
},
"request" : {
"method" : "POST",
"url" : "Practitioner"
}
},
{
"fullUrl" : "http://example.org/fhir/Organization/TumorzentrumMamma",
"resource" : {
"resourceType" : "Organization",
"id" : "TumorzentrumMamma",
"language" : "en",
"text" : {
"status" : "generated"
},
"name" : "Zertifiziertes Brustzentrum Musterklinik"
},
"request" : {
"method" : "POST",
"url" : "Organization"
}
},
{
"fullUrl" : "http://example.org/fhir/Organization/Tumorboard",
"resource" : {
"resourceType" : "Organization",
"id" : "Tumorboard",
"language" : "en",
"text" : {
"status" : "generated"
},
"identifier" : [
{
"system" : "https://www.musterklinik.de/fhir/sid/organisationen",
"value" : "tumorboard-brust-001"
}
],
"active" : true,
"type" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/organization-type",
"code" : "team",
"display" : "Organizational team"
}
]
}
],
"name" : "Zertifiziertes Brustzentrum Musterklinik"
},
"request" : {
"method" : "POST",
"url" : "Organization"
}
},
{
"fullUrl" : "http://example.org/fhir/ServiceRequest/ServiceRequestBiopsieMamma",
"resource" : {
"resourceType" : "ServiceRequest",
"id" : "ServiceRequestBiopsieMamma",
"language" : "en",
"text" : {
"status" : "generated"
},
"status" : "completed",
"intent" : "order",
"code" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "44578009",
"display" : "Core needle biopsy of breast (procedure)"
}
]
},
"subject" : {
🔗 "reference" : "Patient/PatientinMamma"
},
"authoredOn" : "2025-09-12",
"requester" : {
🔗 "reference" : "Practitioner/OnkologinMamma"
}
},
"request" : {
"method" : "POST",
"url" : "ServiceRequest"
}
},
{
"fullUrl" : "http://example.org/fhir/ServiceRequest/ServiceRequestPathologieMamma",
"resource" : {
"resourceType" : "ServiceRequest",
"id" : "ServiceRequestPathologieMamma",
"language" : "en",
"text" : {
"status" : "generated"
},
"status" : "completed",
"intent" : "order",
"code" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "788124003",
"display" : "Histopathology service (qualifier value)"
}
],
"text" : "Histopathologische Untersuchung inkl. Rezeptor-/HER2-Status und Ki-67"
},
"subject" : {
🔗 "reference" : "Patient/PatientinMamma"
},
"authoredOn" : "2025-09-15",
"requester" : {
🔗 "reference" : "Practitioner/OnkologinMamma"
},
"specimen" : [
{
🔗 "reference" : "Specimen/SpecimenBiopsieMamma"
}
]
},
"request" : {
"method" : "POST",
"url" : "ServiceRequest"
}
},
{
"fullUrl" : "http://example.org/fhir/ServiceRequest/ServiceRequestStagingMamma",
"resource" : {
"resourceType" : "ServiceRequest",
"id" : "ServiceRequestStagingMamma",
"language" : "en",
"text" : {
"status" : "generated"
},
"status" : "completed",
"intent" : "order",
"code" : {
"text" : "Klinische Ausbreitungsdiagnostik / TNM-Staging"
},
"subject" : {
🔗 "reference" : "Patient/PatientinMamma"
},
"authoredOn" : "2025-09-15",
"requester" : {
🔗 "reference" : "Practitioner/OnkologinMamma"
}
},
"request" : {
"method" : "POST",
"url" : "ServiceRequest"
}
},
{
"fullUrl" : "http://example.org/fhir/ServiceRequest/ServiceRequestGBRCAMamma",
"resource" : {
"resourceType" : "ServiceRequest",
"id" : "ServiceRequestGBRCAMamma",
"language" : "en",
"text" : {
"status" : "generated"
},
"status" : "completed",
"intent" : "order",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "21639-0",
"display" : "BRCA1 gene mutations tested for in Blood or Tissue by Molecular genetics method Nominal"
}
]
},
"subject" : {
🔗 "reference" : "Patient/PatientinMamma"
},
"authoredOn" : "2025-09-18",
"requester" : {
🔗 "reference" : "Practitioner/OnkologinMamma"
}
},
"request" : {
"method" : "POST",
"url" : "ServiceRequest"
}
},
{
"fullUrl" : "http://example.org/fhir/CarePlan/CarePlanMammaDiagnostik",
"resource" : {
"resourceType" : "CarePlan",
"id" : "CarePlanMammaDiagnostik",
"meta" : {
"profile" : [
🔗 "https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-diagnostic-care-plan"
]
},
"language" : "en",
"text" : {
"status" : "generated"
},
"status" : "active",
"intent" : "plan",
"category" : [
{
"text" : "Tumordiagnostik"
}
],
"subject" : {
🔗 "reference" : "Patient/PatientinMamma"
},
"author" : {
🔗 "reference" : "Practitioner/OnkologinMamma"
},
"addresses" : [
{
🔗 "reference" : "Condition/ConditionMamma"
}
],
"goal" : [
{
🔗 "reference" : "Goal/DiagnosticGoal"
}
],
"activity" : [
{
"outcomeReference" : [
{
🔗 "reference" : "Procedure/ProcedureBiopsieMamma"
}
],
"reference" : {
🔗 "reference" : "ServiceRequest/ServiceRequestBiopsieMamma"
}
},
{
"outcomeReference" : [
{
🔗 "reference" : "Observation/ObsHistologieMamma"
},
{
🔗 "reference" : "Observation/ObsGradingMamma"
},
{
🔗 "reference" : "Observation/ObsEstrogenrezeptorMamma"
},
{
🔗 "reference" : "Observation/ObsProgesteronrezeptorMamma"
},
{
🔗 "reference" : "Observation/ObsHER2Mamma"
},
{
🔗 "reference" : "Observation/ObsKi67Mamma"
}
],
"reference" : {
🔗 "reference" : "ServiceRequest/ServiceRequestPathologieMamma"
}
},
{
"outcomeReference" : [
{
🔗 "reference" : "Observation/ObsTNMklinischMamma"
}
],
"reference" : {
🔗 "reference" : "ServiceRequest/ServiceRequestStagingMamma"
}
},
{
"outcomeReference" : [
{
🔗 "reference" : "Observation/ObsGBRCAMamma"
}
],
"reference" : {
🔗 "reference" : "ServiceRequest/ServiceRequestGBRCAMamma"
}
}
]
},
"request" : {
"method" : "POST",
"url" : "CarePlan"
}
},
{
"fullUrl" : "http://example.org/fhir/Goal/DiagnosticGoal",
"resource" : {
"resourceType" : "Goal",
"id" : "DiagnosticGoal",
"meta" : {
"profile" : [
🔗 "https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-therapy-goal"
]
},
"language" : "en",
"text" : {
"status" : "extensions"
},
"extension" : [
{
"extension" : [
{
"url" : "individual",
"valueReference" : {
🔗 "reference" : "Patient/PatientinMamma"
}
},
{
"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"
}
],
"lifecycleStatus" : "active",
"achievementStatus" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/goal-achievement",
"code" : "in-progress",
"display" : "In Progress"
}
]
},
"category" : [
{
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "261004008",
"display" : "Diagnostic intent"
}
]
}
],
"priority" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/goal-priority",
"code" : "high-priority",
"display" : "High Priority"
}
]
},
"description" : {
"text" : "Diagnosesicherung für die Verdachtsdiagnose"
},
"subject" : {
🔗 "reference" : "Patient/PatientinMamma"
},
"startDate" : "2025-09-12",
"target" : [
{
"measure" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "21905-5",
"display" : "Primary tumor.clinical [Class] Cancer"
}
]
}
},
{
"measure" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "21906-3",
"display" : "Regional lymph nodes.clinical [Class] Cancer"
}
]
}
},
{
"measure" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "21907-1",
"display" : "Distant metastases.clinical [Class] Cancer"
}
]
}
},
{
"measure" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "21908-9",
"display" : "Stage group.clinical Cancer"
}
]
}
},
{
"measure" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "40556-3",
"display" : "Estrogen receptor Ag [Presence] in Tissue by Immune stain"
}
]
}
},
{
"measure" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "85339-0",
"display" : "Progesterone receptor Ag [Presence] in Breast cancer specimen by Immune stain"
}
]
}
},
{
"measure" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "48676-1",
"display" : "HER2 Ag [Interpretation] in Tissue"
}
]
}
},
{
"measure" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "21855-2",
"display" : "Primary site Cancer"
}
]
}
},
{
"measure" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "44648-4",
"display" : "Histologic grade [Score] in Breast cancer specimen by Nottingham"
}
]
}
},
{
"measure" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "33732-9",
"display" : "Histology grade [Identifier] in Cancer specimen"
}
]
}
},
{
"measure" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "85347-3",
"display" : "Sentinel lymph nodes examined [#] in Cancer specimen by Light microscopy"
}
]
}
}
],
"expressedBy" : {
🔗 "reference" : "Practitioner/OnkologinMamma"
},
"addresses" : [
{
🔗 "reference" : "Condition/ConditionMamma"
}
],
"outcomeReference" : [
{
🔗 "reference" : "Observation/ObsDiseaseStatusMamma"
}
]
},
"request" : {
"method" : "POST",
"url" : "Goal"
}
},
{
"fullUrl" : "http://example.org/fhir/Condition/ConditionMamma",
"resource" : {
"resourceType" : "Condition",
"id" : "ConditionMamma",
"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" : "2025-09-15"
}
],
"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" : "C50.4",
"display" : "Bösartige Neubildung: Oberer äußerer Quadrant der Brustdrüse"
}
],
"text" : "Invasives Mammakarzinom links, oberer äußerer Quadrant (NST), triple-negativ"
},
"bodySite" : [
{
"text" : "Mamma links, oberer äußerer Quadrant"
}
],
"subject" : {
🔗 "reference" : "Patient/PatientinMamma"
},
"onsetDateTime" : "2025-09-15",
"recordedDate" : "2025-09-15"
},
"request" : {
"method" : "POST",
"url" : "Condition"
}
},
{
"fullUrl" : "http://example.org/fhir/Procedure/ProcedureBiopsieMamma",
"resource" : {
"resourceType" : "Procedure",
"id" : "ProcedureBiopsieMamma",
"language" : "en",
"text" : {
"status" : "generated"
},
"status" : "completed",
"category" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "103693007",
"display" : "Diagnostic procedure (procedure)"
}
]
},
"code" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "44578009",
"display" : "Core needle biopsy of breast (procedure)"
}
],
"text" : "Sonografisch gesteuerte Stanzbiopsie der Mamma links"
},
"subject" : {
🔗 "reference" : "Patient/PatientinMamma"
},
"performedDateTime" : "2025-09-15",
"reasonReference" : [
{
🔗 "reference" : "Condition/ConditionMamma"
}
],
"bodySite" : [
{
"text" : "Mamma links, oberer äußerer Quadrant"
}
]
},
"request" : {
"method" : "POST",
"url" : "Procedure"
}
},
{
"fullUrl" : "http://example.org/fhir/Specimen/SpecimenBiopsieMamma",
"resource" : {
"resourceType" : "Specimen",
"id" : "SpecimenBiopsieMamma",
"language" : "en",
"text" : {
"status" : "generated"
},
"status" : "available",
"type" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "122737001",
"display" : "Specimen from breast obtained by core needle biopsy"
},
{
"system" : "http://snomed.info/sct",
"code" : "119376003",
"display" : "Tissue specimen (specimen)"
}
],
"text" : "Stanzbiopsat (Gewebeprobe) Mamma links"
},
"subject" : {
🔗 "reference" : "Patient/PatientinMamma"
},
"collection" : {
"collectedDateTime" : "2025-09-15",
"method" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "9911007",
"display" : "Core needle biopsy"
}
]
},
"bodySite" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "76365002",
"display" : "Structure of upper outer quadrant of breast"
}
],
"text" : "Mamma links, oberer äußerer Quadrant"
}
}
},
"request" : {
"method" : "POST",
"url" : "Specimen"
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/ObsHistologieMamma",
"resource" : {
"resourceType" : "Observation",
"id" : "ObsHistologieMamma",
"language" : "en",
"text" : {
"status" : "generated"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "59847-4",
"display" : "Histology and Behavior ICD-O-3 Cancer"
}
]
},
"subject" : {
🔗 "reference" : "Patient/PatientinMamma"
},
"effectiveDateTime" : "2025-09-15",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "82711006",
"display" : "Infiltrating duct carcinoma"
},
{
"system" : "urn:oid:2.16.840.1.113883.6.43.1",
"code" : "8500/3",
"display" : "Invasives duktales Karzinom / Karzinom ohne speziellen Typ (NST)"
}
],
"text" : "Invasives Mammakarzinom, NST (ICD-O-3 8500/3)"
},
"specimen" : {
🔗 "reference" : "Specimen/SpecimenBiopsieMamma"
}
},
"request" : {
"method" : "POST",
"url" : "Observation"
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/ObsGradingMamma",
"resource" : {
"resourceType" : "Observation",
"id" : "ObsGradingMamma",
"language" : "en",
"text" : {
"status" : "generated"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "44648-4",
"display" : "Histologic grade [Score] in Breast cancer specimen by Nottingham"
}
]
},
"subject" : {
🔗 "reference" : "Patient/PatientinMamma"
},
"effectiveDateTime" : "2025-09-15",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "1155704001",
"display" : "G3: Poorly differentiated"
},
{
"system" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-grading",
"code" : "3",
"display" : "schlecht differenziert"
}
],
"text" : "G3 – schlecht differenziert (Elston-Ellis)"
},
"specimen" : {
🔗 "reference" : "Specimen/SpecimenBiopsieMamma"
}
},
"request" : {
"method" : "POST",
"url" : "Observation"
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/ObsTNMklinischMamma",
"resource" : {
"resourceType" : "Observation",
"id" : "ObsTNMklinischMamma",
"language" : "en",
"text" : {
"status" : "generated"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "21908-9",
"display" : "Stage group.clinical Cancer"
}
]
},
"subject" : {
🔗 "reference" : "Patient/PatientinMamma"
},
"effectiveDateTime" : "2025-09-16",
"valueCodeableConcept" : {
"text" : "cT2 cN1 cM0 – UICC IIB"
}
},
"request" : {
"method" : "POST",
"url" : "Observation"
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/ObsEstrogenrezeptorMamma",
"resource" : {
"resourceType" : "Observation",
"id" : "ObsEstrogenrezeptorMamma",
"language" : "en",
"text" : {
"status" : "generated"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "85337-4",
"display" : "Estrogen receptor Ag [Presence] in Breast cancer specimen by Immune stain"
},
{
"system" : "http://snomed.info/sct",
"code" : "1234806008",
"display" : "Observation using immunohistochemistry (observable entity)"
}
]
},
"subject" : {
🔗 "reference" : "Patient/PatientinMamma"
},
"effectiveDateTime" : "2025-09-17",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "LA6577-6",
"display" : "Negative"
}
]
},
"note" : [
{
"text" : "Immunhistochemie: <1 % positive Kerne → ER-negativ."
}
],
"specimen" : {
🔗 "reference" : "Specimen/SpecimenBiopsieMamma"
}
},
"request" : {
"method" : "POST",
"url" : "Observation"
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/ObsProgesteronrezeptorMamma",
"resource" : {
"resourceType" : "Observation",
"id" : "ObsProgesteronrezeptorMamma",
"language" : "en",
"text" : {
"status" : "generated"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "85339-0",
"display" : "Progesterone receptor Ag [Presence] in Breast cancer specimen by Immune stain"
},
{
"system" : "http://snomed.info/sct",
"code" : "1234806008",
"display" : "Observation using immunohistochemistry (observable entity)"
}
]
},
"subject" : {
🔗 "reference" : "Patient/PatientinMamma"
},
"effectiveDateTime" : "2025-09-17",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "LA6577-6",
"display" : "Negative"
}
]
},
"note" : [
{
"text" : "Immunhistochemie: <1 % positive Kerne → PR-negativ."
}
],
"specimen" : {
🔗 "reference" : "Specimen/SpecimenBiopsieMamma"
}
},
"request" : {
"method" : "POST",
"url" : "Observation"
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/ObsHER2Mamma",
"resource" : {
"resourceType" : "Observation",
"id" : "ObsHER2Mamma",
"language" : "en",
"text" : {
"status" : "generated"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "48676-1",
"display" : "HER2 Ag [Interpretation] in Tissue"
}
]
},
"subject" : {
🔗 "reference" : "Patient/PatientinMamma"
},
"effectiveDateTime" : "2025-09-17",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "LA6577-6",
"display" : "Negative"
},
{
"system" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-mamma-her2neu-status-obds",
"code" : "N",
"display" : "negativ"
},
{
"system" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-mamma-her2neu-status-leitlinie",
"code" : "negativ",
"display" : "HER2-negativ"
}
]
},
"note" : [
{
"text" : "Immunhistochemie 1+ → HER2-negativ; keine In-situ-Hybridisierung erforderlich."
}
],
"specimen" : {
🔗 "reference" : "Specimen/SpecimenBiopsieMamma"
}
},
"request" : {
"method" : "POST",
"url" : "Observation"
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/ObsKi67Mamma",
"resource" : {
"resourceType" : "Observation",
"id" : "ObsKi67Mamma",
"language" : "en",
"text" : {
"status" : "generated"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "85330-9",
"display" : "Cells.Ki-67 nuclear Ag/cells in Breast cancer specimen by Immune stain"
},
{
"system" : "http://snomed.info/sct",
"code" : "1234806008",
"display" : "Observation using immunohistochemistry (observable entity)"
}
],
"text" : "Ki-67 Proliferationsindex (MIB-1)"
},
"subject" : {
🔗 "reference" : "Patient/PatientinMamma"
},
"effectiveDateTime" : "2025-09-17",
"valueQuantity" : {
"value" : 70,
"unit" : "%",
"system" : "http://unitsofmeasure.org",
"code" : "%"
},
"specimen" : {
🔗 "reference" : "Specimen/SpecimenBiopsieMamma"
}
},
"request" : {
"method" : "POST",
"url" : "Observation"
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/ObsGBRCAMamma",
"resource" : {
"resourceType" : "Observation",
"id" : "ObsGBRCAMamma",
"language" : "en",
"text" : {
"status" : "generated"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "21639-0",
"display" : "BRCA1 gene mutations tested for in Blood or Tissue by Molecular genetics method Nominal"
}
]
},
"subject" : {
🔗 "reference" : "Patient/PatientinMamma"
},
"effectiveDateTime" : "2025-09-25",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "260385009",
"display" : "Negative"
}
]
},
"note" : [
{
"text" : "gBRCA1/2: keine (wahrscheinlich) pathogene Variante (Klasse 4/5) nachgewiesen."
}
]
},
"request" : {
"method" : "POST",
"url" : "Observation"
}
},
{
"fullUrl" : "http://example.org/fhir/EpisodeOfCare/TherapielinieChemo",
"resource" : {
"resourceType" : "EpisodeOfCare",
"id" : "TherapielinieChemo",
"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" : "373847000",
"display" : "Neoadjuvant intent"
}
]
}
},
{
"url" : "phase",
"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"
},
{
"extension" : [
{
"url" : "setting",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "https://bih-cei.de/fhir/therapieziele-onkologie/CodeSystem/enlist-lot-setting",
"code" : "eLoT",
"display" : "eLoT — frühes Setting"
}
]
}
},
{
"url" : "line",
"valuePositiveInt" : 1
},
{
"url" : "modification",
"valueUnsignedInt" : 0
},
{
"url" : "notation",
"valueString" : "eLoT 1.0"
},
{
"url" : "lineId",
"valueIdentifier" : {
"system" : "https://bih-cei.de/fhir/therapieziele-onkologie/sid/enlist-line",
"value" : "mamma-baumann-elot-1"
}
}
],
"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"
}
]
}
},
{
"url" : "https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-therapy-line-medication-request",
"valueReference" : {
🔗 "reference" : "MedicationRequest/MedicationRequestPembroChemoNeoadjuvantMamma"
}
}
],
"status" : "finished",
"type" : [
{
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "385786002",
"display" : "Chemotherapy care"
}
]
}
],
"diagnosis" : [
{
"condition" : {
🔗 "reference" : "Condition/ConditionMamma"
},
"role" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/diagnosis-role",
"code" : "CC",
"display" : "Chief complaint"
}
]
},
"rank" : 1
}
],
"patient" : {
🔗 "reference" : "Patient/PatientinMamma"
},
"managingOrganization" : {
🔗 "reference" : "Organization/Tumorboard"
},
"period" : {
"start" : "2025-10-01",
"end" : "2026-03-15"
},
"careManager" : {
🔗 "reference" : "Practitioner/OnkologinMamma"
}
},
"request" : {
"method" : "POST",
"url" : "EpisodeOfCare"
}
},
{
"fullUrl" : "http://example.org/fhir/EpisodeOfCare/TherapielinieOperation",
"resource" : {
"resourceType" : "EpisodeOfCare",
"id" : "TherapielinieOperation",
"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" : "373808002",
"display" : "Curative - procedure intent"
}
]
}
}
],
"url" : "https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-therapy-intent"
},
{
"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" : "not-counted",
"display" : "Zählt nicht"
}
]
}
}
],
"status" : "finished",
"type" : [
{
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "387713003",
"display" : "Surgical procedure"
}
]
}
],
"diagnosis" : [
{
"condition" : {
🔗 "reference" : "Condition/ConditionMamma"
},
"role" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/diagnosis-role",
"code" : "CC",
"display" : "Chief complaint"
}
]
},
"rank" : 1
}
],
"patient" : {
🔗 "reference" : "Patient/PatientinMamma"
},
"managingOrganization" : {
🔗 "reference" : "Organization/Tumorboard"
},
"period" : {
"start" : "2026-03-20",
"end" : "2026-04-06"
},
"referralRequest" : [
{
🔗 "reference" : "ServiceRequest/ServiceRequestProcedure"
}
],
"careManager" : {
🔗 "reference" : "Practitioner/OnkologinMamma"
}
},
"request" : {
"method" : "POST",
"url" : "EpisodeOfCare"
}
},
{
"fullUrl" : "http://example.org/fhir/Goal/TherapiezielMammaHeilung",
"resource" : {
"resourceType" : "Goal",
"id" : "TherapiezielMammaHeilung",
"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"
},
{
"extension" : [
{
"url" : "individual",
"valueReference" : {
🔗 "reference" : "Patient/PatientinMamma"
}
},
{
"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://hl7.org/fhir/goal-relationship-type",
"code" : "predecessor",
"display" : "Predecessor"
}
]
}
},
{
"url" : "target",
"valueReference" : {
🔗 "reference" : "Goal/DiagnosticGoal"
}
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/goal-relationship"
},
{
"extension" : [
{
"url" : "type",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/goal-relationship-type",
"code" : "successor",
"display" : "Successor"
}
]
}
},
{
"url" : "target",
"valueReference" : {
🔗 "reference" : "Goal/FollowUpGoal"
}
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/goal-relationship"
}
],
"lifecycleStatus" : "active",
"achievementStatus" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/goal-achievement",
"code" : "achieved",
"display" : "Achieved"
}
]
},
"category" : [
{
"coding" : [
{
"system" : "https://bih-cei.de/fhir/therapieziele-onkologie/CodeSystem/onko-therapy-goal-type",
"code" : "heilung",
"display" : "Heilung"
}
]
},
{
"coding" : [
{
"system" : "https://bih-cei.de/fhir/therapieziele-onkologie/CodeSystem/onko-therapy-goal-type",
"code" : "funktionserhalt",
"display" : "Funktionserhalt"
}
]
}
],
"priority" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/goal-priority",
"code" : "high-priority",
"display" : "High Priority"
}
]
},
"description" : {
"text" : "Kurative Behandlung des frühen triple-negativen Mammakarzinoms mittels neoadjuvanter Systemtherapie und brusterhaltender Operation; Erreichen einer pathologischen Komplettremission (pCR)."
},
"subject" : {
🔗 "reference" : "Patient/PatientinMamma"
},
"startDate" : "2025-09-22",
"target" : [
{
"measure" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "21908-9",
"display" : "Stage group.clinical Cancer"
}
]
},
"dueDate" : "2026-04-15"
}
],
"expressedBy" : {
🔗 "reference" : "Practitioner/OnkologinMamma"
},
"addresses" : [
{
🔗 "reference" : "Condition/ConditionMamma"
}
],
"outcomeReference" : [
{
🔗 "reference" : "Observation/ObsDiseaseStatusMamma"
}
]
},
"request" : {
"method" : "POST",
"url" : "Goal"
}
},
{
"fullUrl" : "http://example.org/fhir/ServiceRequest/ServiceRequestProcedure",
"resource" : {
"resourceType" : "ServiceRequest",
"id" : "ServiceRequestProcedure",
"meta" : {
"profile" : [
🔗 "https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-tumorboard-service-request"
]
},
"language" : "en",
"text" : {
"status" : "generated"
},
"status" : "active",
"intent" : "proposal",
"category" : [
{
"coding" : [
{
"system" : "http://loinc.org",
"code" : "85232-7",
"display" : "Tumor board Consult note"
}
]
},
{
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "387713003",
"display" : "Surgical procedure"
}
]
}
],
"code" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "392021009",
"display" : "Lumpectomy of breast (procedure)"
}
]
},
"subject" : {
🔗 "reference" : "Patient/PatientinMamma"
}
},
"request" : {
"method" : "POST",
"url" : "ServiceRequest"
}
},
{
"fullUrl" : "http://example.org/fhir/MedicationRequest/MedicationRequestPembroChemoNeoadjuvantMamma",
"resource" : {
"resourceType" : "MedicationRequest",
"id" : "MedicationRequestPembroChemoNeoadjuvantMamma",
"meta" : {
"profile" : [
🔗 "https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-tumorboard-medication-request"
]
},
"language" : "en",
"text" : {
"status" : "extensions"
},
"extension" : [
{
"url" : "https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/enlist-change",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "https://bih-cei.de/fhir/therapieziele-onkologie/CodeSystem/enlist-change-type",
"code" : "new",
"display" : "New LoT"
}
]
}
}
],
"status" : "completed",
"intent" : "plan",
"category" : [
{
"coding" : [
{
"system" : "http://loinc.org",
"code" : "85232-7",
"display" : "Tumor board Consult note"
}
]
}
],
"medicationCodeableConcept" : {
"text" : "Pembrolizumab + Carboplatin/Paclitaxel, gefolgt von Pembrolizumab + Epirubicin/Cyclophosphamid (KEYNOTE-522)"
},
"subject" : {
🔗 "reference" : "Patient/PatientinMamma"
}
},
"request" : {
"method" : "POST",
"url" : "MedicationRequest"
}
},
{
"fullUrl" : "http://example.org/fhir/MedicationAdministration/MedicationAdministrationPembroChemoNeoadjuvantMamma1",
"resource" : {
"resourceType" : "MedicationAdministration",
"id" : "MedicationAdministrationPembroChemoNeoadjuvantMamma1",
"language" : "en",
"text" : {
"status" : "generated"
},
"status" : "completed",
"medicationCodeableConcept" : {
"text" : "Pembrolizumab + Carboplatin (q3w), Paclitaxel wöchentlich begleitend (KEYNOTE-522, Phase 1)"
},
"subject" : {
🔗 "reference" : "Patient/PatientinMamma"
},
"effectiveDateTime" : "2025-10-01",
"request" : {
🔗 "reference" : "MedicationRequest/MedicationRequestPembroChemoNeoadjuvantMamma"
},
"note" : [
{
"text" : "Zyklus 1 von 4 (Pembro/Carbo q3w); begleitend wöchentliche Paclitaxel-Gaben, hier nicht einzeln erfasst"
}
]
},
"request" : {
"method" : "POST",
"url" : "MedicationAdministration"
}
},
{
"fullUrl" : "http://example.org/fhir/MedicationAdministration/MedicationAdministrationPembroChemoNeoadjuvantMamma2",
"resource" : {
"resourceType" : "MedicationAdministration",
"id" : "MedicationAdministrationPembroChemoNeoadjuvantMamma2",
"language" : "en",
"text" : {
"status" : "generated"
},
"status" : "completed",
"medicationCodeableConcept" : {
"text" : "Pembrolizumab + Carboplatin (q3w), Paclitaxel wöchentlich begleitend (KEYNOTE-522, Phase 1)"
},
"subject" : {
🔗 "reference" : "Patient/PatientinMamma"
},
"effectiveDateTime" : "2025-11-01",
"request" : {
🔗 "reference" : "MedicationRequest/MedicationRequestPembroChemoNeoadjuvantMamma"
},
"note" : [
{
"text" : "Zyklus 2 von 4 (Pembro/Carbo q3w); begleitend wöchentliche Paclitaxel-Gaben, hier nicht einzeln erfasst"
}
]
},
"request" : {
"method" : "POST",
"url" : "MedicationAdministration"
}
},
{
"fullUrl" : "http://example.org/fhir/MedicationAdministration/MedicationAdministrationPembroChemoNeoadjuvantMamma3",
"resource" : {
"resourceType" : "MedicationAdministration",
"id" : "MedicationAdministrationPembroChemoNeoadjuvantMamma3",
"language" : "en",
"text" : {
"status" : "generated"
},
"status" : "completed",
"medicationCodeableConcept" : {
"text" : "Pembrolizumab + Carboplatin (q3w), Paclitaxel wöchentlich begleitend (KEYNOTE-522, Phase 1)"
},
"subject" : {
🔗 "reference" : "Patient/PatientinMamma"
},
"effectiveDateTime" : "2026-02-10",
"request" : {
🔗 "reference" : "MedicationRequest/MedicationRequestPembroChemoNeoadjuvantMamma"
},
"note" : [
{
"text" : "Zyklus 3 von 4 (Pembro/Carbo q3w); begleitend wöchentliche Paclitaxel-Gaben, hier nicht einzeln erfasst"
}
]
},
"request" : {
"method" : "POST",
"url" : "MedicationAdministration"
}
},
{
"fullUrl" : "http://example.org/fhir/MedicationAdministration/MedicationAdministrationPembroChemoNeoadjuvantMamma4",
"resource" : {
"resourceType" : "MedicationAdministration",
"id" : "MedicationAdministrationPembroChemoNeoadjuvantMamma4",
"language" : "en",
"text" : {
"status" : "generated"
},
"status" : "completed",
"medicationCodeableConcept" : {
"text" : "Pembrolizumab + Carboplatin (q3w), Paclitaxel wöchentlich begleitend (KEYNOTE-522, Phase 1)"
},
"subject" : {
🔗 "reference" : "Patient/PatientinMamma"
},
"effectiveDateTime" : "2026-03-15",
"request" : {
🔗 "reference" : "MedicationRequest/MedicationRequestPembroChemoNeoadjuvantMamma"
},
"note" : [
{
"text" : "Zyklus 4 von 4 (Pembro/Carbo q3w); begleitend wöchentliche Paclitaxel-Gaben, hier nicht einzeln erfasst"
}
]
},
"request" : {
"method" : "POST",
"url" : "MedicationAdministration"
}
},
{
"fullUrl" : "http://example.org/fhir/Procedure/ProcedureOperationMamma",
"resource" : {
"resourceType" : "Procedure",
"id" : "ProcedureOperationMamma",
"language" : "en",
"text" : {
"status" : "generated"
},
"status" : "completed",
"code" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "392021009",
"display" : "Lumpectomy of breast (procedure)"
}
],
"text" : "Brusterhaltende Operation (BET) links + Sentinel-Lymphknoten-Biopsie"
},
"subject" : {
🔗 "reference" : "Patient/PatientinMamma"
},
"performedDateTime" : "2026-04-02"
},
"request" : {
"method" : "POST",
"url" : "Procedure"
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/ObsTNMpathologischMamma",
"resource" : {
"resourceType" : "Observation",
"id" : "ObsTNMpathologischMamma",
"language" : "en",
"text" : {
"status" : "generated"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "21902-2",
"display" : "Stage group.pathology Cancer"
}
]
},
"subject" : {
🔗 "reference" : "Patient/PatientinMamma"
},
"effectiveDateTime" : "2026-04-07",
"valueCodeableConcept" : {
"text" : "ypT0 ypN0 – pathologische Komplettremission (pCR)"
}
},
"request" : {
"method" : "POST",
"url" : "Observation"
}
},
{
"fullUrl" : "http://example.org/fhir/Observation/ObsDiseaseStatusMamma",
"resource" : {
"resourceType" : "Observation",
"id" : "ObsDiseaseStatusMamma",
"language" : "en",
"text" : {
"status" : "generated"
},
"status" : "final",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "97509-4",
"display" : "Cancer disease progression"
}
]
},
"subject" : {
🔗 "reference" : "Patient/PatientinMamma"
},
"effectiveDateTime" : "2026-04-07",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "260415000",
"display" : "Not detected"
}
]
},
"note" : [
{
"text" : "Pathologische Komplettremission (pCR, ypT0 ypN0) nach neoadjuvanter Systemtherapie."
}
]
},
"request" : {
"method" : "POST",
"url" : "Observation"
}
},
{
"fullUrl" : "http://example.org/fhir/CarePlan/CarePlanMammaNeoadjuvant",
"resource" : {
"resourceType" : "CarePlan",
"id" : "CarePlanMammaNeoadjuvant",
"meta" : {
"profile" : [
🔗 "https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-care-plan"
]
},
"language" : "en",
"text" : {
"status" : "extensions"
},
"extension" : [
{
"url" : "https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-careplan-custodian",
"valueReference" : {
🔗 "reference" : "Organization/TumorzentrumMamma"
}
}
],
"status" : "active",
"intent" : "plan",
"category" : [
{
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "736252007",
"display" : "Cancer care plan"
}
]
}
],
"subject" : {
🔗 "reference" : "Patient/PatientinMamma"
},
"period" : {
"start" : "2025-09-22"
},
"author" : {
🔗 "reference" : "Practitioner/OnkologinMamma"
},
"addresses" : [
{
🔗 "reference" : "Condition/ConditionMamma"
}
],
"goal" : [
{
🔗 "reference" : "Goal/TherapiezielMammaHeilung"
}
],
"activity" : [
{
"outcomeReference" : [
{
🔗 "reference" : "MedicationAdministration/MedicationAdministrationPembroChemoNeoadjuvantMamma1"
},
{
🔗 "reference" : "MedicationAdministration/MedicationAdministrationPembroChemoNeoadjuvantMamma2"
},
{
🔗 "reference" : "MedicationAdministration/MedicationAdministrationPembroChemoNeoadjuvantMamma3"
},
{
🔗 "reference" : "MedicationAdministration/MedicationAdministrationPembroChemoNeoadjuvantMamma4"
}
],
"reference" : {
🔗 "reference" : "MedicationRequest/MedicationRequestPembroChemoNeoadjuvantMamma"
}
},
{
"outcomeReference" : [
{
🔗 "reference" : "Procedure/ProcedureOperationMamma"
}
],
"reference" : {
🔗 "reference" : "ServiceRequest/ServiceRequestProcedure"
}
},
{
"reference" : {
🔗 "reference" : "MedicationRequest/MedicationRequestPembroAdjuvantMamma"
}
},
{
"outcomeReference" : [
{
🔗 "reference" : "Observation/ObsDiseaseStatusMamma"
}
]
}
]
},
"request" : {
"method" : "POST",
"url" : "CarePlan"
}
},
{
"fullUrl" : "http://example.org/fhir/Goal/FollowUpGoal",
"resource" : {
"resourceType" : "Goal",
"id" : "FollowUpGoal",
"meta" : {
"profile" : [
🔗 "https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-therapy-goal"
]
},
"language" : "en",
"text" : {
"status" : "extensions"
},
"extension" : [
{
"extension" : [
{
"url" : "individual",
"valueReference" : {
🔗 "reference" : "Patient/PatientinMamma"
}
},
{
"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://hl7.org/fhir/goal-relationship-type",
"code" : "predecessor",
"display" : "Predecessor"
}
]
}
},
{
"url" : "target",
"valueReference" : {
🔗 "reference" : "Goal/DiagnosticGoal"
}
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/goal-relationship"
},
{
"extension" : [
{
"url" : "type",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/goal-relationship-type",
"code" : "predecessor",
"display" : "Predecessor"
}
]
}
},
{
"url" : "target",
"valueReference" : {
🔗 "reference" : "Goal/TherapiezielMammaHeilung"
}
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/goal-relationship"
}
],
"lifecycleStatus" : "planned",
"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" : "lebensqualitaet",
"display" : "Lebensqualität"
}
]
}
],
"priority" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/goal-priority",
"code" : "high-priority",
"display" : "High Priority"
}
]
},
"description" : {
"text" : "Monitoring der Lebensqualität und des Krankheitsstatus nach der onkologischen Erkrankung und Therapie"
},
"subject" : {
🔗 "reference" : "Patient/PatientinMamma"
},
"startDate" : "2026-08-15",
"target" : [
{
"measure" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "21976-6",
"display" : "Cancer outcome status"
}
]
},
"detailCodeableConcept" : {
"text" : "Kein Hinweis auf Lokalrezidiv oder Fernmetastasen"
},
"dueDate" : "2026-11-15"
},
{
"measure" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "24606-6",
"display" : "Mammografie"
}
]
},
"detailCodeableConcept" : {
"text" : "Unauffällige Nachsorge-Mammographie (jährlich), kein Rezidivnachweis"
},
"dueDate" : "2027-04-15"
},
{
"measure" : {
"text" : "Arm-/Schulterfunktion und Lymphödem-Status nach axillärem Eingriff"
},
"detailCodeableConcept" : {
"text" : "Kein manifestes Lymphödem, erhaltene Schulterbeweglichkeit"
}
},
{
"measure" : {
"text" : "Gesundheitsbezogene Lebensqualität (PROM, EORTC QLQ-C30 / BR23) – MII PRO-Modul"
},
"detailCodeableConcept" : {
"text" : "Stabile bis verbesserte Lebensqualität im Verlauf"
}
}
],
"expressedBy" : {
🔗 "reference" : "Practitioner/OnkologinMamma"
},
"addresses" : [
{
🔗 "reference" : "Condition/ConditionMamma"
}
],
"outcomeReference" : [
{
🔗 "reference" : "Observation/ObsDiseaseStatusMamma"
}
]
},
"request" : {
"method" : "POST",
"url" : "Goal"
}
},
{
"fullUrl" : "http://example.org/fhir/ServiceRequest/ServiceRequestMammographieNachsorge",
"resource" : {
"resourceType" : "ServiceRequest",
"id" : "ServiceRequestMammographieNachsorge",
"language" : "en",
"text" : {
"status" : "generated"
},
"status" : "active",
"intent" : "plan",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "24606-6",
"display" : "Mammografie"
}
],
"text" : "Nachsorge-Mammographie beidseits (jährlich)"
},
"subject" : {
🔗 "reference" : "Patient/PatientinMamma"
},
"occurrenceDateTime" : "2027-04-15",
"requester" : {
🔗 "reference" : "Practitioner/OnkologinMamma"
},
"reasonReference" : [
{
🔗 "reference" : "Condition/ConditionMamma"
}
]
},
"request" : {
"method" : "POST",
"url" : "ServiceRequest"
}
},
{
"fullUrl" : "http://example.org/fhir/CarePlan/CarePlanMammaNachsorge",
"resource" : {
"resourceType" : "CarePlan",
"id" : "CarePlanMammaNachsorge",
"meta" : {
"profile" : [
🔗 "https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-care-plan"
]
},
"language" : "en",
"text" : {
"status" : "extensions"
},
"extension" : [
{
"url" : "https://bih-cei.de/fhir/therapieziele-onkologie/StructureDefinition/onko-careplan-custodian",
"valueReference" : {
🔗 "reference" : "Organization/TumorzentrumMamma"
}
}
],
"status" : "active",
"intent" : "plan",
"category" : [
{
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "736252007",
"display" : "Cancer care plan"
}
]
}
],
"subject" : {
🔗 "reference" : "Patient/PatientinMamma"
},
"period" : {
"start" : "2026-08-15"
},
"author" : {
🔗 "reference" : "Practitioner/OnkologinMamma"
},
"addresses" : [
{
🔗 "reference" : "Condition/ConditionMamma"
}
],
"goal" : [
{
🔗 "reference" : "Goal/FollowUpGoal"
}
],
"activity" : [
{
"reference" : {
🔗 "reference" : "ServiceRequest/ServiceRequestMammographieNachsorge"
}
}
]
},
"request" : {
"method" : "POST",
"url" : "CarePlan"
}
}
]
}